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Carolyn's lectures > Pathophysiology and Pharmacology of obstructive airway diseases > Flashcards

Pathophysiology and Pharmacology of obstructive airway diseases Flashcards

1
Q

What is asthma?

A
  • Asthma is a chronic inflammatory disorder in susceptible individuals
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2
Q

What are the features of asthma?

A
  • bronchospasm

- Bronchial hyperresponsiveness

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3
Q

What is bronchospams?

A
  • It is reversible airflow obstruction caused by the constriction of the bronchi
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4
Q

Bronchial hyperresponsiveness can be non specific i.e histamine, old air, sulphur or it can be specific i.e adenosine. TRUE OR FALSE?

A

TRUE

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5
Q

Which cells produce IgE?

A

B cells

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6
Q

What are dug targets for asthma?

A

B2 receptor agonits
CyaLT - antangonists
Theophyllines
Glucocorticosteriods

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7
Q

what occurs in acute inflammation?

A
  • Symptoms of bronchoconstriction
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8
Q

What occurs in chronic inflammation?

A
  • Exacerbations

- Non-specific hyperreactivity

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9
Q

what occurs in airway remodelling?

A

-Persistent airflow obstruction

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10
Q

what are the airway changes in chronic to severe asthma?

A
  • Inflitration of inflammatory cells e.g eosinophiles
  • Mast cells
  • Thicked basement membrane
  • Dilated blood vessels and oedema
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11
Q

what are the goals for asthma treatment?

A 
Relief
- relief bronchoconstriction 
in severe attacks:
- Reduce mucus production 
- Supress airway oedema

Prevent:

  • Inhibit bronchoconstriction
  • Supress chronic inflammation
  • Inhibit airway remodelling
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12
Q

What is COPD and what are these patients likely to suffer from?

A

Chronic obstructive pulmonary disease

  • It is an impairement in lung function and defence against infection
  • People with COPD are at greater chances of obtaining lung infections e.g Bronchitis and pneumonia
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13
Q

Inflammatory reaction in COPD leads to tissue destrcution i.e emphysema. TRUE OR FALSE?

A
  • TRUE
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14
Q

What are the goals of COPD therapy?

A

Relief

  • Increasing airway patency
  • Controlling reccurent infections

Prophylaxis

  • Supress chronic inflammation
  • Reduce mucuc secretion
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15
Q

Name some drug classes for the treatment of asthma?

A

Relievers

  • B2 adrenoceptor agonist
  • Muscarinic receptor antangonists

Preventers

  • Long acting bronchodilators
  • Cromones
  • Glucortiocoids (can be inhaled)
  • Leukotriene receptor antangonists
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16
Q

Provide an example of a bronchodilator drug and mechanism of action of bronchodilators?

A
  • Salbutamol

- Bronchodilators work by relaxation of bronchiol smooth muscle usually cAMP mediated

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17
Q

Salbutamol is a B2-adrenoceptor agonist. TRUE OR FALSE?

A

TRUE

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18
Q

B2 adrenoceptors agonists have rapid onset of action when taken as inhaler, this also reduces side effects.

Duration of action is 5 minutes and lasts up to 6hrs . TRUE OR FALSE?

A

TRUE

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19
Q

where are B2 adrenoceptors agonists metabolised?

A

In the liver of conjugate sulphate

20
Q

what is the oral half life of B2 adrenoceptors agonists?

A

4 hrs

21
Q

B2 adrenoceptors agonists have drug interactions with B2 adrenoceptor antangonist. TRUE OR FALSE?

A

TRUE

22
Q

Salbutamol has off target effects at the B1 receptors in the heart. TRUE OR FALSE?

A

TRUE

23
Q

B2 receptors causes relaxation of heart and skeletal smooth muscles, this leads to dilation of blood vessels, this drop in presure can lead to tachycardia. TRUE OR FALSE?

A
  • TRUE
24
Q

Name a long acting adrenceptor agonist (LABA) drug?

A

Salmeterol and formoterol

25
Q

Salmeterol does not have the same mechanims of action as salbutamol. TRUE OR FALSE?

A

FALSE

26
Q

Name a muscarinic receptor antangonist drug?

A

Ipratriopium

27
Q

What is the mechanism of action of muscarinic receptor antangonist?

A
  • relax bronchiol smooth muscle
  • inhibit bronchiol mucus secretion
  • Antagonist of the muscarinic receptors
  • They are speicif cto parasympathetic bronchoconstrction
28
Q

muscarinic receptor antangonist e.g ipratropium is activated by inhilation and 10-30% is deposited in the airway the rest is swallowed. TRUE OR FALSE?

A

TRUE

29
Q

Ipratropium has High pulmonary biolavailability but low oral bioavailability. TRUE OR FLASE?

A

TRUE

30
Q

Duration of action of ipratropoium is 3-5 hr for tiotropium is more than 24hr. true or false/

A

true

31
Q

Name a drug in the class of Methylxanthines?

A

e.g Theophyllines

32
Q

What sis the mechanims of action of Methylxanthines e.g theophyllines?

A
  • Bronchiol smooth muscle relaxtaion
  • Inhibition of cyclic nucleotide PDE
  • Possible anti-inflammatory actions
33
Q

Theophyllines are non- selective PDE inhibitors. TRUE OR FALSE?

A

TRUE

34
Q

Name a glucocorticoid drug?

A
  • Beclometasone
35
Q

What is the mechanism of action of glucocorticoids drugs?

A
  • Reduce activation of inflammatory cells
  • Reduce IgE synthesis
  • Up regulate B2 adrenoceptor expression
36
Q

Glucocorticoids are activated by inhilation. TRUE OR FALSE?

A

TRUE

37
Q

glucocorticoid (Beclometasone) have low pulmonary biolavilability and oral bioavailability. TRUE OR FALSE?

A

TRUE

38
Q

Which glucocorticoid drug has a rapid first pass metabolism?

A
  • Fluticasone
39
Q

Name a cromone drug?

A
  • Sodium cromoglyate nedocromil
40
Q

What is the mechanism of action for cromones?

A
  • Casue mast cell stabilization
  • Inhibit sensory nerves (blcoking cl- chanels)
  • Small effect in paediatricsmild asthma
41
Q

cromones have extremely low oral and pulmonary bioavailbility.
They are excreted via coughing and throug faeces. TRUE OR FALSE?

A

TRUE

42
Q

Provide an example of a anti-leukotriene inhibitor?

A
  • 5-lipoxygenase inhibitors (orally active with few adevrse reactions)
43
Q

Name an anti- IgE therapy drug?

A
  • Omalizumab - humanised monoclonal antibody
44
Q

What does anti-IgE drugs do?

A
  • get rid of circulating IgE

- Supress allergic reactions esapecially those underling from asthma

45
Q

List some drug therapies for COPD?

A
  • LABA
  • Theophillines
  • Bronchodilators - antimuscarinic prefered
  • Glucocorticoids

Carolyn's lectures (3 decks)

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