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Cardiovascular Respiratory and Renal Pharmacology > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

What does gas flow equal?

A

Pressure gradient divided by resistance

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2
Q

How thick is the respiratory membrane?

A

0.5- 1 micrometres thick- efficient gaseous exchange

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3
Q

What does pneumonia do to membrane?

A

Increases thickness

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4
Q

What does carbonic anhydrase catalyses?

A

The reaction between carbon dioxide and water to form carbonic acid

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5
Q

What does the chloride shift do?

A

HC03 moves out of the red blood cellars Cl- ions move in, to balance the ion exchange

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6
Q

What regions of the brain regulates breathing?

A

reticular formation: medulla and pons

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7
Q

What are the key physiological features of chronic obstructive pulmonary diseases?

A

Irreversible decrease in ability of lungs to force out air

80% sufferers have a history of smoking

Dispnea- difficult or laboured breathing (air hunger) that gets progressively worse

Coughing and frequent pulmonary infections

Development of respiratory failure manifesting as hypoventilation, respiratory acidosis and hypoxemia

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8
Q

What is COPD linked to?

A

Emphysema
Chronic bronchitis
Asthma

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9
Q

What does emphysema cause?

A

Permanent enlargement of the alveoli

Destruction of the alveolar walls

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10
Q

What must be enlisted to breathe due to emphysema?

A

Accessory muscles leading to fatigue

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11
Q

How much of total energy is required for breathing if a individual has emphysema as oppose to being healthy?

A

15-20% total energy as oppose to 5% in healthy individuals

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12
Q

What happens to the bronchioles during breathing with emphysema?

A

They open during inspiration but collapse during expiration, trapping air in the alveoli

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13
Q

What causes the left ventricle of the heart to enlarge in emphysema?

A

Damage to pulmonary capillaries as alveolar walls disintegrate

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14
Q

What causes chronic bronchitis?

A

Inhaled irritants lead to chronic production of excessive mucus.
Mucosae of the lower respiratory passageway becomes inflamed and fibrosed.

Obstructs airway

Increases pulmonary infections.

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15
Q

What are the two types oaf patients who have COPD?

A
  1. ‘Pink Puffer’- loose weight due to increased effort in maintaining adequate ventilation
  2. ‘Blue Boaters’- stocky build, becoming hypoxicconstriction of pulmonary blood vessels leading to pulmonary hypertension and right sided heart failure
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16
Q

What are treatments of COPD?

A

Bronchodilators

Corticosteroids

Surgery- removal of enlarged part of lung to allow greater expansion of remaining lung tissue

Oxygen- (use with caution) dilates pulmonary arteries and drives more CO2 form Hb into alveoli from where it cannot be removed

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17
Q

What is asthma characterised by?

A

Coughing, dyspnea, wheezing and chest tightness.

Sense of panic for acute attacks

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18
Q

What is the cause of asthma?

A

Immune response associated inflammation of the lungs

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19
Q

What is the treatments of asthma?

A

bronchodilators and inhaled corticosteroids

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20
Q

What is Tuberculosis caused by?

A

Infectious disease caused by the bacterium Mycobacterium tuberculosis

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21
Q

What is TB spread by?

A

Coughing and spread by inhaled air

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22
Q

When are symptoms of TB apparent?

A

When immunity is reduced

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23
Q

What are symptoms of TB?

A

Fever, night sweats, weight loss, racking cough, coughing up blood

24
Q

What causes lung cancer?

A

90% cases from smoking

25
Q

When do sufferers usually die from diagnosis?

A

Within one year of diagnosis

26
Q

What are the three common types of lung cancer?

A

Adenocarcinoma

Squamous cell carcinoma

Small cell carcinoma

27
Q

Where does Adenocarcinoma develop?

A

develops from bronchial glands and alveolar cells

28
Q

Where does Squamous cell carcinoma develop?

A

develops from epithelium of the bronchi

29
Q

Where does small cell carcinoma develop?

A

develop from the main bronchi and grow aggressively

30
Q

What are the specific causes of asthma?

