Pharmacology of COPD

Question 1

What is the role of M 1-3 muscarinic receptors?

Answer 1

M1- role is Ach transmission
M2: role in Ach inhibition
M3: role in bronchoconstriction + mucus secretion

Question 2

Name a short acting muscarinic receptor used in COPD?

Answer 2

Ipratropium

Question 3

Name some long acting muscarinic receptors used in COPD?

Answer 3

Tiotropium
Glycopyrronium
Aclidinium
Umeclidinium

Question 4

What drug is a non-selective blocker of M1, M2 and M3 receptors?

Answer 4

Ipratropium

Question 5

Why are LAMAs superior the Ipratropium?

Answer 5

Block of M3 (and M1) is desirable
but block of M2 is not because release of ACh from parasympathetic post-ganglionic neurones is increased by autoreceptor antagonism

Question 6

What is bronchoconstriction caused by?

Answer 6

smooth muscle M3 receptor activation in response to ACh released from postganglionic parasympathetic fibres

Question 7

Name some BBlockers that cause bronchodilation in COPD?

Answer 7

salbutamol - short acting

salmeterol and formoterol - long acting