Pulmonary pharmacology

Question 1

Describe the 3 phases of the inflammatory response in Asthma.

Answer 1

1. Initial Phase (minutes)
   - Mast Cell/IgE interaction releases Histamine and PGD2 causing Bronchoconstriction.
2. Intermediate phase (hours)
   - Release of chemokines (IL-4,5,13) that cause leukocyte release.
   - Inflammation and oedema
3. Late phase (Days)
   - Th2 lymphocytes activate neutrophils and eosinophils which release toxic substances that dmg the lung epithelium. (leukotrienes, TNFa, IFNg).

Question 2

Examples of B2 Agonists and where they are used?

Answer 2

Bronchodilators used to treat asthma and COPD.
Salbutamol (short acting).
Salmeterol, Foroterol, Indacaterol, Vilanterol (long acting)

Usually given inhaled, rarely orally or IV.

They bind to B2 adrenoreceptor (GPCR)=> Activate AC=> Increases cAMP=> inhibits mediator release from mast cells= Bronchodilation

Question 3

Side effects of B2 Agonists.

Answer 3

Tremor, arrhythmias, hypokalemia, muscle cramps

Question 4

Examples of Muscarinic Antagonists and where are they used?

Answer 4

Bronchodilators to treat astha and COPD.
Ipratropium (inhibits M1,M2,M3)
Tiotropium (inhibits M1 and M3)
-ium bromides are longer acting.

Given inhaled

Question 5

SE’s of muscarinic antagonists?

Answer 5

Dry mouth and urinary retention.

Question 6

Examples of Xanthines and where they are used?

Answer 6

Bronchodilators to treat ashtma and COPD.
Caffeine, Theophylline, Aminophylline.

Inhibit PDE4.

Question 7

SE’s of Xanthines?

Answer 7

> 110microns/mol