Pharmacology

Question 1

Where are the cell bodies of the preganglionic fibres located?

Answer 1

In the brainstem

Question 2

Where are the cell bodies of the postganglionic fibres located?

Answer 2

Embedded in the bronchi and bronchioles

Question 3

Stimulation of postganglionic cholinergic fibres causes___

Answer 3

• bronchial smooth muscle constriction
• mediated by M3 –> ACh muscarinic receptors
• increased mucus secretions

Question 4

Stimulation of postganglionic non-cholinergic fibres causes____

Answer 4

• bronchial smooth muscle relaxation

- mediated by nitric oxide (NO) and Vasoactive interstinal peptide (VIP)

Question 5

Stimulation of autonomic sympathetic transmitters causes_____

Answer 5

• bronchial smooth muscle relaxation by b2-adrenoceptors
• decreased mucus secretion
• vascular smooth muscle contraction by a1-adrenoceptors

Question 6

What initates smooth muscle contraction?

Answer 6

Ca2+

• causes phosphorylation of myosin heads
• myosin light chain (MLC) activated

Question 7

what does Ca2+ bind to in smooth muscle contraction?

Answer 7

Calmodulin –> Ca2+ Calmodulin

Question 8

what causes smooth muscle relaxation?

Answer 8

• MLC dephosphorylated

- myosin phosphatase

Question 9

What happens when Ca2+ levels increase

Answer 9

• rate of phosphorylation is greater than dephophorylation

- contraction

Question 10

M3 is _____ coupled

Answer 10

Gq

Question 11

M3 causes _____ to smooth muscles by increases in ___

Answer 11

contraction

ca2+

Question 12

Beta2 is ______ coupled

Answer 12

Gs

Question 13

Beta2 causes _____ to vascular airway smooth muscle by _____

Answer 13

dilation

protein kinase A and cAMP

Question 14

What characteristics are involved in chronic asthma

Answer 14

• increased mass of smooth muscle
• accumulation of interstitial fluid
• increased mucus secretion
• sub-epithelial fibrosis

Question 15

Differences in time scale between type I and IV hypersensitivity

Answer 15

type I is immediate

type IV is delayed

Question 16

Th___ is involved in atopic person

Answer 16

Th2
antibody mediated
IgE

Question 17

Th___ is involved in non-atopic person

Answer 17

Th1
cell mediated
IgG and macrophages

Question 18

What interleukin causes eosinophils to come

Answer 18

IL 5

Question 19

Mast cells produced IgE receptors by which two interleukins?

Answer 19

IL 4

IL 13

Question 20

Cross links of IgE receptors cause what?

Answer 20

• Ca2+ to enter mast cell

- release ofsecretory granules containing preformed histamine

Question 21

Bronchodilators 2 examples

Answer 21

Beta2 agonist

CysLT1 antagonist

Question 22

Beta 2 agonist

Answer 22

B2 - Gs coupled
Bronchodilation
SABA - Salbutamol
LABA - Formerotol

Question 23

CysLT1 antagonist

Answer 23

Montelukat

• reduces bronchoconstriction
• oral

Question 24

What are methylxathines

Answer 24

• bronchodilators + anti-inflammatory

- oral

Question 25

Corticosteroids

Answer 25

- glucocorticoids - anti-inflammatory - beclomethasone

Question 26

Where is M1 found

Answer 26

ganglia – facilitate fast neurotransmission mediated by ACh acting on nicotinic receptors

Question 27

Where is M2 found

Answer 27

postganglionic neurone terminals – act as inhibitory autoreceptors reducing release of ACh

Question 28

Where is M3 found

Answer 28

– ASM –mediate contraction to ACh (also present on mucus-secreting cells evoking

Question 29

Examples of muscarinic antagonists

Answer 29

Ipratropium (SAMA) - no selective M1,2,3 blocker | Tiotropium (LAMA)

Question 30

How do muscarinic antagonists work?

Answer 30

block M3 recptor coupled to Gq | - bronchoconstriction effect

Question 31

Explain anti-histamines

Answer 31

- H1 receptor anatgonists | - competitive antagonists that reduce effects of mast cell derived histamine including

Question 32

Why is triotropium more desirable than iprotropium?

Answer 32

- iprotropium is non selective, meaning it blocks M1, M2,M3 - triotropium is selective, block M3 only - blocking of m2 is not desirable as it causes an increased release of Ach (non-desirable)

Question 33

What drug class is Omalizumab , and what does it do?

Answer 33

Monoclonal Antibodies directed against IgE | suppresses Mast cell response to allergens (EXPENSIVE)

Question 34

What is rhinitis?

Answer 34

- may be acute or chronic inflammation of the nasal mucosa | - may be allergic, non-allergic or mixed

Question 35

What are the characteristics of rhinitis?

Answer 35

- rhinorrohea (runny nose) - sneezing - itching - nasal congestion

Question 36

3 types of allergic rhinitis?

Answer 36

- sesonal - perennial - episodic

Question 37

What are the causes of non allergic rhinitis?

Answer 37

- infection - hormone imbalance - vasomotor disturbances - medication induced - occupational

Question 38

What causes the feeling of a congested nose?

Answer 38

- increased in mucosal blood flow - increased in blood vessel permability - increased mucosa - difficulty in breathing in

Question 39

Treatments of rhinitis?

Answer 39

- ani-inflammatory - mediator receptor blockade - anti-allergic - reduced nasal blood flow

Question 40

How do glucocoricoids work for rhinitis? and name an example

Answer 40

- anti-inflammatory - reduce vascular permeability - beclomethasone - predinsolone

Question 41

How do anti-histamines work for rhinitis? and name an example

Answer 41

- reduce the effects of mast cell dervied anti-histamines - loratidine - fexofenadine - cetrizine

Question 42

An example of a muscarinic receptor antagonist used in rhinitis?

Answer 42

- ipratropium

Question 43

Example of a CysLT1 anatgonist used in rhinitis?

Answer 43

- montelukast

Question 44

What are the effects of vasoconstrictors on rhinitis? and name an example?

Answer 44

- mimic the effect of noradrenaline - reduces swelling - oxymetazoline