Respiratory Tract

Question 1

Receptors act on the lungs

Answer 1

Sympathetic: B2- bronchodilation
Parasympathetic: M3 - bronchoconstriction
Histamine: H1- bronchoconstriction

Question 2

Bronchodilators- indications

Answer 2

Asthma, RAO, COPD, pulmonary edema, allergic bronchitis, pneumonia, pneumothorax

Question 3

Drugs - list

Answer 3

1. sympathomimetics
2. parasympatholytics
3. Inhalational Glucocorticoids
4. chromones
5. Leukotriene antagonists

Question 4

Sympathomimetics

Answer 4

Non specific:
*Andrenaline: B2, only in life threatening cases (e.g anaphylaxis)
*Ephedrine: direct+ indirect
Specific:
*Beta2 agonists: short acting- Salbutamol
Long acting- Terbutalile, Clenbuterole , salmeterole (longest, most specific)

Question 5

Sympathomimetics adverse effect

Answer 5

Minimized in inhalation
B1- tachycardia
B2: skeletal muscle tremor
Vasoconstriction, hypertension

Question 6

Parasympatholytics

Answer 6

Bronchodialation+ dec. Mucus secretion

Atropine , glycopyrrolate, Ipratropium

Question 7

Methylxanthine derivatives

Answer 7

Small TI, PDE inhibitors- bronchodialation, used when beta agonists dont work
Aminophylline, propentophyllin (+vasodolator), pentoxyfilline

SE: nervousness, arrhythmia, GI bleeding, vomiting

Question 8

Inhalational Glucocorticoids

Answer 8

Most effective, inhibits genes of cytokines IL-4 , IL-5 , eosinophil apoptosis

• Beclomethasone - never orally
• Fluticasone - B2 mimetics+steriod

Question 9

Chromones

Answer 9

Mast cell inhibition and degranulation

*Na -chromoglycate , nedocromil

Question 10

Central antitussive

Answer 10

1.Codeine (vs morphine)
Antitussive, SE rare (cat: excitation, convulsions , sedation, constipation)
2.dihydrocodeine
3.hydrocodone
4.buterphanol
5.tramadol
6.dextrometorphan - delta-receptor, non addictive , non-analgestic

Question 11

Mucolytics

Answer 11

1. N-acetyl cysteine: breaks disulphide bonds in mucoproteins. Antidote for paracetamol
2. Carbocystein : similar action, better PO

Question 12

Expectorants

Answer 12

1. Bromhexine: i. dissolve mucus, ii. Inc. serous gl. Secretion. iii. Enhances cillary muscle movement. Used in sinusitis and rhinitis
2. Ambroxol: metabolite of bromohexine
3. Dembrezxin:. Eq: long HL
4. Guafensin: no change in amout of mucus secretion. , Inc. cillary movement, combined with antitussive