Pharmacology Asthma COPD

Question 1

Muscarinic Antagonists

Answer 1

Site of action:Bronchial Smooth muscle and mucosal glands
MOA: Acetylcholine stimulates muscarinic receptors
Outcome:Bronchial Constriction and mucus Secretion

Question 2

Beta 2 agonists

Answer 2

Site of Action: Bronchial smooth muscle and mast cells
MOA: NE stimulates Beta 2 adrenergic Receptors
Outcome: Bronchial Dilation, mucus clearance, and mast cell stabilization preventing degranulation.

Question 3

What helps with the onset and duration of Beta 2 agonists?

Answer 3

water and lipid solubility.
Examples:
Albuterol: Hydrophillic, Rapid onset, short duration
Formoterol: Amphiphillic, Long duration and rapid onset
Salmeterol: Lipophillic, long duration, slow onset

Question 4

Side effects of Beta 2 Agonists

Answer 4

Anxiety/restlessness, tremors, Reflex Tachycardia, and Tolerance

Question 5

Why is M3 Antagonism preferred compared to M2

Answer 5

M3 receptors mediate constriction of bronichal smooth muscle

M2 receptors act as negative feedback to inhibit Ach Release

Question 6

Leukotriene Modifying agents

Answer 6

Inhibit the synthesis of leukotrienes or inhibit Leukotriene receptors.
Zileuton inhibits 5-lipooxygenase
Montelukast inhibits Leukotriene D4
Zariflukast inhibits Leukotriene E4

Question 7

Why are corticosteroids more effective than treating asthma than COPD

Answer 7

Beneficial target for corticosteroids is histone deacetylase which is found to be reduced in COPD

Question 8

Adverse Effects of Oral Corticosteroids and Inhaled corticosteroids

Answer 8

Hypertension, Cataracts/glaucoma, infections, myopathy, osteoporosis, skin thinning, Hyperglycemia (weight gain) and HPA insufficeny

Question 9

Side effects from inhaled corticosteroids

Answer 9

Oral Candidiasis, dysphonia, cough, Pneumonia (COPD)

Question 10

Can inhaled Corticosteroids reach systemic circulation?

Answer 10

It depends on the amount of drug reaching the lungs plus the oral bio-available fraction, but yes it is possible.