Pharmacology of Airways Disease

Question 1

Which drugs can inhibit the bronchospasm in the immediate/early phase of asthma?

Answer 1

B₂ receptor agonists (salbutamol, terbutaline, salmeterol, formoterol)

Anticholinergics (ipratropium, tiotropium)

Methyxanthines (theophylline)

(+ leukotriene receptor antagonists)

BAM

Question 2

Which drugs are used to reverse the inflammation in the late phase of asthma?

Answer 2

Glucocorticoids:

• Beclomethasone
• Fluticasone
• Prednisolone
• Hydrocortisone

Leukotriene receptor antagonists

LuGlu

Question 3

What are the 3 main systems to target in obstructive airways disease?

Answer 3

Bronchiolar smooth muscle constriction (nervous system control)

Airway hyper-responsiveness (acute immune response)

Airway chronic inflammation (target immune system in the lung)

Question 4

What is used for the management of severe acute asthma?

Answer 4

• *O:** Oxygen
• *S​:** Salbutamol (B₂ agonists)
• *H:** Hydrocortisone (glucocorticoid)
• *I:** Iptraropium (anticholinergic)
• *​T:** Theophylline (methyxanthine)

Question 5

What are the effects of the sympathetic and parasympathetic nervous systems on bronchiolar smooth muscle?

Answer 5

Sympathetic: bronchodilation

Parasympathetic: bronchoconstriction

Question 6

Which receptor do anticholinergics act on to reduce smooth muscle constriction?

Which neurotransmitter do they block at this receptor?

Answer 6

Muscarinic (M₃) receptors

Block the binding of ACh

Question 7

Which intracellular substance do methylxanthines act on?

Answer 7

Inhibit phosphodiasterase enzymes preventing the breakdown of cAMP

Question 8

Which immune cells in the lungs do glucocorticoids target?

Answer 8

• T-lymphocytes
• Macrophages
• Eosinophils