Pharmacology

Question 1

where in the parasympathetic system located in the respiratory system?

Answer 1

walls of the bronchi and bronchioles

Question 2

parasympathetic signalling pathway in the lungs

Answer 2

ACh on M3 muscarinic receptors (Gq/11)

Question 3

what does the parasympathetic NS cause?

Answer 3

bronchial smooth muscle contraction and increased mucus production

Question 4

where is the sympathetic NS located in the respiratory system

Answer 4

innervates submucosal glands and smooth muscle of blood vessels

Question 5

sympathetic signalling pathway in the lungs

Answer 5

adrenaline on B2-adrenoceptors (Gs)

Question 6

what does the sympathetic NS cause in the respiratory system?

Answer 6

bronchial smooth muscle relaxation and decreased mucus secretion

Question 7

signalling pathway for vascular contraction

Answer 7

adrenaline on alpha1-adrenoceptors

Question 8

example of a SABA

Answer 8

salbutamol

Question 9

how are SABAs administered?

Answer 9

inhalation

Question 10

adverse effects of SABAs

Answer 10

fine tremor, tachycardia, arrhythmias and hypokalaemia

Question 11

examples of corticosteroids

Answer 11

beclomethasone
budesonide
prednisolone

Question 12

example of a mineralocorticoid

Answer 12

aldosterone

Question 13

role of aldosterone

Answer 13

retain salt and water by the kidney

Question 14

mechanism of action of corticosteroids

Answer 14

prevent Th2 pathway reducing eosinophils and mast cells

Question 15

what are corticosteroids used in?

Answer 15

COPD
asthma
rhinitis (as monotherapy)

Question 16

examples of LABAs

Answer 16

salmeterol

formoterol

Question 17

when are LABAs used?

Answer 17

nocturnal asthma

Question 18

LABAs are not used as a mono therapy, what are they combined with?

Answer 18

glucocorticoid

Question 19

examples of cysteinyl leukotriene receptor antagonists

Answer 19

montelukast

zafirlukast

Question 20

mechanism of action of cysteinyl leukotriene receptor antagonists

Answer 20

blocks effects of mast cells e.g. smooth muscle contraction, mucus secretion and oedema

Question 21

adverse of cysteinyl leukotriene receptor antagonists

Answer 21

headache

GI symptoms

Question 22

examples of methylxanthines

Answer 22

theophylline

aminophylline

Question 23

what is used in combination with methylxanthines?

Answer 23

beta-2 agonist and glucocorticoids

Question 24

adverse of methylxanthines

Answer 24

narrow therapeutic window resulting in dysrhythmias, seizures and hypotension (at therapeutic it can still cause nausea, vomiting and headaches)

Question 25

example of a cromone

Answer 25

sodium cromoglicate

Question 26

function of cromones

Answer 26

mast cell stabilisers (suppress histamine release)

Question 27

monoclonal antibody for IgE

Answer 27

omalizumab

Question 28

monoclonal antibody for IL-5

Answer 28

mepolizumab

Question 29

example of a SAMA

Answer 29

ipratropium

Question 30

examples of LAMAs

Answer 30

tiotropium glycopyrronium aclidinium umeclidinium

Question 31

what reduces systemic exposure of SAMAs and LAMAs?

Answer 31

quaternary ammonium group

Question 32

mechanism of action in SAMAs and LAMAs

Answer 32

reduce bronchospasm, mucus secretion, nasal glands in rhinorrhoea (only ipratropium used)

Question 33

is ipratropium non-selective

Answer 33

yes

Question 34

examples of anti-histamines (H1 receptor antagonists)

Answer 34

loratadine, azelastine, fexofenadine and cetirizine

Question 35

role of anti-histamines

Answer 35

reduce effects of mast cell derived histamine e.g. vasodilation, sensory nerves and mucus secretion

Question 36

when are anti-histamines used?

Answer 36

effective as monotherapy in rhinitis

Question 37

example of a vasoconstrictor?

Answer 37

oxymetazoline

Question 38

mechanism of action of oxymetazoline

Answer 38

mimic the effect of adrenaline (vasoconstriction via alpha1-adrenoceptors)