Respiratory pharmacology

Question 1

Name the two main groups of asthma medication.

Answer 1

Bronchodilators & Anti-inflammatory drugs.

Question 2

Name 3 groups of bronchodilators.

Answer 2

Beta-2 agonist, anticholinergics & theophylline.

Question 3

Name 4 groups anti-inflammatory drugs.

Answer 3

Steroids, leukotriene antagonist, Anti-IgE & sodium chromoglicate.

Question 4

Name the side effects of Beta2-agonist.

Answer 4

Tachycardia, headache, muscle tremor, blood glucose increase and cardiac arrhythmias.

Question 5

Name two short-acting Beta2-agonist.

Answer 5

Salbutamol & terbutaline.

Question 6

Name two long-acting Beta2-agonist.

Answer 6

Salmeterol & formoterol.

Question 7

What is the mechanism of action of Theophylline?

Answer 7

It inhibits phosphodiesterase, leading to increase in intracellular levels of cAMP and cGMP and it is a competitive antagonist of adenosine A1- and A2-receptors –> contribute to bronchodilatation.

Question 8

What are the side effects of theophylline?

Answer 8

Insomnia, palpitation, tremors, increased urine output, vomiting, anorexia, arrhythmias and seizures.

Question 9

What is the mechanism of action of corticosteriods?

Answer 9

Inhibits formation of inflammatory mediators, reduces recruitment of leucocytes, does not prevent histamine release. Prevent the progression of pathological change in asthma.

Question 10

Name 4 corticosteroid drugs for asthma.

Answer 10

Beclomethasone, Budesonide, Fluticasone and Mometasone.

Question 11

Name a leucotriene receptor antagonist for asthma.

Answer 11

Montelukast

Question 12

Name an anti-IgE drug against asthma.

Answer 12

Omalizumab

Question 13

What is the mechanism of action of sodium cromoglicate?

Answer 13

Stabilizes the mast cells - the release of histamine and other mediators. Inhibits release of mediators from C fibers.

Question 14

Name 2 mucolytic drugs.

Answer 14

Bromhexine/ambrosol & acetylcysteine

Question 15

Name 4 expectorant.

Answer 15

Sodium citrate or acetate, potassium iodide, guaiacol and ammonium salts.

Question 16

Name 3 opioid antitussives.

Answer 16

Codein, Pholcodeine and ethylmorphine.

Question 17

Name 3 nonopioid antitussives.

Answer 17

Noscapine, dextromethorphan and oxeladin.

Question 18

What causes the early phase of asthma?

Answer 18

An allergen or non-specific stimulus activates mast cells to release histamine, prostaglandin D2 and leukotriene B4, which in turn induces bronchoconstriction. Mononuclear cells release IL-4, IL-5, IL-13, macrophages inflammatory protein-1 alpha and TNF.

Question 19

What causes the late phase of asthma?

Answer 19

A massive inflammatory reaction with severe mucosal thickening/eodema and mucus production. Dendritic cells activateTh2 cells, and Th2 activate eosinophils that release cysteinyl leukotrienes, IL-3, Il-5, IL-8 and toxic proteins that damage the mucosa. The exposed nerve ending contribute to the hyperactivity.

Question 20

What are the advantage of inhaling asthma drugs?

Answer 20

Rapid effect, less side effects, poor per oral bioavailability and hepatic first passage metabolism.

Question 21

What is the mechanism of action of Beta2-agonists?

Answer 21

Induces an increase in cAMP and reduction of intracellular calcium in bronchial smooth muscle cells resulting in relaxation.

Question 22

What is the mechanism of action of anticholinergic drug?

Answer 22

Inhibit m3 receptors and effect the mucus secretion and mucociliary clearance.

Question 23

What is the mechanism of action of leukotriene receptor antagonist?

Answer 23

Inhibits leukotriene receptor-1, which has an anti-inflammatory effect and also some bronchodilators effect.

Question 24

Which drugs can trigger an asthma attack?

Answer 24

Aspirin, beta blockers, acetylcholinesterase inhibitors, ACE-inhibitors.

Question 25

With drug can be used to treat COPD?

Answer 25

Roflumilast

Question 26

What is the mechanism of cough?

Answer 26

Stimulation of mechanical-or chemoreceptors –> afferent impulses to cough center –> efferent impulses via parasympathetic & motor nerves to diaphragm, intercostal muscle & lungs –> increased contraction of diagrammatic abdominal & intercostal muscles.

Question 27

What is the mechanism of action of mucolytics?

Answer 27

Break the disulphide bridges between glycoprotein molecules in the mucus.

Question 28

Which drugs are used to treat Rhinitis?

Answer 28

Anti-histaminic H1 blockers.

Question 29

What are the side effects of anti-histaminic H1 blockers?

Answer 29

Drowsiness, mental confusion, sedation, dry mouth, anorexia, epigastric distress, hypotension, tachycardia, urinary retention, dysthymia.

Question 30

Which drug is used to treat nasal congestion?

Answer 30

Alpha -agonist –> Nezeril, otrivin, xylometazoline.