Respiratory Pharmacology

Question 1

Is mast cell degranulation responsible for late or early phase asthma?

Answer 1

Early

Question 2

Mast cell degranulation releases which cell types?

Answer 2

Histamine, leukotrienes and prostaglandin D2

Question 3

Which T cells are activated in asthma?

Answer 3

T 2 helper cells + CD4

Question 4

Which immunoglobulin is involved in allergic asthma?

Answer 4

IgE

Question 5

Explain late vs early phase

Answer 5

Early = bronchospasms
Late = inflammation

Question 6

Cell type responsible for late phase?

Answer 6

Eosinophils (a type of white blood cell)

Question 7

Name 3 structural changes in the airway of an asthmatic

Answer 7

• mucus hypersecretion in epithelium
• thickening if basement membrane - harder for gas exchange to occur
• hyperplasia of smooth muscle

Question 8

Name 2 SABAs and 1 LABA

Answer 8

SABA - salbutamol and terbutaline
LABA - formeterol

Question 9

Describe the development of tolerance to beta agonists

Answer 9

Body can decrease expression of beta receptors

Question 10

Action of beta agonists?

Answer 10

Causes smooth muscle relaxation and therefore, bronchodilator. Independent of the causative spasmogen

Question 11

Impact of beta agonists on mast cells?

Answer 11

Stabilises mast cells and prevents degranulation - therefore relief in early phase. Has no effect on late phase

Question 12

Name 3 ADRs of beta agonists

Answer 12

Tachycardia, muscle tremors and headache (vasodilatory)

Question 13

When should corticosteroids be used?

Answer 13

Regularly - as a preventer

Question 14

Discuss the actions of corticosteroids

Answer 14

• decrease formation of pro-inflammatory molecules like leukotrienes and prostaglandins

Question 15

Why are ICSs used in combo with beta agonists?

Answer 15

Corticosteroids increase expression of beta 2 receptors

Question 16

Which phase (early or late) are corticosteroids most effective against?

Answer 16

Late - essentially wipes this phase out

Question 17

Omalizumab reserves hypersensitivity of allergic asthma by binding to which molecule?

Answer 17

IgE. Mops it up and reduces its levels.
This reduces the activation of mast cells, T cells, eosinophils, etc and therefore reduces chronic inflammation and airway remodelling

Question 18

Montelukast prevents smooth muscle contraction by binding to which receptor?

Answer 18

Leukotriene receptor. Also prevents leukotriene-mediated inflammation