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respiratory > pharmacology > Flashcards

pharmacology Flashcards

1
Q

How many muscarinic receptors

A

5

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2
Q

Where are M1

A

Ganglia

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3
Q

What do M1 do

A

Facilitate ACh transmission

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4
Q

What do M2 do

A

Inhibitory

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5
Q

What does stimulation of vagus nerve cause

A

Bronchoconstriction

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6
Q

What do NANC do

A

Regulates the airways

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7
Q

What do NANC release

A

Bronchodilators

  • VIP
  • NO
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8
Q

Sympathetic innervate the airways

true or false

A

False

They innervate submucosal glands

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9
Q

What do b agonist do

A

Relax bronchial smooth muscle

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10
Q

What does irritation of C fibers cause

A
  • cough

- mucus

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11
Q

What does parasympathetic work through

A

M3

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12
Q

What do amiodarone and methotrexate do to the lung

A

Damage it

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13
Q

What does heart failure lead to

A

Pulmonary oedema

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14
Q

What is commonest disease in children

A

Asthma

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15
Q

What is asthma

A

Recurrent reversible obstructive disease in response to irritant stimuli

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16
Q

What does asthma cause

A

Wheeze

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17
Q

Is COPD reversible

A

No

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18
Q

Symptoms of asthma

A
  • wheeze

- SOB

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19
Q

Underlying pathology of asthma

A

Chronic asthma

  • inflammation
  • bronchial hyper-reactivity
  • reversible obstruction
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20
Q

What is bronchial hyper-reactivity

A

Abnormal sensitivity to a wide range of stimuli

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21
Q

What are the phases of asthma

A
  • immediate

- delayed

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22
Q

What does Th2 do In asthma

A
  • attracts eosinophils
  • IL-5 attracts eosinophils
  • eosinophils attract CySTL1 receptors
  • promote IgE
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23
Q

What does IL-4 and IL-13 do

A

Switch B cells to IgE

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24
Q

What is omalizumab

A

Anti IgE antibody

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25
Q

What does allergen interaction with IgE cause release of

A
  • histamine
  • leukotriene
  • prostaglandin
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26
Q

What can delayed phase cause

A

Nocturnal asthma

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27
Q

What does Th0 give rise to

A

Th1 and Th2

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28
Q

What do glucocorticoid do

A

Inhibit action of IL-4 …

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29
Q

What are type of asthmatic drugs

A
  • bronchodilators

- anti-inflammatory agents

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30
Q

How is asthma treatment monitored

A

FEV1

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31
Q

What drug can precipitate asthma

A

NSAID (aspirin)

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32
Q

What do bronchodilators reverse

A

Bronchospasm

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33
Q

SABA example

A

Salbutamol

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34
Q

When is glucocorticoid added

A

When SABA used more than 3 times a week

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35
Q

What is step 3

A

Add LABA to glucocorticoid

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36
Q

Example of LABA

A

Salmeterol

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37
Q

Leukotriene example

A

Monteleukast

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38
Q

What is oral glucocorticoid

A

Prednisone

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39
Q

How are B2 adrenoreceptor agonist administered

A

Inhaled

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40
Q

Example of methylxanthine

A

Aminophylline

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41
Q

What do methylxanthine

A

Inhibits PDE4

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42
Q

How is methylxanthine given

A

IV or oral as add on therapy

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43
Q

How is methylxanthine metabolized

A

In liver by P450

44
Q

Example of leukotriene

A

Montelukast

45
Q

How is leukotriene given

A

Add on therapy

46
Q

Side effect of SABA

A
  • tremor

- tachycardia

47
Q

What does theophylline activate

A

Histone deacetylase (HDAC)

