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Pharmacology > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

1
Q

What is the hierarchy of lung structure?

A

Trachea - bronchus - bronchioles - alveoli

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2
Q

Which part of the lung is distal?

A

Bronchus through to capillaries

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3
Q

How many British people have asthma? How much does it cost the NHS per annum?

A

5.4 million.

Costs £1 billion

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4
Q

Pathophysiology of bronchoconstriction, mucous plugs, mucosal oedema, increased vascularity, increased smooth muscle mass and inflammatory cell activation describes what condition?

A

Asthma

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5
Q

What is the difference between a brief vs longer asthma attack?

A 
Brief = Last minutes, caused by tightening of muscles.
Longer = Increased mass decreasing lumen of bronchioles
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6
Q

What is COPD?

A

Resp disease where airflow is limited - not fully reversible. Usually progressive and associated with abnormal inflammatory response due to noxious particles/gases.

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7
Q

How many British people have COPD? How much does COPD cost NHS per annum?

A

1.2 million people.

£3 billion per year.

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8
Q

What is the pathophysiology of COPD?

A

Narrowing of airways by:

  • Collagen disposition
  • Mucosal thickening
  • Inflammatory exudate in airway lumen
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9
Q

What happens in emphysema?

A

Alveolar membrane breakdown

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10
Q

Signs and symptoms of COPD?

A
  • SOB
  • Chronic cough
  • Phlegm
  • Wheezing
  • Chest tightness
  • Resp infection
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11
Q

What is main route of drug admin for resp diseases?

A

Inhalation

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12
Q

What percent of inhaled medication is deposited in lung and swallowed?

A 
Lung = 5%
Swallowed = 95%
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13
Q

What kind of metabolism do inhaled drugs take?

A

First-pass metabolism

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14
Q

What are two main types of inhalers?

A

1) Breath actuated metered dose (i.e. mine)

2) Dry powder inhalers

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15
Q

What are two main drug classes of resp drugs?

A
  • Bronchodilators

- Anti-inflammatory

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16
Q

Mechanism of action of beta-2-agonists?

A
  • Treat asthma/COPD
  • Targets ANS - sympathetic innervation
  • Bronchial smooth muscle relaxation, mucocilary clearance => breathe easier
17
Q

Example of short acting beta-2-agonist, with onset/duration?

A

Salbutamol

Onset 5 mins, lasts 4-6 hours.

18
Q

Example of long acting beta-2-agonist, with onset/duration?

A

Salmeterol

Onset 10-20 mins, lasts 12 hours.

19
Q

How do beta-1 and beta-2 blockers differ in location of effect?

A 
B1= Heart
B2= Lungs
20
Q

Antimuscarinic/anticholinergic MoA?

A

Blocks muscarinic receptors on bronchial smooth muscle, preventing bronchoconstriction mediated by parasympathetic NS

21
Q

Antimuscarinic/anticholinergic side effects?

A
  • Dry mouth
  • Headache
  • Dizziness
  • Cough
  • Dry throat
22
Q

Example of short-acting antimuscarinic with onset/duration?

A

Ipratopium - onset 15-30 mins, lasts 6-8 hours.

23
Q

Example of long-acting antimuscarinic with onset/duration?

A

Tiotropium - onset 3-7 days, lasts 24 hours

24
Q

Methylxanthines MoA?

A

Direct effect on bronchial smooth muscle, affecting contraction. Inhibits phosphodiesterase, increasing cAMP

25
Q

Methylxanthines side effects?

A

GI effects (nausea, vomiting etc)
CVS (hypotension, tachycardia, arrhythmias)
CNS (irritability, headaches, insomnia, seizures)
Hypokalaemia

26
Q

Why do we need to be cautious about Theophylline?

A

It has a narrow therapeutic index.

27
Q

Factors affecting Theophylline levels?

A 
Increase:
- Congestive HF
- Liver disease
- Concurrent enzyme inhibitors
Decrease:
- Smoking
- Use of enzyme inducing drugs
28
Q

MoA of corticosteroids?

A

Inhibit synthesis/release of mast cells. Inhibits migration of inflammatory cells and decreases capillary permeability, decreasing oedema.

29
Q

Side effects of inhaled steroids?

A
  • Oropharyngeal candidiasis
  • Hoarseness/dysphonia
  • Suppress adrenal function?
30
Q

Side effects of oral steroids?

A
  • Hyperglycaemia
  • Hypokalaemia
  • Fluid retention
  • Infection risk
  • Suppress hypothalamic-pituatary axis
31
Q

Why is it important for resp medications to targets leukotrienes?

A

They are linked to increases mucus production, airway wall oedema and bronchoconstriction

32
Q

MoA of leukotriene receptor antagonists?

A

Blocks effect of leukotriene by binding to receptors i.e. antagonist

33
Q

Side effects of leukotrienes?

A
  • Headache
  • Nausea
  • Dyspepsia
  • Diarrhoea
  • Dizziness

Pharmacology (9 decks)

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