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342 > treatments for the respiratory system > Flashcards

treatments for the respiratory system Flashcards

1
Q

what is asthma charcterised by

A

airway obstruction

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2
Q

in context to asthma, what is airway obstruction caused by (2)

A

hyper responsive airway smooth muscle
airway inflammation

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3
Q

what can airway hyper responsiveness be triggered by (4)

A

allergens
cold air
excercise
emotional stress

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4
Q

what does exposure to stimuli result in

A

release of pro-inflammatory proteins

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5
Q

what are symptoms of asthma (4)

A

difficulty breathing
shortness of breath
wheezing
coughing

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6
Q

what drugs are used to treat asthma (2)

A

anti inflammatory drugs
bronchodilators

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7
Q

what drugs can patients with asthma benefit from

A

corticosteroids (type of glucocorticoid)

ideal as asthma is inflammatory

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8
Q

how to minimise off target effects from corticosteroids

A

inhaled corticosteroids (ICSs)

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9
Q

examples of inhaled corticosteroids (3)

A

fluticasone
budesonide
beclomethasone

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10
Q

are inhaled corticosteroids useful for long or short term asthma attack prevention

A

long term

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11
Q

how are inhaled corticosteroids administered and why

A

spacer device e.g. AeroChamber

dec. amount of drug deposited from mouth and upper airways

facilitates delivery of ICSs to bronchioles

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12
Q

what occurs when corticosteroids are inhaled

A

diffuse across cell membrane, bind to glucocortioid receptors in cell cytoplasm

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13
Q

what are glucocorticoid receptors (GRs)

A

type of nuclear receptor

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14
Q

what are nuclear receptors

A

sense steroid and thyroid hormones

bind directly to DNA and regulate expression genes

are thus classified as transcription factors

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15
Q

what occurs once glucocorticoid receptors (GRs) are activated

A

in cell cytoplasm form homodimer

translocate into nucleus and produce effect

the glucocorticoid receptors interact with the glucocorticoid response element (GRE) in the promoter region of steroid responsive genes

this switches on (sometimes off) gene transciption

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16
Q

examples of genes activated by inhaled corticosteroids (ICSs) (2)

A

β2-adrenergic receptors

Anti-inflammatory proteins

17
Q

examples of anti inflammatory proteins

A

secretory leukoprotease inhibitor

mitogen activated protein kinase phosphatase-1 (MKP-1)

18
Q

what does mitogen activated protein kinase phosphatase-1 (MKP-1) do

A

inhibit MAP kinase pathways which promotes mucus production to obstruct airways

19
Q

what occurs when glucocorticoid receptors (GRs) interact with negative glucocorticoid response element (GRE)

A

may suppress gene transcription

may be important in mediating side effects associated with ICS use

20
Q

when glucocorticoid receptors (GRs) interact with negative glucocorticoid response element (GRE) gene transcription may be suppressed. this may be important in mediating side effects associated with ICS use. what is an example of this?

A

corticosteroids inhibit the expression of osteocalcin that is involved in bone synthesis

21
Q

what is the major action of corticosteroids

A

to switch off multiple activated inflammatory genes that encode for pro-inflammatory mediators e.g. cytokines

22
Q

corticosteroids switch off multiple activated inflammatory genes that encode for pro-inflammatory mediators e.g. cytokines. how are these genes switched on in airways?

A

by proinflammatory transcription factors e.g. nuclear factor-κB (NF-κB)

interact with coactivator molecules like CREB-binding protein (CBP)

23
Q

what is an example of a proinflammatory transcription factor

A

nuclear factor-κB (NF-κB)

24
Q

Corticosteroid-activated glucocorticoid receptors (GR) interact with coactivator molecules such as CREB-binding protein (CBP) and this inhibits the action of ____ with coactivators

A

NF-κB

25
Q

Corticosteroid-activated glucocorticoid receptors (GR) interact with coactivator molecules such as ____ and this inhibits the action of NF-κB with coactivators

A

CREB-binding protein (CBP)

26
Q

ICSs only inhibit inflammation when____

A

it is activated through proteins such as NF-κB

27
Q

what are bronchodilators

A

dilates bronchi and bronchioles to decrease airway resistance in and increase airflow to lungs

28
Q

what are the three main drug classes of bronchodilators

A

Short-Acting β2-agonists (SABA) aka ‘Reliever inhalers’

Long-Acting β2-agonists (LABA) aka ‘Preventer inhalers’

Muscarinic acetylcholine receptor antagonists, also called short - acting muscarinic antagonists (SAMA)
29
Q

what is an example of a Short-Acting β2-agonist (SABA)

A

salbutamol

30
Q

mechanism of action of Short-Acting β2-agonists (SABA)

A

SABAs bind to β2-adrenergic receptors (β2-AR) in the lower respiratory tract

β2-AR stimulates cyclic adenosine monophosphate (cAMP) production

cAMP activates protein kinase A (PKA)

cAMP and PKA both cause airway muscle relaxation

31
Q
A

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