Respiratory Pharmacology Flashcards
<p>What is a cough?</p>
<p>A protective reflex that prevents lungs from aspiration. Common symptom of respiratory diseases</p>
<p>What is aspiration?</p>
<p>Process of drawing breath</p>
<p>What is a useless cough?</p>
<p>Persistent and unproductive --> dry cough</p>
<p>Should a useless cough be suppressed?</p>
<p>Yes</p>
<p>What are cough suppressants?</p>
<p>Antitussives</p>
<p>What are examples of useless coughs?</p>
<p>Asthma (worse in morning), oesophageal reflux, sinusitis</p>
<p>What is a useful cough?</p>
<p>Expels secretions and sputum --> productive</p>
<p>Should useful coughs be suppressed?</p>
<p>No as condition could get worse. Need to treat underlying condition</p>
<p>When should a useful cough be treated?</p>
<p>Only if exhausting and dangerous</p>
<p>What is an example of a useful cough?</p>
<p>Chest infection</p>
<p>Where does a cough originate?</p>
<p>From stimulation of structures innervated by the vagus nerve (including airways and distal oesophagus)</p>
<p>What are the 3 steps of the mechanism of a cough?</p>
<p>1. Cough receptors or lung irritant receptors detect stimuli
2. Sends to cough centre in medulla
3. Vagal stimulation leads to cough</p>
<p>On the afferent side, how can dry coughs be treated?</p>
<p>Reduce stimuli</p>
<p>What are linctuses?</p>
<p>Medicine to relieve cough --> coat mucous membrane with protective layer and soothes inflammation</p>
<p>Above the larynx, how can dry coughs be treated?</p>
<p>Linctuses</p>
<p>Below the larynx, how can coughs be treated?</p>
<p>1. Steam inhalation
| 2. Nebulised local anaesthetics</p>
<p>How can steam inhalation soothe a dry cough?</p>
<p>Makes environment warmer so more mucous secreted which provides protective layer to inflamed laryngeal membrane</p>
<p>How can nebulised local anaesthetics soothe a dry cough?</p>
<p>Inhibit sensory nerves in airways involved in cough reflex. Numb afferent receptors in larynx and trachea.</p>
<p>How can dry coughs be treated on the efferent side?</p>
<p>Medullary cough centre --> suppressed by antitussives
1. Opioids (codeine, methadone)
2. Non-opioids (dextromethorphan, noscapine)
3. Sedatives (diaphenhydramine)</p>
<p>What are side effects of opioids?</p>
<p>Sleepy, overdose</p>
<p>What are side effects of sedatives?</p>
<p>Make secretions very thick</p>
<p>How are productive coughs treated?</p>
<p>1. Expectorants
| 2. Mucolytics</p>
<p>What are 2 examples of expectorants?</p>
<p>1. Guaiphenesin
| 2. Ipecacuanha</p>
<p>What is effect of expectorants?</p>
<p>Increase volume of secretion to help bring up mucus (no added value)</p>
<p>What are 3 examples of mucolytics?</p>
<p>1. Acetyl cysteine
2. Carbocystine
3. Recombinant human DNA</p>
<p>When are mucolytics used?</p>
<p>Treat chronic conditions such as cystic fibrosis (very expensive)
Recombinant human DNA used in special circumstances</p>
<p>What is effect of mucolytics?</p>
<p>Decrease viscosity of sputum by breaking disulphide bonds</p>
<p>What is atelectasis?</p>
<p>A complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid</p>
<p>What should be asked about a cough in clinical scenario?</p>
<p>1. What type of cough? (useless or useful)
2. Should it be suppressed?
3. What is best treatment? (antibiotics, cough suppressants)</p>
<p>What are 4 likely causes of chronic coughs?</p>
<p>1. COPD
2. Bronchial asthma
3. Gastroesophageal reflux disease
4. Upper airways cough syndrome (post nasal drip)</p>
<p>What is bronchoconstriction?</p>
<p>Constriction of airways in lungs due to tightening of surrounding smooth muscle</p>
<p>How can inflammation lead to narrowing of lumen?</p>
<p>- Causes swelling of epithelium mucosa which leads to narrowing of lumen
- Release of inflammatory mediators leads to constriction of smooth muscle so lumen is compromised further (bronchoconstriction)</p>
<p>What are mucus plugs?</p>
<p>- Build up of mucus in airways
- Common after surgery (drugs make you breathe less deeply so normal secretions collect) or in people with CF and asthma</p>
<p>What are chronic obstructive lung diseases important causes of in adults?</p>
<p>1. Sickness absence from work
2. Reduced quality of life
3. Disability and hospital admissions</p>
<p>What are the 4 types of asthma?</p>
<p>1. Associated with allergic reactions
2. Not associated with specific allergens (intrinsic asthma)
3. Exercise induced asthma
4. Associated with COPD</p>
<p>What type of asthma is IgE mediated?</p>
<p>Type 1 - associated with allergic reactions</p>
<p>What are stages in allergen mediated asthma?</p>
<p>1. Antigen crosses epithelium and presented to T helper cells
2. Stimulates B cells to produce IgE
3. IgE antibodies combine with mast cells --> mast cell actication
4. Release of inflammatory mediators by mast cells (histamines)</p>
<p>What is result of inflammatory mediators?</p>
<p>Inflammation of mucosa, swelling of mucosa layer, constriction of smooth muscle --> BRONCHOCONSTRICTION</p>
<p>How can asthma be prevented?</p>
<p>1. Avoidance of antigen
| 2. Non-specific reduction of bronchial hyperactivity</p>
<p>How can non-specific reduction of bronchial hyperactivity be achieved?</p>
<p>1. Stopping cause (stop smoking, lose weight)
| 2. Pharmacological - corticosteroids</p>