Pharmacology of Respiratory Disorders Flashcards
Respiration is concerned with the exchange of what two gases?
Oxygen and carbon dioxide
Major causes of respiratory disorders
Smoking
Radon
Air pollution
Infections
What are the four categories of pulmonary disease?
Airway disease
Interstitial lung disease
Pulmonary circulation disease
Lung disorder due to infection
Examples of airway diseases
Asthma, COPD
Examples of interstitial lung diseases
Cystic fibrosis/pulmonary fibrosis, sarcoidosis
Interstitial lung disease causes
Scarring
Inflammation
Reduced elasticity
Examples of pulmonary circulation diseases
Pulmonary hypertension, pulmonary embolism
Examples of lung disorders due to infection
Influenza, pneumonia
True or false: Respiratory disease is the leading cause of death in the U.S.
False. It is after cardiovascular disease and cancer.
Two major characteristics of asthma
Inflammation of airways
Exaggerated airway smooth muscle constriction
Asthma is both a(n) _________ lung disease and a(n) _______ lung disease
Obstructive, inflammatory
The inflammatory component of asthma is marked by what characteristics?
Airway edema
Goblet cell hyperplasia
Mucus secretion
Infiltration and cytokine release by immune cells
True or false: Over time, asthma can cause airway remodeling and permanent deterioration in pulmonary function
True
The ________ tone causes bronchodilation
sympathetic (adrenergic)
The ________ tone causes bronchoconstriction
Parasympathetic (cholinergic)
Bronchial tone can be regulated by adrenergic, cholinergic and _______ fibers
Nonadrenergic noncholinergic fibers (NANC)
The airway smooth muscle cells express what kind of receptors that are responsive to circulating catecholamines?
beta-2-adrenergic receptors
Which nerve parasympathetically innervates the lungs?
Vagus nerve
Airway smooth muscle cells express which muscarinic receptor subtype?
M3
Acetylcholine stimulates muscarinic receptors inducing what action?
Bronchodilation
Are airway NANC fibers primarily under parasympathetic or sympathetic control?
Parasympathetic
What do NANAC fibers release?
Neuropeptides; neurokinin A, bradykinin, tachykinin, etc
Measurements of what can be used to assess intensity of airway inflammation?
Nitric oxide
Two important agents used in the treatment of asthma are
Bronchodilators and anti-inflammatory agents
What class of anti-inflammatory medication is most often used to treat asthma?
Corticosteroids
What is cough variant asthma?
Airway inflammation leading to chronic cough in asthmatic individuals
What are the four categories of asthma phenotyping?
Early onset asthma
Late onset asthma
Exercise induced asthma
Obesity related asthma
Patients with early onset asthma have high levels of _____ antibodies and respond well to ________ therapy
IgE, corticosteroid
Patients with late onset asthma have high levels of _____ antibodies and respond well to ________ and _______ therapy
IL-5; IL-5 antibody and cysteinyl leukotriene modifiers
Patients with exercise induced asthma have high levels of _____, _____ and ______. They respond well to ________, ________ and _______ therapy
mast cells, TH2 cytokines and cysteinyl leukotrienes; cysteinyl leukotriene modifiers, beta agonists and IL-9 antibody
What is the best treatment for obesity related asthma?
Weight loss. Other therapies that may help include antioxidants and hormonal therapy
True or false: Late onset asthma and obesity related asthma most often affect men
False. They mostly affect women
True or false: Early onset asthma is the most common type of the four phenotypes
True. About 50% of the patient population
What are acute symptoms of asthma?
SOB Wheezing Whistling when exhaling Cough Chest tightness
What are two signs of chronic pulmonary hyperinflation?
Barrel chest and diminished diaphragm movement
Beta-2-adrenergic agonist MOA
Relaxes smooth muscle of the airway causing bronchodilation
Beta-2-adrenergic agonist examples
Albuterol, terbutaline, levalbuterol, pirbuterol, epinephrine, isoproterenol
Anticholinergic examples
Ipratropium bromide, methylxanthines, phosphodiesterase inhibitors
Adverse effects of methylxanthines
Cardiac arrhythmias, nausea and vomiting
