L08: Drugs Affecting Airway Resistance

Question 1

What happens to resistance as radius decreases

Answer 1

Resistance increases

Question 2

Does the Lower or upper airway have the greatest airway resistance

Answer 2

Upper airway

Question 3

Why does the lower airway have the least resistance when the radius is smaller than the upper airway

Answer 3

The lower airway has a larger cross sectional area

Question 4

Which nervous system controls the smooth muscle in the airway

Answer 4

Autonomic nervous system

Question 5

Which two systems is the autonomic system composed of

Answer 5

Sympathetic

Parasympathetic

Question 6

What does the parasympathetic nervous system cause the airways to do

Answer 6

Bronchoconstriction

Question 7

What does the sympathetic nervous system cause the airway to do

Answer 7

Bronchodilation

Question 8

What are the neurotransmitters involved in the parasympathetic nervous system

Answer 8

Ach

Question 9

Which receptor does ach act on in the airway

Answer 9

M3 receptor

Question 10

What neurotransmitter does the sympathetic nervous system release

Answer 10

Adrenaline or noradrenaline

Question 11

Which receptor does adrenaline act on in the airway

Answer 11

Beta 2 receptors

Question 12

What does beta 2 stimulation inhibit

Answer 12

Mast cell activity

Question 13

What do mast cells release

Answer 13

Bronchoconstrictors of histamine and platelets

Question 14

What does beta 2 stimulation promote

Answer 14

Muscle-ciliary escalator

Question 15

What is the purpose of the musco-ciliary escalator

Answer 15

Move foreign particles out

Question 16

What other innervation does the airways have

Answer 16

NANC

Question 17

What does NANC innervation result in

Answer 17

Bronchodilation or bronchoconstriction

Question 18

Where are mast cells found

Answer 18

Airway walls

Question 19

What doe mast cells cause

Answer 19

Degranulation of mast cells release histamine which causes bronchoconstriction

Question 20

Name 2 mechanical receptors found in the airway

Answer 20

Rapidly adapting receptors

Slowly adapting pulmonary stretch receptors

Question 21

What does RAAR receptors cause

Answer 21

Bronchoconstriction

Question 22

What does PSR cause

Answer 22

Bronchodilation

Question 23

What occurs when carbon dioxide builds up in the lungs

Answer 23

Bronchodilation

Question 24

Does airway resistance increase or decrease when lung volume increases

Answer 24

Decrease

Question 25

Give 2 reasons why airway resistance decreases as lung volume increases

Answer 25

Radial traction | Alveolar interdependence

Question 26

Explain what is meant by radial traction

Answer 26

1) airways are embedded in lung parenchyma which form scaffolds 2) scaffolds opens airway due to radial traction 3) during inspiration parenchyma is stretches and increases the radius of the airways 4) increase in radius decreases airway resistance

Question 27

What is meant by alveolar interdependence

Answer 27

1) adjacent alveoli share walls together which keep them open 2) this reduces airway resistance

Question 28

Why does COPD present with airway resistance

Answer 28

Loss of radial traction | Loss of alveolar interdependence

Question 29

What happens in asthma

Answer 29

Airway diameter decreases | Airway resistance increases

Question 30

How does asthma occur

Answer 30

1) patients have bronchial hypersensitivity which causes inflammation of airway mucosa 2) mucosa is infiltrated with immune cells 3) asthma attack causes immune cells to release mediators of bronchoconstriction

Question 31

What are the two general ways to treat asthma

Answer 31

Target bronchoconstrictors | Target inflammatory responce

Question 32

Name 4 groups of drugs that target bronchoconstrictors

Answer 32

Beta 2 agonist Methyxanthines Anti-cholinergics/muscarinic antagonist

Question 33

Name 2 beta agonist

Answer 33

Salbutamol | Sameterol

Question 34

How do beta 2 agonist work

Answer 34

Stimulate beta 2 receptors to cause bronchodilation

Question 35

How does methylxanthines work

Answer 35

Inhibit phosphodiesterase This increases camp This alters calcium Bronchodilation occurs

Question 36

Name an example of a methylxanthine

Answer 36

Theophylline

Question 37

What is the mechanism of action of anti-cholinergic/muscarinic antagonist

Answer 37

Block ach from biding to M3 receptors | This stops bronchoconstricton from occuring

Question 38

Name an example of an anti-cholineric/muscarinic antagonist drug

Answer 38

Ipratropium

Question 39

Name 5 ways of treatment to target inflammation in asthma

Answer 39

``` Corticosteroids Targeting leukotriene pathway Sodium cromoglicate Histamine receptor antagonist Monoclonal anti-igE antibodies ```

Question 40

What is the mechanism of action of corticosteroids

Answer 40

Reduce airways inflammation

Question 41

Name an example of a corticosteroid

Answer 41

Beclamethasone

Question 42

What is the mechanism for targeting leukotriene pathway

Answer 42

Mast cells release leukotriene Leukotriene cause bronchoconstriction and other inflammatory responses Inhibiting leukotriene stops this from occuring

Question 43

Name 2 ways to inhibit leukotriene

Answer 43

Inhibit leukotriene formation | Inhibit leukotriene from acting on its receptor

Question 44

Name a leukotriene formation antagonist

Answer 44

Zileuton

Question 45

Name a leukotriene receptor antagonist

Answer 45

Montelukast

Question 46

What is the mechanism of action of sodium cromoglicate

Answer 46

Inhibits release of inflammatory mediators from mast cells

Question 47

Describe the mechanism of action of histamine receptor antagonist

Answer 47

Mast cell degranulation releases histamine Histamine causes inflammatory response Histamine receptor antagonist stop histamine from acting on its receptor

Question 48

Name a histamine receptor antagonist

Answer 48

Ketotifen

Question 49

What is the name of histamine receptor that ketotifen works on

Answer 49

H1

Question 50

What is the mechanism of action of anti-igE antibodies

Answer 50

B cell produces igE in allergens IgE binds to mast cells to cause mast cell degranulation of inflammation Stopping igE from binding to mast cells reduces inflammation

Question 51

Name a monoclonal anti-igE antibody

Answer 51

Omalizumab

Question 52

What is aspirin induced asthma

Answer 52

Asthma exacebated by aspirin (painkiller)

Question 53

What are the symptoms of aspirin induced asthma

Answer 53

Runny nose Nasal congestion Sinusitis

Question 54

What is the treatment for aspirin induced asthma

Answer 54

Montelukast

Question 55

Which transmitters cause bronchodilation in NANC innervation

Answer 55

VIP | NO

Question 56

Which transmitter causes bronchoconstriction in NANC innervation

Answer 56

Substance p

Question 57

Is a corticosteroid a preventer or treatment in asthma

Answer 57

Preventer

Question 58

Why does bronchoconstriction occur in asthma

Answer 58

Due to inflammation