Respiratory Disease Flashcards
What are the effects of smoking?
Smoke contains CO2, effecting the CO2 diffusion gradient.
- Carcinogenic chemicals that can trigger tumours.
- Toxic nicotine, which paralyses cilia that normally clean the lungs so mucous, dirt, bacteria not removed.
What is emphysema?
Alveoli become dry + brittle + eventually rupture.
(All types of smoke, not just tobacco, can cause this)
Also, alveoli merge to form large air spaces + septum an dissolve.
What is cystic fibrosis?
Mutation of CFTR gene which controls healthy salt balance in the lungs.
If cell interior too salty, H2O drawn from the lung mucus by osmosis, causing the mucus to become thick + sticky.
What does a healthy CFTR protein normally do?
Regulates the amount of Cl- across the cell membrane of lung cells.
What is bronchospasm?
The rapid tightening of the airways.
Useful to keep irritants out.
What is the function of the cilia?
Hair-like structures that sweep foreign particles like mucous up to the mouth
What are goblet cells?
Mucus-secreting cells lining the trachea, bronchi + bronchioles to trap foreign particles
What is the main cause of lung, mouth, throat + oesophageal cancer?
Smoking
What are the risk factors of emphysema?
- Air pollution
- Male Gender
- Hereditary/Genetic
- Age (>35 yrs)
What 2 ways does smoking contribute to emphysema?
- destroys lung tissue (cause of obstruction)
- causes inflammation + irritation of airways (disease gets worse)
- Cytokines released by immune system + dissolve + break down septum
What does emphysema cause aside from large air spaces + destroyed alveoli?
- Less SA for gas exchange
- Loss of pulmonary capillaries
- Loss of elastic fibres
- Less support for small bronchi
- Progressive difficulty with expiration
- Bigger residual volume
- Fixation of ribs in inspiration position
What 3 medicines can pharmacist give to help emphysema?
- Bronchodilators - relax the airways
- Inhaled steroids - corticosteroids decrease inflammation + relieve shortness of breath
- Antibiotics - bacterial infections like pneumonia or acute bronchitis
What is asthma?
Chronic inflammatory disease of small bronchi + bronchioles.
- Inflammation
- Excess muscles in airways
- Tightening of muscles around airways
- Edema (fluid/swelling)
How can asthma be controlled?
Not cured but controlled.
- Avoid triggers/reduce exposure to them
- Use medication to control symptoms
What 2 general medications can be used to relieve asthma symptoms?
Long-term drugs: prevent excess production of mucus + reduce inflammation
Short-term drugs (rescue/quick relief): taken to relax muscles around airways to improve breathing
What is COPD?
A common PREVENTABLE + TREATABLE disease characterised by persistent airflow limitation that is usually progressive + associate with an enhanced chronic inflammatory response in the airways + lung.
What 4 ways can we help COPD patients?
- Assess + Monitor disease
- Reduce risk factors
- Manage stable COPD
- Manage exacerbations (when things get worse)
What us acute bronchitis?
Chest cold
- common
- improves within 7-10 days
- no lasting effects
What is chronic bronchitis?
- constant irritation + inflammation of the lining of the bronchial tube
- can last up to 3 months
- progressive damage to lungs
Why do people with chronic bronchitis struggle to breathe?
- Significant changes in bronchi (irreversible + progressive)
- Inflammation
- Obstruction of the airways
- Repeated infection
- Chronic coughing
- Swollen mucosa
- Increased number of goblet cells
- Decreased number of cilia cells
Common types of bronchodilators:
short-acting: salbutamol
long-acting: salmeterol
anticholinergic agents
theophylline
Common types of corticosteroids
prednisone
hydrocortisone
dexamethasone
What are leukotriene antagonists?
Family of inflammatory mediators produced in leukocytes + mediate signalling to regulate immune responses (help determine bronchial tone.
What are common types of leukotriene antagonists?
Montelukast
Zafirlukast
Pranlukast
What is Omalizumab used for?
Treatment of allergic asthma ( that can’t be controlled by inhaled steroids)
What is a mast cell?
A cell that releases histamines
What is a mast cell stabiliser used for?
Used to prevent/control allergic disorders
What is the MOA of bronchodilators?
Relaxes smooth muscle by:
- inhibiting phosphodiesterase
- decreasing cAMP levels
What is the MOA of leukotriene antagonists?
Blocks binding to the receptor + blocks inflammation in the lungs.
What is the MOA of corticosteroids?
Suppresses chronic airway inflammation by:
- inhibiting prostaglandin, leukotriene + histamine
What is the MOA of omalizumab?
Prevents activation by asthma triggers by:
- binding to IgE sensitised mast cells.
What is the MOA of a mast cell stabiliser?
Acts by:
- stabilising mast cell membrane
- blocking histamine release
