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PHA321 > Respiratory System Pharmacology > Flashcards

Respiratory System Pharmacology Flashcards

1
Q

Parasympathetic stimulation of airway smooth muscle via muscarinic M3 receptors causes…

A

Constriction of airways.

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2
Q

How do the alveoli get rid of dust and debris without cilia?

A

They contain phagocytic cells

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3
Q

Treatment of pulmonary embolism is with…

A

…anticoagulant medication.

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4
Q

Examples of URT diseases

A

Sinusitis
Tonsilitis
Laryngitis
Allergic rhinitis
Cough

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5
Q

What are the mediators of the cough reflex

A

Cough reflex is via both the afferent and efferent nerves (i.e. involving the central and peripheral nervous systems), as well as the smooth muscles of the bronchial tree.

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6
Q

Types of antitussives

A

Centrally-acting
Peripherally-acting

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7
Q

Types of centrally-acting antitussives

A

Narcotics
Non-narcotics

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8
Q

Examples of narcotics used as antitussives

A

Codeine, Pholcodeine, Hydrocodone, Morphine.
Opioid derivatives like Dextromethorphan, Levopropozyphene, Noscapine

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9
Q

Examples of non-narcotics used as antitussives

A

Benzonatate, dimemorfan, benproperine, first generation Antihistamines e.g. diphenhydramine

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10
Q

Examples of peripherally-acting antitussives

A

Diphenhydramine, Benzonatate

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11
Q

Antitussives MOA

A

Centrally:
- Depressing the medullary centre or associated higher centres.
- Increase threshold of cough centre
Peripherally:
- Interrupt tussal impulses in the respiratory tract.
- Inhibit conduction along motor pathways.

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12
Q

Pharmacological action of expectorants

A

aka Mucokinetics, they make cough more productive by loosening and liquefying bronchial secretions

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13
Q

Reflexly-acting mucokinetics examples

A

a. Ipecacuanha
b. Ammonium chloride
c. Potassium iodide

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14
Q

Directly-acting mucokinetics examples

A

Guaiphenesin

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15
Q

Pharmacological action of mucolytics

A

Break down thick mucus, making it thinner and easier to cough out. Split disulphide bonds in mucoprotein present in sputum and reduces its viscosity.

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16
Q

Examples of demulcents

A

Liquorice, Glycerin, Lozenges

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16
Q

Examples of mucolytics

A

Acetylcysteine
Carbocysteine
Methylcysteine

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17
Q

Lower respiratory tract disorders include

A

Infections
Restrictive pulmonary disorders Obstructive pulmonary disorders Lung cancer.

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18
Q

‘A nonproductive cough turns into a deep cough that will expectorate mucus and sometimes pus’ describes which condition?

A

Acute bronchitis

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19
Q

Risk factors for asthma

A

Genetic
Environmental

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20
Q

Genetic risk factors for asthma

A

Atropy
Gender
Race/ethnicity

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21
Q

Environmental risk factors for asthma

A

Smoking
Allergens
Occupational sensitizers
Respiratory infections
Parasitic infections
Perinatal risk factors
Diet and nutrition

22
Q

Asthma symptoms

A

Cough
Wheezing
Shortness of breath
Chest tightness

23
Q

Phases of allergic induction in asthma

A
  1. Induction of allergic reaction involving antigen uptake, processing and presentation
  2. Early-phase asthmatic reaction (EAR),
  3. Late-phase asthmatic reactions (LAR), and
  4. Chronic allergic inflammation.
24
Q

Which acute signs and symptoms are associated with EAR

A
  • Mild rhinitis
  • Anaphylactic shock
  • Vasodilation
  • Contraction of the bronchial smooth muscle (producing airflow obstruction and wheezing)
  • Increased mucus secretion (exacerbating airflow obstruction in the lower airways).
25
Q

Granule basic proteins synthesised by eosinophils

A
  • Major basic proteins (MBP)
  • Eosinophil cationic protein (ECP)
  • Eosinophil peroxidase (EPO)
  • Eosinophil-derived neurotoxin (EDN)
26
Q

Lipid mediators generated by eosinophils

A

Prostaglandins and cysteinyl leukotrienes)

27
Q

Cytokines produced by eosinophils

A

Tumour necrosis factor and transforming growth factor beta (TNF, TGF-β), IL-4 and IL-13 and chemokines.

