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PED2006 - Systems Pharmacology > Respiratory Medicine [10&11] > Flashcards

Respiratory Medicine [10&11] Flashcards

1
Q

3 main reasons for respiratory issues

A
  1. Ventilation - airway obstruction
  2. Perfusion - circulation problems
  3. Diffusion - thick scar tissue
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2
Q

What is affected by fibrosis (scarring)

A

Interstitium - tissue between air sacs

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3
Q

What are type 1 cells in the lungs for

A

Gas exchange - thin surface

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4
Q

What are type 2 cells in the lungs for

A

Secreting surfactant
- resist surface tension so alveoli don’t collapse

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5
Q

What are fibroblasts in the lungs for

A

They lay down collagen & elastin in fibrosis

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6
Q

What is the perinuclear zone in type 1 cells

A

Clustered organelles & nucleus
Synthesises products that diffuse into cytoplasmic flaps

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7
Q

Can type 1 cells regenerate

A

No
The have no mitosis potential

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8
Q

Can type 2 cells regenerate

A

Yes
They can replace type 1 cells after injury

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9
Q

What to macrophages in the lungs target

A

Particulate material that escapes tracheobronchial filters

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10
Q

How do macrophages leave the lungs

A

Migrate to nearest bronchiole & exit via mucociliary escalator
Or pass into interstitium & exit via blood or lymph

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11
Q

What mechanisms lead to bronchoconstriction

A

Inflammation
Obstruction
Mucus overproduction

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12
Q

What happens to extra-cellular matrix in lung disease

A

Excessive ECM accumulation and reduced degradation of ECM
- scar tissue

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13
Q

3 types of bronchodilator

A

Beta 2 agonist
Anticholinergic
Theophylline

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14
Q

2 diseases that require bronchodilators

A

Asthma
COPD

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15
Q

Bronchoconstriction reflex

A

Ach binds M3 Muscarinic receptors in muscle
Intracellular calcium release
Contraction

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16
Q

What are anticholinergics

A

Competitive antagonists of Muscarinic ach receptors

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17
Q

Example of short acting cholinergic

A

Ipratropium bromide

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18
Q

Example of long acting anticholinergic

A

Tiotropium bromide

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19
Q

Why are anticholinergics not helpful in asthma

A

They only reduced vagal my mediated bronchoconstriction
- not inflammatory mediated constriction

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20
Q

Side effects of anticholinergics

A

Dry mouth
Urinary retention
Constipation

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21
Q

How much inhaled ipratopium is absorbed

A

1-2%

22
Q

How is ipratropium eliminated

A

Unchanged in faeces or urine

23
Q

What could form a precipitate with ipratropium bromide

A

Eromolyn sodium

24
Q

Mechanism of beta 2 agonists

A

Bind G protein coupled beta 2 receptors
Activate adenylyl cyclase
Catalyses formation of cAMP
Activates PKA
Phosphorylates protein targets leading to muscle relaxation

25
Q

Beta 2 agonists - Pathways downstream of PKA lead to

A

Decreased Ca2+
- sliding filament theory -> contraction needs high Ca2+

26
Q

2 examples of short acting beta 2 agonists

A

Salbutamol
Terbutaline

27
Q

2 examples of long acting beta 2 agonists

A

Salmeterol
Formoterol

28
Q

Side effects of beta 2 agonists

A

Non-selective ones have non-specificity problems
Tachycardia
Tremor

29
Q

When is salbutamol used

A

Premature labour to prevent uterine muscle contraction

30
Q

What do theophylline’s do

A

Inhibit phosphodiesterase which breaks down camp
- promotes lowering of Ca2+ levels
- bronchodilation

31
Q

What causes decreased clearance of theophyllines

A

Heart failure
Viral infections

32
Q

What causes increased clearance of theophyllines

A

Smoking
Alcohol

33
Q

What do glucocorticosteroids do

A

Downregulate proinflammatory cytokines

34
Q

Example of oral steroid

A

Prednisolone

35
Q

Example of inhaled steroid & side effect

A

Beclomerhasone
Can cause oral candidiasis

36
Q

What happened when histamine binds the H1 receptor

A

Increased calcium
Contraction

37
Q

What happens when histamine binds the H2 receptor

A

Increased camp
Gastric acid secretion
Vasodilation

38
Q

What happens when histamine binds the H3 receptor

A

Decreased camp
Decreased histamine release

39
Q

Example of an anti histamine

A

Loratidine for allergic inflammation

40
Q

Which generation of histamines can cross the blood brain barrier

A

First generation

41
Q

Which generation of histamines is non-sedating

A

Second generation

42
Q

What is an expectorant

A

Hypertonic saline
Increases secretion and hydration of mucus

43
Q

What is a mucoregulator

A

Anticholinergic agents
Decreases secretion volume

44
Q

What is a mucolytic

A

N-acetylcysteine
Breaks disulphide bonds linking mucin polymers

45
Q

What is a mucokinetic

A

Bronchodilator
Improves cough clearance

46
Q

What is the cough reflex

A

Vocal chords close
Abdominals contract & intercostals brace
Pressure in thorax
Vocal chords open
Expel air

47
Q

What drug class suppresses cough

A

Antitussive

48
Q

2 examples of antitussives

A

Dextromethorphan
Codeine

49
Q

What is IPF and how is it treated

A

Idiopathic pulmonary fibrosis
Treatments only reduce decline

50
Q

3 IPF treatments

A

Perfinidone
Nintedamib
Simtuzumab

PED2006 - Systems Pharmacology (19 decks)

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