Pharmacology

Question 1

Stimulation of parasympathetic division causes bronchial smooth muscle _____, mediated by __ acting on __ receptors

Answer 1

Contraction, ACh, M3

Question 2

Mucus secretion is increased when parasympathetic division is active. True/False?

Answer 2

True

Question 3

There is no sympathetic innervation of bronchial smooth muscle. True/False?

Answer 3

True

Question 4

Stimulation of sympathetic division causes bronchial smooth muscle _____, mediated by __ released from the ___ ___ acting on __ receptors

Answer 4

Relaxation, adrenaline, adrenal gland, B2

Question 5

Mucus secretion is increased when sympathetic division is active. True/False?

Answer 5

False
Mucus secretion decreases; mucociliary elevator activity increases

Question 6

Asthma is irreversible obstruction of small airways. True/False?

Answer 6

False
It is reversible

Question 7

FEV1 and PEFR increase in asthma sufferers. True/False?

Answer 7

False
They both decrease

Question 8

What causes hypersensitivity of airways in asthma?

Answer 8

Epithelial damage, exposing sensory nerve endings

Question 9

What are the 2 components of an asthma attack?

Answer 9

Initial bronchospasm followed by late inflammation

Question 10

In non-atopic individuals, THo cells mature into TH_ cells

Answer 10

TH1

Question 11

In atopic individuals, THo cells mature into TH_ cells

Answer 11

TH2

Question 12

TH2 suppresses the production of which TH cell?

Answer 12

TH1

Question 13

Which interleukin helps/allows TH2 cells to activate B cells?

Answer 13

IL-4

Question 14

Activated B cells can mature into plasma cells which secrete __ in the allergic response

Answer 14

IgE

Question 15

IgE binds to eosinophils and mast cells via which receptor?

Answer 15

FcE

Question 16

When mast cells are activated, which substances do they release?

Answer 16

Histamine
Chemokines
Leukotrienes

Question 17

Relievers act as anti-inflammatory agents. True/False?

Answer 17

False
They are bronchodilators used for acute attacks

Question 18

Name the 3 main types of relievers used in asthma

Answer 18

SABAs, LABAs, CysLT antagonists

Question 19

Name controllers/preventers used in asthma

Answer 19

Glucocorticoids, chromoglicate

Question 20

Give an example of a SABA

Answer 20

Salbutamol

Question 21

SABAs are usally administered via the _____ route. Why?

Answer 21

Inhalational
Reduces systemic effects

Question 22

Give an example of a LABA

Answer 22

Salmeterol

Question 23

LABAs are recommended for acute relief of bronchospasm. True/False

Answer 23

False
They are slow to act

Question 24

LABAs can be used as a monotherapy. True/False?

Answer 24

False
They would desensitise receptors

Question 25

CysLT1 receptor activation causes bronchodilation. True/False?

Answer 25

False Causes bronchoconstriction and inflammation

Question 26

Give an example of a CysLT antagonist?

Answer 26

Montelukast Zafirlukast

Question 27

CysLT antagonists are less potent than salbutamol in acute asthma. True/False?

Answer 27

True

Question 28

How are CysLT antagonists administered (which route)?

Answer 28

Oral

Question 29

Give an example of a Xanthine?

Answer 29

Theophylline Aminophylline

Question 30

Xanthines have little adverse effects. True/False?

Answer 30

False Nausea, vomiting, headache are some of the side effects

Question 31

What are the 2 main classes of corticosteroid released by the adrenal cortex?

Answer 31

Glucocorticoids Mineralocorticoids

Question 32

What is the effect of cortisol on inflammatory responses?

Answer 32

Decreases them

Question 33

What is the effect of cortisol on gluconeogenesis?

Answer 33

Increases it

Question 34

What is the function of mineralocorticoids?

Answer 34

Regulate salt and water retention by the kidney

Question 35

Glucocorticoids have good bronchodilator action. True/False?

Answer 35

False

Question 36

How do glucocorticoids enter cells?

Answer 36

Diffusion - they are lipophilic

Question 37

Glucocorticoids combine with GRa which causes dissociation of which class of proteins?

Answer 37

HSP (heat shock proteins)

Question 38

Glucocorticoids stimulate production of proteins which suppress inflammation. True/False?

Answer 38

True Also decrease production of proteins which stimulate inflammation

Question 39

Give an example of a glucocorticoid used in asthma and its adverse effects

Answer 39

Inhaled beclomethasone Hoarse voice + oral thrush Also oral prednisolone in combination for severe asthma

Question 40

COPD can be divided into which 2 disease states?

Answer 40

Chronic bronchitis Emphysema

Question 41

Describe chronic bronchitis and its symptoms

Answer 41

Inflammation of bronchi + bronchioles Causes cough + purulent sputum

Question 42

Describe emphysema and its symptoms

Answer 42

Collapse of alveoli, decreasing SA available for gas exchange Breathlessness

Question 43

Give an example of a SAMA

Answer 43

Ipratropium

Question 44

Give an example of a LAMA

Answer 44

Tiotropium

Question 45

Ipratropium is a selective blocker of M3 receptors. True/False?

Answer 45

False Tiotropium is a selective blocker of M3; ipratropium is non-selective

Question 46

What is Indacaterol?

Answer 46

An "ultra-LABA" which has rapid onset of action (vs salmeterol)

Question 47

A combination of LABA + LAMA is not recommended. True/False?

Answer 47

False This combination is superior to using each drug alone in increasing FEV1

Question 48

What is rhinitis and its symptoms?

Answer 48

Inflammation of nasal mucosa Typically rhinorrhoea, sneezing, itching, nasal congestion

Question 49

What is non-allergic rhinitis and its causes?

Answer 49

Rhinitis not involving IgE Infection, drug-induced, hormonal, idiopathic

Question 50

List drug classes that can be used for rhinitis

Answer 50

Glucocorticoids H1 and cysLT1 receptor antagonists Sodium chromoglicate

Question 51

Mechanism of action of H1 receptor antagonists Examples

Answer 51

Reduce effects of histamine released from mast cells Given orally or nasal spray Loratidine, fexofenadine, cetirizine

Question 52

Mechanism of action of sodium chromoglicate

Answer 52

Mast cell stabilisation Nasal spray, usually better for children