Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 2 > Pharmacology Of Airway Diseases > Flashcards

Pharmacology Of Airway Diseases Flashcards

1
Q

What occurs in the immediate phase of asthma?

A

Allergen stimulates mast cells to produce spasmogens of the bronchials & chemotaxins/chemokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What occurs in the late phase of asthma?

A

Infiltration of cytokine-released Th2 cells & monocytes

Activation of inflammatory cells particularly eosinophils

Release of mediators & EMBP/ECP (epithelial damage)

Airway inflammation & hyper-reactivity causing bronchospasm, wheezing & coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What drug inhibit bronchospasm in asthma?

A

B2-adrenoceptor agonists
CysLT-receptor antagonists
Theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What drugs can target the inflamamtory response of asthma?

A

Glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What occurs in COPD gained from smoking?

A

Tobacco stimulates production of ROS from neutrophils -> IL-, LTB4 & TNF release, inactivation of antiproteases (functional OR congenital α1AT deficiency) + neutrophil elastase increase -> tissue damage -> increased alveolar macrophage elastase & metalloproteinases

= prolonged inflammatory tissue damaging environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 pathophysiological features of airway disease that can be targeted with drugs?

A
  1. Neurotransmitter-controlled airway SM contractility
  2. Airway hyper-responsiveness i.e. acute inflammatory response
  3. Airway chronic inflammation by targeting IS in lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drugs can be used for bronchodilation?

A

B: B2-agonist
A: Anti-cholinergics
M: Methylxantines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What drugs can be used with anti-inflammatory action?

A

Lu: Leukotriene receptor antagonists
Glu: Glucocorticoids (AKA corticosteroids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the drugs used for severe acute asthma treatment?

A 
O: O2
S: Salbutamol (B2-agonist)
H: Hydrocortisone (glucocorticoid)
I: Ipratropium (anticholinergic)
T: Theophylline (methylxanthine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What neurological activity controls lung function?

A
  • SNS mostly via adrenergic nerve fibres releasing noradrenaline drive BRONCHODILATION
  • PNS mostly via cholinergic nerve fibres releasing acetylcholine drive BRONCHOCONSTRICTION
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do B2-adrenoceptor agonists (B2-agonists) work?

A
  1. Stimulates B2 adrenergic receptor on bronchiolar SMCs
  2. Increases Adenylate Cyclase (AC) which converts AMP -> cAMP
  3. cAMP activates PKA
  4. PKA drives Ca2+ into storage vesicles away from cytoplasm & inactivates MLCK driving dephosphorylation of MLC
  5. Reduced SMC contraction = bronchodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some examples of B2-adrenoceptor agonists (B2-agonists)?

A

Short-acting (3-4hrs): Salbutamol & Terbutaline

Long-acting (12hrs): Salmeterol & Formoterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the key side effects of B2-adrenoceptor agonists (B2 agonists)?

A

Tremor
Tachycardia
Cardiac arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the difference between the 2 types of B2-adrenoceptor agonists (B2-agonists)?

A

Short-acting (relievers): binds to active site of receptor & has affect only once dissociating afterwards

Long-acting (preventers): binds to exosite of receptor allowing molecule to be in constant contact with active site producing its effects over a longer period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do anticholinergnic drugs work?

A
  1. Binds to M3 receptor blocking its active site
  2. G protein on IC side does not activate PLC as it would when stimulated
  3. PLC does not produce IP3 & then increase IC Ca2+ levels causing bronchoconstriction
  4. Instead there is reduced Ca2+ release from IC stores
  5. This causes reduced SM contraction = bronchodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some examples of anti-cholinergic drugs?

A

Short-acting: Ipratropium

Long-acting: Tiotropium

17
Q

What are the key side effects of anti-cholinergic drugs?

A

Dry mouth
Constipation
Urinary retention

18
Q

How do methylxanthines work?

A
  1. Phosphodiesterase (PDE) normally inactivates cAMP
  2. Drugs inhibit PDE sustaining cAMP
  3. PKA produced
  4. Reduced phosphorylation of MLC via MLCK & reduced IC Ca2+ = reduced SM contraction
  5. Bronchodilation
19
Q

What are some examples of methylxanthines? How are they taken?

A

Theophylline
Aminiphylline

Either as an oral tablet or IV in acute asthma

20
Q

What are some key side effects of methylxanthines?

A

Cardiac arrhythmias
Seizures

Very toxic cardiac & neurological side effects (must monitor serum levels; Ph3)

21
Q

How does the immune system lead to lung damage and respiratory disease?

A
  1. Abnormal & hypersensitive immune response to materials e.g. allergens which activates cells such as MCs & eosinophils
  2. Mediators released can drive bronchospasm & augment further immune reactions
  3. Infiltrates of lymphocytes e.g. T cells lead to chronic inflammation -> tissue remodelling & destruction
22
Q

What are leukotrienes (LT) and how do they work?

A

Lipid-based signalling molecules with multiple effects in lung via LT receptors (LT-R) which transduce IC signals in response to LT secretion

LT-R on bronchiolar SMC stimulate constriction via PLC activation

LT-R on eosinophils guide eosinophil chemotaxis to sites of inflammation

23
Q

What are some examples of leukotriene receptor (LT-R) antagonists? How are they taken?

A

Montelukat
Zafirlukast

As oral tablets

24
Q

What leukotriene receptor (LT-R) do antagonists act on?

A

CysLT1

25
Q

What are the uses of leukotriene receptor (LT-R) antagonists?

A

Reduce inflammatory responses in early & late phases of asthma

Additive effect when used with other drugs e.g. inhaled glucocorticoids

Used as preventer

26
Q

What are the side effects of leukotriene receptor (LT-R) antagonists?

A

Abdominal pain

Headache

27
Q

Do leukotriene receptor (LT-R) antagonists improve the tissue remodelling seen in chronic asthma?

A

No evidence of effect

28
Q

How do glucocorticoids work?

A
  1. Stimulate IC glucocorticoid receptor (GR) on immune cells of lungs especially macrophages, T cells & eosinophils
  2. Activated GR interacts with selected nuclear DNA sequences & influences expression of many key genes
  3. Suppresses pro-inflammatory mediators e.g. Th2 cytokines (IL-3, IL-5)
  4. Expresses anti-inflammatory products e.g. lipcortin-1, SLPI & B2-adrenoceptor upregulation
  5. Reduced inflammation
29
Q

What are some common examples of glucocorticoids? How are they taken?

A

Beclomethasone (inhaled)
Fluticasone (inhaled)
Prednisolone (oral)
Hydrocortisone (IV)

30
Q

What are the key side effects of glucocorticoids?

A

Many side effects especially with long-term oral glucocorticoids e.g.

Moon face w/ red cheeks
Weight gain (abdominal fat gain)
Osteoporosis
Hyperglycaemia tendency

Block 2 (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions