Pulmonary Pharmacology Flashcards
Provide two examples of why pulmonary pharmacology is of clinical importance
Feline Asthma
-similar to huma asthma (delayed hypersensitivity
to inhaled allergens)
Equine recurrent airways obstruction (RAO)
What is NANC?
Non-cholinergic non-adrenergic
Modulators of pulmonary circulation that are not inhibited by adrenergic or cholinic blockades
What is NO?
Nitric Oxide
Regulator of pulmonary vasomotor tone
How do muscarinic mediated bronchospasms occur?
Muscarinic receptors control smooth muscle tone, mucus secretion, vasodilation and inflammation
Possible some Alpha 1…
Define respiritory disease
Respiratory disease is often characterized by abnormal production of secretions and exudates and by a reduced ability to remove them
Outline the primary goal of the body during respiratory disease and how this is accomplished
Reduce volume and viscosity of the secretions & facilitate their removal.
Accomplished by controlling infection, modifying the
secretions, and when possible, improving postural
drainage and mechanically removing the material.
Therapeutic methods include altering the inspired air and
administering expectorants, antitussives (suppress
coughing), bronchodilators, antimicrobials, diuretics
(remove salt?), and other drugs.
List the characteristics of airway inflammation
Prolonged exposure to irritants:
- Narrowed airways
- Increased smooth muscle constriction
- Increased resistance
- Number of inflammatory mediators
What are the potential targets of respiritory disease?
Airway inflammation
Bronchoconstriction
Irritation and cough
Infection
Which division of the ANS is the adrenergic system apart of?
Sympathetic
Name the different types / subtypes of adrenoreceptor system
α1, α2, β1, β2, and β3-receptors - (these have therapeutic relevance)
In which cardio-respiratory structures are these different adrenoreceptors found?
Smooth muscle of the bronchioles and heart muscle
How does bronchodilation occur by sympathetic stimulation
Beta2 adrenoreceptors
- (Nor)Adrenaline / (Nor)Epinephrine acting as agonist
- relax smooth muscle in lung
- dilation via increased cAMP
a1 mediated constriction in diseased airway
Which division of the ANS is the cholinergic system apart of?
Parasympathetic
Name the different types / subtypes of cholinergic system
Muscarinic receptors
M1, M2, M3
In which cardiorespiratory structures are these different cholinergic receptors found?
Bronchiole and heart muscle
How does bronchoconstriction occur by parasympathetic stimulation
Muscarinic receptors
M3 receptors:
Decrease cellular cAMP,
Increased mucus secretion
Contraction of bronchial smooth muscle
M1 receptors:
Increased mucus secretion
What class of drugs acting on the autonomic nervous system could be used to reduce airway resistance?
Beta 2 agonists and M3 antagonists
Outline the host defence system in the lungs (parasympathetic control)
Airway inflammation signal is sent to CNS via C fibre
CNS send information to parasympathetic airway ganglion via Vagal nerve.
Ganglion stimulates releases of Ach which will bind to M3 trigger mucus secretion or M1 which trigger bronchoconstriction
Which of the following drugs would be most suitable and why?
Beta agonists: Epinephrine; Isoprenaline (isoproterenol); Salbutamol or Clenbuterol
Muscarinic antagonists: Atropine; Tiotropium or Ipratropium
Salbutamol or Clenbuterol
Tiotropium or Ipratropium
Provide an overview of the peripheral nervous systems response to respiritory disease
Non-adrenergic non-cholinergic (NANC) neurotransmitter in many tissues
Released at same time as acetylcholine / noradrenaline
Primarily slower response
Excitatory or inhibitory
Potential therapeutic targets: limited research
How is control of airway muscle tone maintained?
Parasympathetic release of ACh stimulates M3 & M1 which causes constriction and increase in glandular secretions
Sympathetic/adrenal medulla both act to release noradrenaline which acts on B2 receptors leading to relaxation of smooth muscle
NANC can both relax (by use of VIP, NO) and contract (by use of SP, NK-A)
What therapeutics are used to decrease inflammation?
Antihistamines
Glucocorticoids
Outline how antihistamines work
Act to block effects of histamine as an H1antagonist by binding with H1 receptors on smooth muscle. Due to this blocking it prevents mast cells from degranulating releasing their histamine
Outline the characteristics of corticosteroids
Control the signs of respiritory disease and not the cause
Reduce mucosal oedema Reduce release of inflammatory mediators Sensitise membranes to beta agonists Prolong half life of adrenaline – slows uptake