28
Q

Cytokines produced by eosinophils

A

Tumour necrosis factor and transforming growth factor beta (TNF, TGF-β), IL-4 and IL-13 and chemokines.

29
Q

Categories of Asthma

A
  1. Mild intermittent (occasional attacks)
  2. Mild persistent (> 2 attacks/week)
  3. Moderate persistent (daily attacks)
  4. Severe persistent
30
Q

Classes of drugs used for asthma treatment

A

Bronchodilators
Corticosteroids
Mediator antagonists
Mast cell stabilizers
Anti-IgE antibody

31
Q

Types of bronchodilators

A

Sympathomimetics-β2-receptor agonists
Xanthine derivatives
Anticholinergic drugs
Monoclonal antibodies
Prophylactic agents

32
Q

Examples of Sympathomimetics-β2-receptor agonists

A

i. Short-acting: salbutamol, pirbuterol, terbutaline

ii. Long-acting: salmeterol, formoterol
33
Q

Examples of Xanthine derivatives

A

Theophylline (water insoluble)
Theophylline + Ethylene Di-Amine = Aminophylline

34
Q

Anticholinergic drugs examples

A

Short-acting: ipratropium
Long-acting: tiotropium

35
Q

Anti-inflammatory drugs

A

Corticosteroids
Systemic drugs

36
Q

Corticosteroids examples

A

Corticosteroids:
1. Topical/inhalation:
- betamethasone
- beclomethasone
2. Systemic:
- oral: predisone, prednisolone
- i.v: hydrocortisone

37
Q

Example of monoclonal antibodies

A

Omalizumab

38
Q

Classes of prophylactic agents

A

Mast cell stabilisers
Mediator antagonists
Leukotriene pathway inhibitors

39
Q

Examples of mast-cell stabilizers

A

i. Cromones: Na cromoglycate, Nedocromil Na
ii. Ketotifen

40
Q

Examples of antihistamines

A

Azelastine, cetirizine

41
Q

Leukotriene pathway inhibitors

A
  • 5-lipoxygenase enzyme inhibitor
  • Leukotriene-receptor antagonists
42
Q

Examples of 5-lipoxygenase enzyme inhibitors

A

Zileuton

43
Q

Mild intermittent asthma treatment

A

Use short-acting inhaled β2-adrenoceptor agonists

44
Q

Moderate persistent asthma treatment

A

inhaled steroids + long-acting bronchodilator; antileukotriene drug

45
Q

Severe persistent asthma treatment

A

high dose inhaled steroids; oral steroids and if very severe give i.v steroids + bronchodilator. Very severe (status asthmaticus) will require hospitalization and oxygen gas.

46
Q

Among the symptoms of COPD are:

A

cough, wheeze, excessive secretion, shortness of breath, chest tightness.

47
Q

What causes breathing difficulties in COPD

A
  1. the airways and air sacs lose their elastic quality.
  2. the walls between many of the air sacs are destroyed.
  3. the walls of the airways become thick and inflamed.
  4. the airways produce more mucus than usual, which can clog them.
48
Q

Pharmacological action of analeptics

A

They antagonize drug-induced depression of the central nervous system. They act primarily on the medullary center and stimulate the central nervous system, which act to increase the action of the respiratory system

49
Q

How are analeptics used?

A
  • Acute exacerbations of chronic lung diseases with hypercapnia, drowsiness and inability to cough.
  • Apnea in premature infants.
  • Obesity-hypoventilation syndrome.
  • In some patients with COPD and alveolar hypoventilation.
50
Q

Examples of clinically used analeptics

A

Doxapram and Amphifinazole

51
Q

Clinical uses of doxapram

A

For treating respiratory depression in patients who have taken excessive doses of drugs such as buprenorphine (an opioid for treating opioid addiction and pain), which may fail to respond adequately to treatment with naloxone.

52
Q

Other analeptics:

A
  • Picrotoxin
  • Biccuculline
  • Strychnine
  • Pentylenetetrazol (leptazol)
  • Nikethamide

PHA321 (12 decks)

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