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Respiratory > Pharmacology of Asthma and COPD > Flashcards

Pharmacology of Asthma and COPD Flashcards

1
Q

parasympathetic nervous system causes bronchial __ mediated by __ acting on __

A

contraction
ACh
M3

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2
Q

what causes smooth muscle relaxation

A

parasympathetic stimulation of non-cholingeric fibres

mediated by NO and VIP

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3
Q

does the sympathetic nervous system innervate bronchial smooth muscle

A

no

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4
Q

where does the sympathetic nervous system innervate

A

submucosal glands and blood vessels supplying smooth muscle

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5
Q

what is the effect of sympathetic stimulation

A

bronchial smooth muscle relaxation acting on beta-2 medicated by adrenaline

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6
Q

sympathetic nervous system causes decreased mucus secretions true/false

A

true

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7
Q

how does the contraction of smooth muscle occur

A

presence of intracellular calcium forms calmodulin
calmodulin activated MLCK which hydrolyses ATP
ATP phosphorylates myosin cross bridge - binds to actin forcing contraction

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8
Q

relaxation of smooth muscle requires high or low Ca2+ concentration

A

low

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9
Q

which enzyme is responsible for the relaxation of smooth muscle

A

myosin phosphatase

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10
Q

what are some of the chronic consequences of asthma (5)

A 
increased smooth muscle 
increased interstitial fluid 
increased mucus secretion 
epithelial damage 
fibrosis
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11
Q

what are the two phases of asthma

A

acute bronchospasm

chronic inflammation

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12
Q

in non-atopic less severe asthma Th0 cells mediate into

A

Th1 cells

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13
Q

in atopic individuals Th0 cells mediate into

A

Th2 cells

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14
Q

mast cells express their IgE receptors through which interleukins

A

IL-4

IL-13

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15
Q

what are the two types of treatment areas in asthma

A

relievers

preventers

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16
Q

which types of asthma treatments are relievers and what are they used for

A

SABAs, LABAs, CysLT1 antagonists

used for the initial relief of bronchospasm

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17
Q

which types of asthma treatments are preventers and what are they used for

A

Glucocorticoids, Chromoglicate

anti-inflammatory agents used to reduce chronic inflammation

18
Q

what are SABAs and give an example

A

short acting beta-adrenoceptor agonists, increase smooth muscle relaxation within 5 minutes
eg salbutamol

19
Q

what are LABAs and give an example

A

long acting beta-adrenoceptor agonists, increase smooth muscle relaxation but no immediate relief
eg salmeterol

20
Q

what is the route of administration of SABAs and LABAs

A

inhalation - avoids systemic circulation

21
Q

when are LABAs used most effectively

A

as nocturnal therapy - last for up to 8 hours

22
Q

should LABAs be used as monotherapy

A

no as not effective

must be combined with corticosteroid

23
Q

when is an oral route of administration more effective in asthma

A

when asthma is more severe

24
Q

what is the route of administration of CysLT1 antagonists

A

oral administration

25
Q

name some examples of CysLT1 antagonists

A

montelukast

zafirlukast

26
Q

do glucocorticoids relieve bronchospasm

A

no - reduce inflammation

27
Q

how do corticosteroids reduce inflammation in ASM

A

reduce number or eosinophils and mast cells

reduce number of cytokines in T lymphocytes and macrophages

28
Q

name an example of an inhaled corticosteroid

A

beclometasone

29
Q

what are the side effects of beclometasone

A

hoarse voice

oral thrush

30
Q

name an example of an oral corticosteroid

A

prednisolone

31
Q

COPD is made up of which two conditions

A

chronic bronchitis and emphysema

32
Q

what are the symptoms of chronic bronchitis

A

cough + clear sputum

33
Q

what are the symptoms of emphysema

A

breathlessness due to destruction of alveolar air spaces

34
Q

how does the main COPD treatment work

A

reduces parasympathetic transmission of smooth muscle contraction using muscarinic antagonists

35
Q

name an example of short acting muscarinic antagonists

A

ipratropium

36
Q

name an example of a long acting muscarinic antagonist

A

tiotropium and glycopyronium

37
Q

SAMAs are more effective in COPD treatment than LAMAs true/false - why

A

false - LAMAs only act on M3 whereas SAMAs act on M1, 2, 3

38
Q

why is a selective muscarinic antagonist better than a non-selective one

A

M2 works to reduce the release of ACh - this function is desirable

39
Q

are corticosteroids an effective treatment for severe COPD when combined with a LAMA

A

yes - useful for frequent and severe exacerbations

40
Q

which drug classification blocks activation by ACh preventing contraction

A

muscarinic antagonists

41
Q

which drug classification causes relaxation of smooth muscle

A

B2-adrenoceptor agonists

Respiratory (12 decks)

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