Pharmacology of Respiratory Disorders

Question 1

Respiration is concerned with the exchange of what two gases?

Answer 1

Oxygen and carbon dioxide

Question 2

Major causes of respiratory disorders

Answer 2

Smoking
Radon
Air pollution
Infections

Question 3

What are the four categories of pulmonary disease?

Answer 3

Airway disease
Interstitial lung disease
Pulmonary circulation disease
Lung disorder due to infection

Question 4

Examples of airway diseases

Answer 4

Asthma, COPD

Question 5

Examples of interstitial lung diseases

Answer 5

Cystic fibrosis/pulmonary fibrosis, sarcoidosis

Question 6

Interstitial lung disease causes

Answer 6

Scarring
Inflammation
Reduced elasticity

Question 7

Examples of pulmonary circulation diseases

Answer 7

Pulmonary hypertension, pulmonary embolism

Question 8

Examples of lung disorders due to infection

Answer 8

Influenza, pneumonia

Question 9

True or false: Respiratory disease is the leading cause of death in the U.S.

Answer 9

False. It is after cardiovascular disease and cancer.

Question 10

Two major characteristics of asthma

Answer 10

Inflammation of airways

Exaggerated airway smooth muscle constriction

Question 11

Asthma is both a(n) _________ lung disease and a(n) _______ lung disease

Answer 11

Obstructive, inflammatory

Question 12

The inflammatory component of asthma is marked by what characteristics?

Answer 12

Airway edema
Goblet cell hyperplasia
Mucus secretion
Infiltration and cytokine release by immune cells

Question 13

True or false: Over time, asthma can cause airway remodeling and permanent deterioration in pulmonary function

Answer 13

True

Question 14

The ________ tone causes bronchodilation

Answer 14

sympathetic (adrenergic)

Question 15

The ________ tone causes bronchoconstriction

Answer 15

Parasympathetic (cholinergic)

Question 16

Bronchial tone can be regulated by adrenergic, cholinergic and _______ fibers

Answer 16

Nonadrenergic noncholinergic fibers (NANC)

Question 17

The airway smooth muscle cells express what kind of receptors that are responsive to circulating catecholamines?

Answer 17

beta-2-adrenergic receptors

Question 18

Which nerve parasympathetically innervates the lungs?

Answer 18

Vagus nerve

Question 19

Airway smooth muscle cells express which muscarinic receptor subtype?

Answer 19

M3

Question 20

Acetylcholine stimulates muscarinic receptors inducing what action?

Answer 20

Bronchodilation

Question 21

Are airway NANC fibers primarily under parasympathetic or sympathetic control?

Answer 21

Parasympathetic

Question 22

What do NANAC fibers release?

Answer 22

Neuropeptides; neurokinin A, bradykinin, tachykinin, etc

Question 23

Measurements of what can be used to assess intensity of airway inflammation?

Answer 23

Nitric oxide

Question 24

Two important agents used in the treatment of asthma are

Answer 24

Bronchodilators and anti-inflammatory agents

Question 25

What class of anti-inflammatory medication is most often used to treat asthma?

Answer 25

Corticosteroids

Question 26

What is cough variant asthma?

Answer 26

Airway inflammation leading to chronic cough in asthmatic individuals

Question 27

What are the four categories of asthma phenotyping?

Answer 27

Early onset asthma Late onset asthma Exercise induced asthma Obesity related asthma

Question 28

Patients with early onset asthma have high levels of _____ antibodies and respond well to ________ therapy

Answer 28

IgE, corticosteroid

Question 29

Patients with late onset asthma have high levels of _____ antibodies and respond well to ________ and _______ therapy

Answer 29

IL-5; IL-5 antibody and cysteinyl leukotriene modifiers

Question 30

Patients with exercise induced asthma have high levels of _____, _____ and ______. They respond well to ________, ________ and _______ therapy

Answer 30

mast cells, TH2 cytokines and cysteinyl leukotrienes; cysteinyl leukotriene modifiers, beta agonists and IL-9 antibody

Question 31

What is the best treatment for obesity related asthma?

Answer 31

Weight loss. Other therapies that may help include antioxidants and hormonal therapy

Question 32

True or false: Late onset asthma and obesity related asthma most often affect men

Answer 32

False. They mostly affect women

Question 33

True or false: Early onset asthma is the most common type of the four phenotypes

Answer 33

True. About 50% of the patient population

Question 34

What are acute symptoms of asthma?

Answer 34

``` SOB Wheezing Whistling when exhaling Cough Chest tightness ```

Question 35

What are two signs of chronic pulmonary hyperinflation?

Answer 35

Barrel chest and diminished diaphragm movement

Question 36

Beta-2-adrenergic agonist MOA

Answer 36

Relaxes smooth muscle of the airway causing bronchodilation

Question 37

Beta-2-adrenergic agonist examples

Answer 37

Albuterol, terbutaline, levalbuterol, pirbuterol, epinephrine, isoproterenol

Question 38

Anticholinergic examples

Answer 38

Ipratropium bromide, methylxanthines, phosphodiesterase inhibitors

Question 39

Adverse effects of methylxanthines

Answer 39

Cardiac arrhythmias, nausea and vomiting