pharmacology Flashcards
(106 cards)
1
Q
How many muscarinic receptors
A
5
2
Q
Where are M1
A
Ganglia
3
Q
What do M1 do
A
Facilitate ACh transmission
4
Q
What do M2 do
A
Inhibitory
5
Q
What does stimulation of vagus nerve cause
A
Bronchoconstriction
6
Q
What do NANC do
A
Regulates the airways
7
Q
What do NANC release
A
Bronchodilators
- VIP
- NO
8
Q
Sympathetic innervate the airways
true or false
A
False
They innervate submucosal glands
9
Q
What do b agonist do
A
Relax bronchial smooth muscle
10
Q
What does irritation of C fibers cause
A
- cough
- mucus
11
Q
What does parasympathetic work through
A
M3
12
Q
What do amiodarone and methotrexate do to the lung
A
Damage it
13
Q
What does heart failure lead to
A
Pulmonary oedema
14
Q
What is commonest disease in children
A
Asthma
15
Q
What is asthma
A
Recurrent reversible obstructive disease in response to irritant stimuli
16
Q
What does asthma cause
A
Wheeze
17
Q
Is COPD reversible
A
No
18
Q
Symptoms of asthma
A
- wheeze
- SOB
19
Q
Underlying pathology of asthma
A
Chronic asthma
- inflammation
- bronchial hyper-reactivity
- reversible obstruction
20
Q
What is bronchial hyper-reactivity
A
Abnormal sensitivity to a wide range of stimuli
21
Q
What are the phases of asthma
A
- immediate
- delayed
22
Q
What does Th2 do In asthma
A
- attracts eosinophils
- IL-5 attracts eosinophils
- eosinophils attract CySTL1 receptors
- promote IgE
23
Q
What does IL-4 and IL-13 do
A
Switch B cells to IgE
24
Q
What is omalizumab
A
Anti IgE antibody
25
What does allergen interaction with IgE cause release of
- histamine
- leukotriene
- prostaglandin
26
What can delayed phase cause
Nocturnal asthma
27
What does Th0 give rise to
Th1 and Th2
28
What do glucocorticoid do
Inhibit action of IL-4 ...
29
What are type of asthmatic drugs
- bronchodilators
| - anti-inflammatory agents
30
How is asthma treatment monitored
FEV1
31
What drug can precipitate asthma
NSAID (aspirin)
32
What do bronchodilators reverse
Bronchospasm
33
SABA example
Salbutamol
34
When is glucocorticoid added
When SABA used more than 3 times a week
35
What is step 3
Add LABA to glucocorticoid
36
Example of LABA
Salmeterol
37
Leukotriene example
Monteleukast
38
What is oral glucocorticoid
Prednisone
39
How are B2 adrenoreceptor agonist administered
Inhaled
40
Example of methylxanthine
Aminophylline
41
What do methylxanthine
Inhibits PDE4
42
How is methylxanthine given
IV or oral as add on therapy
43
How is methylxanthine metabolized
In liver by P450
44
Example of leukotriene
Montelukast
45
How is leukotriene given
Add on therapy
46
Side effect of SABA
- tremor
| - tachycardia
47
What does theophylline activate
Histone deacetylase (HDAC)
48
Side effect of methylxanthine
- arrhythmia
| - seizure
49
Example of SAMA
Ipratropium
50
Example of LAMA
Tiotropium
51
What limits side effects in muscarinic antagonist
Quaternary ammonium group
52
What is LAMA selective for
M3
53
What is LAMA used with for COPD
LABA
54
What is the role of glucocorticoids
Anti-inflammatory
55
What does IL-3 do
Regulate mast cell production
56
Example of glucocorticoid
- beclometasone
| - fluticasone
57
When are oral glucocorticoid given
Severe disease
58
Side effect of glucocorticoid
- thrush (oral candidiasis)
- sore throat
- hoarse voice
59
What is cromoglicate
Mast cell stabilizer
60
What does cromoglicate prevent
Histamine release from mast cells
61
What is mepolizumab
IL-5 inhibitor
62
Treatment of severe acute asthma
- O2
- inhaled SABA + ipatropium
= IV hydrocortisone
- oral prednisolone
- IV magnesium
63
Treatment of IPF
- pirfenidone
| - nintedanib
64
What is pirfenidone
Immunosuppressant that reduces fibroblast proliferation
65
What is nintedanib
Tyrosine kinase inhibitor
66
what are the 4 stages of drug disposition
ADME
- absorption
- distribution
- metabolism
- excretion
67
what does rate of diffusion depend on
- molecular size
| - diffusion coefficient
68
what size of molecule diffuses more easily
smaller
69
what are pericytes
impermeable layer of periendothelial cells
70
where can cells not go
- across BBB
| - across placenta (to foetus)
71
what are the 4 ways small molecules can cross cell membrane
- diffusion through lipid
- combination with solute carrier
- diffusion through aquaporins
- pinocytosis
72
can polar or non-polar diffuse easily across the membrane
non-polar
73
what are most drugs strong or weak acids and bases
weak acids or bases
74
what is used to calculate dissociation constant (pKa)
Henderson-Hasselbach equation
75
does the ionised or unionised form cross the membrane
unionised
76
what drugs are lipid soluble
- antibiotics
| - aminoglycoside
77
example of weak acid
aspirin
78
example of weak base drug
pethidine
79
can ionised species cross the cell membrane
no
80
does ionised species travel equally to all compartments
no
81
what increases surface area in small intestine
villi and microvilli
82
how do drugs mainly exist
in bound form
83
what is most important protein drugs are bound to
albumin
84
example of drugs bound to albumin
- acidic drugs (warfarin, NSAID)
| - basic drugs (antidepressants)
85
what are the 3 factors that determine the amount of drug bound to a protein
- concentration of free drug
- affinity for binding site
- concentration of protein
86
how many sites is there on albumin
2
87
what does albumin mainly bind
acidic drugs
88
what drug can be absorbed in the mouth
GTN
89
how do most drugs leave the body
urine
90
where are drugs metabolised
liver
91
what is used in drug metabolism
CYP450
92
what are xenobiotics
foreign chemicals
93
how many phases of drug metabolism
2
94
what is phase 1
oxidation
reduction
hydrolysis
95
is phase 1 catabolic or anabolic
catabolic
96
in phase 1 does it make drugs more or less active
more
97
where are CYP enzymes
in smooth endoplasmic reticulum
98
what are CYP450
haemorrhoids proteins
99
what are the most important CYP enzymes
1-3
100
can grapefruit juice inhibit drug metabolism
yes
101
affect of Brussel sprouts and cigarette smoke on P450 enzymes
induce them
102
how is ethanol metabolised
alcohol dehydrogenase
103
is phase 2 catabolic or anabolic
anabolic
104
what happens in phase 2
conjugation
105
does phase 2 make them more active or inactive
inactive
106
where does phase 2 occur
liver