A

Immune dysfunction, allergen crosslinks with IgE bound mast cell membrane receptors and causes mast cell degranulation

31
Q

What are advantages of drugs delivered to the lungs by inhalation?

A

Direct delivery to the lungs

Smaller doses- reduce side effects

Rapid onset of action

32
Q

What is the optimum particle size for drug delivery to the lungs?

A

2-5 micrometers

33
Q

What happens to particles smaller than 1 micrometer?

A

Will not reach lower respiratory tract

34
Q

What happens to particles larger than 10 micrometers?

A

Will be swallowed

35
Q

What are pressurised metered dose inhalers and what is used as the propellant?

A

Most common for delivery of bronchodilators and anti-inflammatory drugs

Uses hydrofluoroalkane as a propellant

36
Q

What is the spacer on the pressurised metered dose inhaler for?

A

A plastic reservoir acts as a chamber

Removes need to co-ordinate inhalation

37
Q

What are the features of breath actuated metered dose inhaler?

A

Activated by inspiration

Needs flow rate of 30L/min to discharge

Can deliver an aerosol or dry powder

38
Q

How does dry powder inhalers work?

A

Inspiration generated turbulence resulting in dispersion of the drug

39
Q

What does nebulisers do?

A

Delivers drug from a reservoir solution

10 times as much drug is required to produced the effect of a metered dose device

40
Q

What are examples of short,long, and ultra long acting beta 2 adrenoceptor agonist?

A

Short acting: sabutamol, terbutaline

Long acting: formoterol, salmeterol

Ultra long acting: indacaterol

41
Q

What is the mechanism of action of beta 2 adrenoceptor agonists?

A

Beta2 adrenoceptors are expressed highly in the bronchial smooth muscle

Stimulation stabilises receptor in its active form

Causes an increase in cAMP and thus PKA leading to regulation of muscle tone

Bronchodilation is due to reduced Ca2+ release from intracellular stores

42
Q

What are examples of antimuscarinic agents?

A

Ipratropium, tiotropium

43
Q

What is the mechanism of action of antimuscarinic agents?

A

Cells of respiratory system have nicotinic and muscarinic surface receptors.
M3 receptors mediate bronchoconstriction and enhance mucociliary clearance; via a PKC and IP3 pathway

M2 receptors inhibit ciliary activity as well as bronchodilation by inhibiting adenylyl cyclase

44
Q

What are examples of methylxanthines?

A

aminophylline, theophylline

45
Q

What is the mechanism of action of methylxanthines?

A

Found in coffee, tea, chocolate
Vasodilatory, anti-inflammatory, immunomodulatory actions

Inhibit enzyme phosphodiesterase (PDE).

46
Q

What are examples of corticosteroids?

A

beclometasone dipropionate, budesonide, fluticasone

47
Q

What is the mechanism of action of corticosteroids?

A

Supress inflammation and the immune response

48
Q

What is a cough for?

A

Protective mechanism that removes excessive mucus

Triggered by receptors located in the epithelial surface of the airway mucosa

49
Q

Where are receptors located in response to a cough reflex?

A

Pharynx, trachea, bronchi and bronchioles

50
Q

What are the afferents nerves involved in a cough reflex?

A

Vague and glossopharyngeal nerves

51
Q

What is the cough centre?

A

medulla

52
Q

What are the efferents nerves in a cough reflex?

A

Vague, phoenix and spinal motor nerves

53
Q

What are the effector muscles in a cough reflex?

A

Glottis, external intercostal, diaphragm

54
Q

What are the treatments for a cough?

A 
Antitussive:
Centrally acting (opioid)

And

Peripherally acting

55
Q

What do centrally acting opioid do?

A

Increase threshold for stimulation

56
Q

What are peripherally acting antitussives and what do they do?

A 
Local anaesthetics (lidocain)
Antihistamines to reduce post-nasal drip from allergic rhinitis, which can stimulate cough

Cardiovascular Respiratory and Renal Pharmacology (2 decks)

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