Pharmacology Flashcards
Bronchial smooth muscle contraction
M3 muscarinic ACh receptors
Bronchial smooth muscle relaxation
B2 adrenoceptors activated by adrenaline
Phosphorylation of MLC
Contraction
Dephosphorylation of MLC
Relaxation
Change in bronchioles in asthma
- Increased mass of smooth muscle
- More interstitial fluid
- More mucus
- Epithelial damage
- Sub-Epithelial fibrosis
Bronchospasm and acute inflammation
Type I hypersensitivity reaction
Delayed inflammation
Type IV hypersensitivity reaction
Nonatopic
Low-level TH1 response involving IgG
Atopic
Strong TH2 response involving IgE
Eosinophil interleukin
IL-5 from TH2 cells
Mast cell interleukin
IL-4 and IL-13 from TH2 cells
Cells involved in the effector phase of asthma
Eosinophils and mast cells
Receptors on mast cells in airway tissue
IgE
Effects of cross linked IgE on mast cells
- Stimulates Ca+ entry into mast cell
2. Release of Ca+ from stores
Activated mast cell
- Releases secretory granules - cause smooth muscle contraction
- Release facts which attract cells to cause inflammation
Relievers in asthma
SABA
LABA
Leyukotrine receptor antagonists
Methylxanthines
Preventers in asthma
Glucocorticoids - ICS or oral
Cromoglicate
Humanised monoclonal IgE antibodies
Methylxanthines
Step 1
SABA - short acting B2-adrenoceptor agonist
Step 2
SABA + inhaled corticosteroid
Step 3
SABA + LABA + inhaled corticosteroid
Step 4
SABA + LABA + Inhaled corticosteroid + theophylline/leukotrine receptor antagonist
Step 5
SABA + LABA + inhaled corticosteroid + theophylline + oral corticosteroid + refer to specialist
Main mineralocorticoid and its function
Aldosterone - regulates retention of salt and water by kidneys
Effects of glucocorticoids on gene transcription
Increase transcription of anti-inflammatory genes, decrease that of inflammatory
Name a SABA
Salbutamol
Name a LABA
Salmeterol
Name a leyukotrine receptor antagonist
Monteleukast
Name an inhaled corticosteroid
Becolomastone
Name an oral glucocorticoid
Prednisolone
Name a methylxanthine
Theophylline
