Pulmonary Pharmacology Flashcards
4 types of bronchodilators
- sympathomimetics
- sympatholytics
- parasympatholytics
- methylxanthines
Bronchial diameter Controlled by:
SNS and PNS
Parasympatholytic Drug Endings
-tropium
Sympathomimetic Drug Endings
- erol
- enol
- olol
Sympathomimetics
- Beta Agonists
- Bronchodilators
- Selective (short/long acting)
- Nonselective
SNS releases ____ which bind to _____ which act on ____
- Norepinephrine
- alpha1, alpha2, beta1, beta2 receptors
- Smooth Muscle of Lungs (through cAMP 2nd messenger)
LRB’s
-leukotriene receptor blocker
no side effects
- erol
- enol
- olol
-sympathomimetics
PNS releases ____ which binds to _____ which act on_____
- Acetylcholine
- nicotinic, muscarinic receptors
- smooth muscle in lungs (through cAMP 2nd Messenger)
Methyxanthines
- bronchodilation
- Therapeutic level close to toxic level
Methylxanthines work by:
- inhibiting phosphodiesterase to increase cAMP
- antag to adenosine
- inhibit intracellular Ca++ release
- inhibit prostaglandins
(increase diaphragm’s ability to contract and resist fatigue)
-phylline
-methyxanthines
-lukast
LRBs
Selective Drug Side Effects
sympathomimetics
- nervousness
- headaches
- tremors
Corticosteroids on ANS
- enhance Beta2 effect
- inhibit Alpha effect
mucolytics
-thin secretions by breaking disulfide bonds of mucus
Mechanism of Chromolyn and Nedocromil
- (prophylactic)
- inhibit release of inflammatory mediators (histamines & leukotrienes)
Non-selective drug side effects
sympathomimetics
- nervousness, headaches, tremors
- Beta: tachycardia, angina, cardiac dysrhythmias
- Alpha: peripheral vasoconstriction
Parasympatholytics
- anti-cholinergics
- tropium
- bronchodilation
Cholinergic input=
-bronchoconstriction
cholinergic=acetylcholine on muscarinic/nicotinic rec
SNS Beta2 Receptor
- Bronchodilation
- via cAMP 2nd messenger
Stimulation of Muscarinic Receptor–>
- increased guanyl cyclase–>
- convert GTP to GMP–>
- Cyclic GMP cause bronchoconstriction
(cGMP broken down by phosphodiesterase)
LRB drug Endings
-lukast
SNS Alpha1 Receptor
- bronchoconstriction
- via cAMP/cGMP
- usually in diseased lungs only
-tropium
parasympatholytics
-asone
-corticosteroids
Signs of Methyxanthine Toxicity
- Heart Arrhythmias
- Seizures
- Nausea
- Restlessness
- Irritability
- Confusion
Methylxanthine Drug Endings
-phylline
Anti-inflammatory drugs
- corticosteroids
- cromolyn & nedocromil
- leukotriene synthesis inhibitors
- leukotriene receptor blockers
Corticosteroid Drug Endings
-asone
Beta1 receptors are also located in:
-the heart
increase HR
Alpha1 receptors are also located in:
- Arteries
- (increase vasoconstriction)
Side effects of Corticosteroids
- osteoporosis
- muscle wasting
- skin break down
- hyperglycemia
- cataracts
Side Effects of Cromolyn & Nedocromil
-irritation of nasal & upper respiratory passages
Sympatholytics
-Alpha antagonists–>bronchodilation
Corticosteroid Mechanism of Action
- inhibits production of prostaglandins & leukotrienes
- inhibit neutraphils & monocyte migration
- reverse decrease in vascular permeability
- bronchodilation through ANS (increase Beta2 effect, decrease Alpha effect