48
Q

Side effect of methylxanthine

A
  • arrhythmia

- seizure

49
Q

Example of SAMA

A

Ipratropium

50
Q

Example of LAMA

A

Tiotropium

51
Q

What limits side effects in muscarinic antagonist

A

Quaternary ammonium group

52
Q

What is LAMA selective for

A

M3

53
Q

What is LAMA used with for COPD

A

LABA

54
Q

What is the role of glucocorticoids

A

Anti-inflammatory

55
Q

What does IL-3 do

A

Regulate mast cell production

56
Q

Example of glucocorticoid

A
  • beclometasone

- fluticasone

57
Q

When are oral glucocorticoid given

A

Severe disease

58
Q

Side effect of glucocorticoid

A
  • thrush (oral candidiasis)
  • sore throat
  • hoarse voice
59
Q

What is cromoglicate

A

Mast cell stabilizer

60
Q

What does cromoglicate prevent

A

Histamine release from mast cells

61
Q

What is mepolizumab

A

IL-5 inhibitor

62
Q

Treatment of severe acute asthma

A
  • O2
  • inhaled SABA + ipatropium
    = IV hydrocortisone
  • oral prednisolone
  • IV magnesium
63
Q

Treatment of IPF

A
  • pirfenidone

- nintedanib

64
Q

What is pirfenidone

A

Immunosuppressant that reduces fibroblast proliferation

65
Q

What is nintedanib

A

Tyrosine kinase inhibitor

66
Q

what are the 4 stages of drug disposition

A

ADME

  • absorption
  • distribution
  • metabolism
  • excretion
67
Q

what does rate of diffusion depend on

A
  • molecular size

- diffusion coefficient

68
Q

what size of molecule diffuses more easily

A

smaller

69
Q

what are pericytes

A

impermeable layer of periendothelial cells

70
Q

where can cells not go

A
  • across BBB

- across placenta (to foetus)

71
Q

what are the 4 ways small molecules can cross cell membrane

A
  • diffusion through lipid
  • combination with solute carrier
  • diffusion through aquaporins
  • pinocytosis
72
Q

can polar or non-polar diffuse easily across the membrane

A

non-polar

73
Q

what are most drugs strong or weak acids and bases

A

weak acids or bases

74
Q

what is used to calculate dissociation constant (pKa)

A

Henderson-Hasselbach equation

75
Q

does the ionised or unionised form cross the membrane

A

unionised

76
Q

what drugs are lipid soluble

A
  • antibiotics

- aminoglycoside

77
Q

example of weak acid

A

aspirin

78
Q

example of weak base drug

A

pethidine

79
Q

can ionised species cross the cell membrane

A

no

80
Q

does ionised species travel equally to all compartments

A

no

81
Q

what increases surface area in small intestine

A

villi and microvilli

82
Q

how do drugs mainly exist

A

in bound form

83
Q

what is most important protein drugs are bound to

A

albumin

84
Q

example of drugs bound to albumin

A
  • acidic drugs (warfarin, NSAID)

- basic drugs (antidepressants)

85
Q

what are the 3 factors that determine the amount of drug bound to a protein

A
  • concentration of free drug
  • affinity for binding site
  • concentration of protein
86
Q

how many sites is there on albumin

A

2

87
Q

what does albumin mainly bind

A

acidic drugs

88
Q

what drug can be absorbed in the mouth

A

GTN

89
Q

how do most drugs leave the body

A

urine

90
Q

where are drugs metabolised

A

liver

91
Q

what is used in drug metabolism

A

CYP450

92
Q

what are xenobiotics

A

foreign chemicals

93
Q

how many phases of drug metabolism

A

2

94
Q

what is phase 1

A

oxidation
reduction
hydrolysis

95
Q

is phase 1 catabolic or anabolic

A

catabolic

96
Q

in phase 1 does it make drugs more or less active

A

more

97
Q

where are CYP enzymes

A

in smooth endoplasmic reticulum

98
Q

what are CYP450

A

haemorrhoids proteins

99
Q

what are the most important CYP enzymes

A

1-3

100
Q

can grapefruit juice inhibit drug metabolism

A

yes

101
Q

affect of Brussel sprouts and cigarette smoke on P450 enzymes

A

induce them

102
Q

how is ethanol metabolised

A

alcohol dehydrogenase

103
Q

is phase 2 catabolic or anabolic

A

anabolic

104
Q

what happens in phase 2

A

conjugation

105
Q

does phase 2 make them more active or inactive

A

inactive

106
Q

where does phase 2 occur

A

liver

respiratory (20 decks)

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