respiratory pharmacology Flashcards

1
Q

What do the post ganglionic fibres supply (sympathetic division) (2)

A

Sub mucosal glands
Smooth muscle of blood vessels

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2
Q

Where are parasympathetic preganglionic fibres found

A

brainstem

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3
Q

Where are cell bodies of parasympathetic post ganglionic fibres found

A

walls of the bronchi and bronchioles

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4
Q

What does stimulation of post ganglionic cholinergic fibres cause (2)

A

bronchial smooth muscle fibre contraction
Increased mucus secretion

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5
Q

What does stimulation of post ganglionic non-cholinergic fibres cause

A

bronchial smooth muscle relaxation

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6
Q

What does smooth muscle contraction result from

A

phosphorylation of regulatory music light chains in the presence of elevated intracellular calcium ions

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7
Q

What is required for smooth muscle relaxation

A

return of intracellular calcium ion concentration to a basal level

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8
Q

What are example of reliever medications (4)

A

short acting beta2 adrenoceptor agonists
Long acting beta2 adrenoceptor agonists
CystLTI receptor antagonists
Methylxanthines

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9
Q

What are examples of controller/prevent or medications (4)

A

glucocorticoids
Cromoglicate
Humanised monoclonal IgE antibodies
Methylxanthines

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10
Q

What are beta2 adrenoceptor agonists

A

physiological antagonists of all spasmogens

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11
Q

Salbutamol

A

shorting acting beta2 adrenoceptor agonists

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12
Q

Sale troll and formoterol

A

long acting beta2 adrenoceptor agonists

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13
Q

Montelukast and zafirlukast

A

CysLTI antagonists

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14
Q

Theophylline

A

Methylxanthine, combines bronchodilator and anti-inflammatory actions

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15
Q

Effects of methylxanthines (4)

A

inhibit mediator release from mast cells
Increase mucus clearance
Increase diaphragmatic contractility
Reduce fatigue

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16
Q

Describe glucocorticoids (3)

A

suppress inflammation
Do not alleviate early stage bronchospasm
Long term treatment

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17
Q

Which type of drug is effective against early bronchospasm

A

cysLTIs, in combination with other drugs

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18
Q

Effects of glucocorticoids (5)

A

decrease formation of TH2 cytokines
Apoptosis
Preventing immunoglobulin production
Prevent allergen-induced influx into lungs
Reduce number of mast cells

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19
Q

Describe cromones (4)

A

second-line drugs
Infrequently used
Prophylaxis of allergic asthma
No direct effect on bronchial smooth muscle

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20
Q

Where are M1 receptors found

A

Ganglia

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21
Q

Where are M2 receptors found

A

post-ganglionic neurone terminals

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22
Q

Where are M3 receptors found

A

airway smooth muscle

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23
Q

Action of M3 receptors

A

mediate contraction to ACh
Evoke increased secretion

24
Q

Muscarinic receptor antagonists (4)

A

Antagonists of bronchoconstriction
Reduce bronchospasm
Block ACh mediated basal tone
Decrease mucus secretion

25
Q

Ipratropium

A

short acting muscarinic antagonist

26
Q

Triotropium and glycopyrronium

A

long acting muscarinic antagonists

27
Q

Which medication is a non-selective blocker

A

Ipratropium

28
Q

How are adverse effects of generalised parasympathetic blockage avoided

A

The quaternary ammonium group reduces systemic absorption and systemic exposure

29
Q

What drugs are effective as a combination treatment for COPD and why

A

LABA and LAMA as they work by complementary mechanisms to cause smooth muscle relaxation

30
Q

When is the LAMA/LABA combination likely to be most effective

A

When both drugs are deposited in the same location in the airways

31
Q

What other drugs maybe be used in treatment of COPD (2)

A

glucocorticoids
PDE4 inhibitors

32
Q

By what methods can drugs be transported across the nasal epithelium (4)

A

Transcellular diffusion
Paracellular diffusion
Carrier mediated transported
Vesicle mediate transport

33
Q

What factors affect drug absorption in the respiratory tract (4)

A

physical barrier of the epithelium
Degradation by proteases
Particle clearance
Macrophage action

34
Q

What are the targets of treatment for rhinitis (4)

A

Anti-inflammatory
Mediator-receptor blockade
Nasal blood flow
Anti-allergic

35
Q

what drugs are used in the anti-inflammatory component of rhinitis treatment + what are the effects (3)

A

Glucocorticoids
Reduced vascular permeability
Reduced inflammatory cell recruitment and activation
Reduced cytokine and mediator release

36
Q

How are glucocorticoids administered in treatment of rhinitis

A

intranasal spray - sometimes orally

37
Q

What drugs are used in the mediator receptor blockade component of rhinitis treatment (3)

A

anti-histamines
Muscarinic receptor antagonists
CysLTi receptor antagonists

38
Q

What does H1 receptor antagonists do

A

Reduce effects of mast cell derived histamine

39
Q

In what types of allergic rhinitis are H1 receptor antagonists effective against

A

Perennial
Seasonal
Episodic

40
Q

What symptom are H1 receptor antagonists not effective at reducing

A

congestion

41
Q

What methods of administration are used for H1 receptor antagonists

A

oral
Intranasal

42
Q

What are examples of H1 receptor antagonists

A

Loratidine
Fexodenadine
Certrizine

43
Q

Describe anticholinergic drug action

A

Block acetylcholine receptors

44
Q

What symptom do anti-cholinergic drugs effect

A

Only rhinorrhoea

45
Q

How are anti-cholinergic drugs administered + what is an adverse effect

A

intranasal
Dryness of the nasal membrane

46
Q

Describe the action of cystLTis

A

Reduce effects of cysLTs on nasal mucosa

47
Q

What types of asthma can cysLTIs treat

A

Perennial and seasonal

48
Q

How are cysLT inhibitors administered

49
Q

What is an example of a cysLT inhibitor

A

Montelukast

50
Q

What medication is used to target nasal blood flow in treatment of rhinitis

A

Vasoconstrictors

51
Q

describe action vasoconstrictors (3)

A

Mimic effect of noradrenaline
Cause vasoconstriction via activation of beta1 adrenoceptors
This decreases swelling in the vascular mucosa

52
Q

What is an example of a vasoconstrictor used in treatment of rhinitis

A

Oxymetazoline

53
Q

Why is long term use of vasoconstrictors not recommended

A

there can be a rebound increase in nasal congestion upon continuation due to desensitisation and down regulation

54
Q

What medication can be used for anti-allergic component of rhinitis treatment

A

sodium chromoglicate