08.14 - ANS and Bronchial Tone (Sweatman) - Questions Flashcards Preview

Pulmonology > 08.14 - ANS and Bronchial Tone (Sweatman) - Questions > Flashcards

Flashcards in 08.14 - ANS and Bronchial Tone (Sweatman) - Questions Deck (41):
1

Clinically, both ___ agonists and ___ antagonists are used to control bronchospasm

B2 agonists, Muscarinic Antagonists

2

Adrenergic receptors in the lung are found in

Airway SM, Epithelial Cells, Mast Cells, Type 2 alveolar cells

3

T/F: The SNS has no direct neural connection to bronchial SM

TRUE

4

How does SNS modulate bronchial SM tone

Modulate PNS, via hetero-receptors

5

Permeability advantages of lung drug delivery

More permeable to macromolecules than other; Most permeable to small molecules than GI tract

6

The less ionized a molecule, the __ it's absorption rate

Faster - Fewer interactions with proteins and lipids that line the pore

7

What type of compounds can "dissove" in the lipid bilayer and rapidly be absorbed transcellular

Lipophilic

8

How do insoluble compounds traverse lung epithelium

Paracellular - Aqueous pores in intercellular tight junctions

9

What determes rate at which molecules pass through lung epithelium

MW and Degree of Ionization, and Lipophilicity

10

How does ionization affect absoprtion rate

Less ionized is absorbed more rapidly

11

Blockade of M2 Auto-receptors ___

increases release of endogenous ACh

12

Paradoxical actions of Atropine, Ipratropium

Decr bronchial SM tone via M3 blockade; But blocking M2 auto-recetpors actually increases release of enodgenous ACh --> bronchial SM contraction

13

M1 Receptor Locations

PG membrane; Nasal mucosa

14

Locations of M2 receptors

Inhibitory autoreceptors on pre-synaptic membrane of PG fibers; Bronchial SM

15

Selectivity of Atropine, Ipratopium

Non-selective: M2 and M3

16

Selectivity of Tiotropium

Functional selectivity for M1 and M3 receptors

17

Tiotropium

Functional selectivity for M1 and M3 receptors

18

Most pervasive group with anticholinergic "side effects"

1st generation antihistamines

19

Effect of Anticholinergics on secretions

Dry secretions

20

Effect of Acetylcholinesterase inhibitors on secretions

Increase

21

Which phase of atopic asthmatic response is Albuterol effective in?

Early (bronchospastic), not Late (Inflammatory)

22

How might B2 agonists produce bronchoconstriction

Increasing PNS Tone

23

Goblet Cells and Submucosal Glands receive primarily __ innervation

PNS

24

Beta agonist effect on mucociliary clearance

Increase glycoportein composition; Incr cilia beat freq -> incr clearance

25

Beta agonist effect on Vascular Endothelial Permeability

Decr microvascular leakage, Decr airways obstruction in asthma

26

At high concentrations, B2 agonists produce (2):

CV stimulatory effects; QT prolongation (esp in hypoK)

27

How does B2 agonism affect QT prolongation

Stimulation of Na/K pump decr serum K --> Hypokalemia --> Worsening QT prolongation

28

Patients with whtat type of problems should be cautions with B2-agonists

Cardiovascular

29

3 drug classes that also promote hypokalemia

Saquinavir; Loop and Thiazide Diuretics; Non-specific Beta Blockers

30

Why should asthmatics not take beta-blockers

Can't treat with B2 Agonists

31

Beta-agonists activate G-proteins, which stimulate __

Adenylyl Cyclase

32

Beta-Arrestin

Binds to phosphorylated domain on B-adrenergic receptor and blocks Gs binding -> Thereby decr AC activity; Endosomal localization

33

M1 is coupled to what g protein

Gq

34

M3 is coupled to what g protein

Gq

35

M2 is coupled to what g protein

Inhibitory action via Gi/o

36

Beta2 agonists activate what g protein

Gs

37

Repeated stimulation of beta adrenergic receptor results in

Phosphorylation --> Beta-arrestin --> internalization

38

Corticosteroid effect on b2 receptors

Transcriptional upregulation of beta-2 receptors

39

4 off-target Beta2 actions

Cardiostimulation, Muscle Fasciculation, Hypokalemia (QT prolongation)

40

B2agonist activity is exacerbated by

Metabolism inhibitors

41

How can you restore beta 2 receptor density

Corticosteroid transcriptional upregulation