Tutorial: Respiratory Disease

Question 1

How is Adrenaline release/production from the adrenal medulla stimmulated?

Answer 1

Via SNS release of ACh binding to a Nicotinic ACh receptor on the Adrenal medulla

Question 2

Which two types of nicotinic receptors are there?

Answer 2

1. Ganglionic Nicotinic receptors
2. Tissue type (NMJ)

Question 3

What is airway resistance and which factors contribute to airway resistance in men?

Answer 3

Resistance= required pressure to generate a flow, mainly altered by

• airway lumen (fibrosis, constriction, brochosecretion

Question 4

Why does smoking lead to constriction of the airway?

Answer 4

Smokint activates the PNS to keep out toxins –> constriction

Question 5

Administration of a muscarenic antagonist has many centralised side effects.

How couly you limit these side effects when you only want to achive bronchodilation?

Answer 5

• OA–> inhaler –> local administration–> low dose
• Rate of absorption= relatively slow absorption –> increase polarity (NH4+-group)
• Speed of metabolism= rapid metabolism (but has then worse effect as drug in treatment of airway disease)

Question 6

Why do antihistamine tablets don’t work in astmah?

Answer 6

Histamine is only one of many bronchoconstrictors in the airways – the percentage contribution of histamine to the overall bronchoconstriction is too small for its blockade to give a clinically useful bronchodilator effect

Question 7

Which mediators contribute to astmatic bronchoconstriction?

Answer 7

Many mediators e.g.

1. Prostanoids,
2. leukotrienes,
3. bradykinin

Question 8

Why should an astmathic patient avoid NSAIDs?

Answer 8

More Leukotrienes produced due to accumulation of Arachidonic acid (COX inhibition) leading to an increase in bronchospasm

Question 9

Which options of analgesia could you offer to someone that can’t take NSAIDs? (e.g. astmathics)

Answer 9

1. Paracetamol
2. low dose-opioids