Respiratory Disease

Question 1

What are the effects of smoking?

Answer 1

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.

Question 2

What is emphysema?

Answer 2

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.

Question 3

What is cystic fibrosis?

Answer 3

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.

Question 4

What does a healthy CFTR protein normally do?

Answer 4

Regulates the amount of Cl- across the cell membrane of lung cells.

Question 5

What is bronchospasm?

Answer 5

The rapid tightening of the airways.

Useful to keep irritants out.

Question 6

What is the function of the cilia?

Answer 6

Hair-like structures that sweep foreign particles like mucous up to the mouth

Question 7

What are goblet cells?

Answer 7

Mucus-secreting cells lining the trachea, bronchi + bronchioles to trap foreign particles

Question 8

What is the main cause of lung, mouth, throat + oesophageal cancer?

Answer 8

Smoking

Question 9

What are the risk factors of emphysema?

Answer 9

• Air pollution
• Male Gender
• Hereditary/Genetic
• Age (>35 yrs)

Question 10

What 2 ways does smoking contribute to emphysema?

Answer 10

1. destroys lung tissue (cause of obstruction)
2. causes inflammation + irritation of airways (disease gets worse)
   - Cytokines released by immune system + dissolve + break down septum

Question 11

What does emphysema cause aside from large air spaces + destroyed alveoli?

Answer 11

• 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

Question 12

What 3 medicines can pharmacist give to help emphysema?

Answer 12

1. Bronchodilators - relax the airways
2. Inhaled steroids - corticosteroids decrease inflammation + relieve shortness of breath
3. Antibiotics - bacterial infections like pneumonia or acute bronchitis

Question 13

What is asthma?

Answer 13

Chronic inflammatory disease of small bronchi + bronchioles.

• Inflammation
• Excess muscles in airways
• Tightening of muscles around airways
• Edema (fluid/swelling)

Question 14

How can asthma be controlled?

Answer 14

Not cured but controlled.

• Avoid triggers/reduce exposure to them
• Use medication to control symptoms

Question 15

What 2 general medications can be used to relieve asthma symptoms?

Answer 15

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

Question 16

What is COPD?

Answer 16

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.

Question 17

What 4 ways can we help COPD patients?

Answer 17

1. Assess + Monitor disease
2. Reduce risk factors
3. Manage stable COPD
4. Manage exacerbations (when things get worse)

Question 18

What us acute bronchitis?

Answer 18

Chest cold

• common
• improves within 7-10 days
• no lasting effects

Question 19

What is chronic bronchitis?

Answer 19

• constant irritation + inflammation of the lining of the bronchial tube
• can last up to 3 months
• progressive damage to lungs

Question 20

Why do people with chronic bronchitis struggle to breathe?

Answer 20

• 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

Question 21

Common types of bronchodilators:

Answer 21

short-acting: salbutamol
long-acting: salmeterol
anticholinergic agents
theophylline

Question 22

Common types of corticosteroids

Answer 22

prednisone
hydrocortisone
dexamethasone

Question 23

What are leukotriene antagonists?

Answer 23

Family of inflammatory mediators produced in leukocytes + mediate signalling to regulate immune responses (help determine bronchial tone.

Question 24

What are common types of leukotriene antagonists?

Answer 24

Montelukast
Zafirlukast
Pranlukast

Question 25

What is Omalizumab used for?

Answer 25

Treatment of allergic asthma ( that can’t be controlled by inhaled steroids)

Question 26

What is a mast cell?

Answer 26

A cell that releases histamines

Question 27

What is a mast cell stabiliser used for?

Answer 27

Used to prevent/control allergic disorders

Question 28

What is the MOA of bronchodilators?

Answer 28

Relaxes smooth muscle by:

• inhibiting phosphodiesterase
• decreasing cAMP levels

Question 29

What is the MOA of leukotriene antagonists?

Answer 29

Blocks binding to the receptor + blocks inflammation in the lungs.

Question 30

What is the MOA of corticosteroids?

Answer 30

Suppresses chronic airway inflammation by:

- inhibiting prostaglandin, leukotriene + histamine

Question 31

What is the MOA of omalizumab?

Answer 31

Prevents activation by asthma triggers by:

- binding to IgE sensitised mast cells.

Question 32

What is the MOA of a mast cell stabiliser?

Answer 32

Acts by:

• stabilising mast cell membrane
• blocking histamine release