L22/23 Second half Flashcards
Glucocorticoid receptor complex mechanisms
Direct activation of gene expression
Direct blocking of NFkB mediated transcription
Annexin A1 in immune system
Decrease leukocyte adhesion
Decrease leuko trasmigration
Increase leuko apoptosis
Attenuates Eicosanoid production
How does Annexin inhibit Prostaglandin synthesis
Blocks PLA
Blocks COX1,2
GR mediated inhibtion of NFkB mediated transcription
Induce transcription of IkB(binds NFkB in cytoplasm) (mech. 1)
Block NFkB mediated transcirption thru chromatin remodeling
Dosage for chronic adrenal insufficiency vs inflammation and immune
Chronic: low dose
Inflammation: high dose
Desired features of Inhalational corticosteroids (4)
High affinity for GR
Minimal systemic absorp
Serum protein bound
Rapid systemic inactivation
Use of SABA w/ asthma
Unless excercise induced or intermittent, SABA less than 3x/week
Use of ICS in treatment of COPD
Recommended as additional therapy for patients with exacerbations already taking bronchodilators
Anticholinergics for COPD
Antimuscarinic (Atropine)
Blockage of which Muscarinic recceptors lead to bronchodilation?
M1
M3
Signaling by muscarinic receptor
Increase kinase –>MLC-P
Decrease phosphatase
Only reversible component of COPD
ACh mediated boncho-constriction
First line of defense in treating COPD
Anti cholinergics (similar to atropine)
Leukotriene biosynthesis
Arachidonic acid
–5 lipoxygenase–>
Leukotrienes
Types of mucous glands
Anterior serous glands: watery, non viscous
Posterior seromucous glands:Nasal discharge