Pharmacology of Asthma and COPD

Question 1

parasympathetic nervous system causes bronchial __ mediated by __ acting on __

Answer 1

contraction
ACh
M3

Question 2

what causes smooth muscle relaxation

Answer 2

parasympathetic stimulation of non-cholingeric fibres

mediated by NO and VIP

Question 3

does the sympathetic nervous system innervate bronchial smooth muscle

Answer 3

no

Question 4

where does the sympathetic nervous system innervate

Answer 4

submucosal glands and blood vessels supplying smooth muscle

Question 5

what is the effect of sympathetic stimulation

Answer 5

bronchial smooth muscle relaxation acting on beta-2 medicated by adrenaline

Question 6

sympathetic nervous system causes decreased mucus secretions true/false

Answer 6

true

Question 7

how does the contraction of smooth muscle occur

Answer 7

presence of intracellular calcium forms calmodulin
calmodulin activated MLCK which hydrolyses ATP
ATP phosphorylates myosin cross bridge - binds to actin forcing contraction

Question 8

relaxation of smooth muscle requires high or low Ca2+ concentration

Answer 8

low

Question 9

which enzyme is responsible for the relaxation of smooth muscle

Answer 9

myosin phosphatase

Question 10

what are some of the chronic consequences of asthma (5)

Answer 10

increased smooth muscle 
increased interstitial fluid 
increased mucus secretion 
epithelial damage 
fibrosis

Question 11

what are the two phases of asthma

Answer 11

acute bronchospasm

chronic inflammation

Question 12

in non-atopic less severe asthma Th0 cells mediate into

Answer 12

Th1 cells

Question 13

in atopic individuals Th0 cells mediate into

Answer 13

Th2 cells

Question 14

mast cells express their IgE receptors through which interleukins

Answer 14

IL-4

IL-13

Question 15

what are the two types of treatment areas in asthma

Answer 15

relievers

preventers

Question 16

which types of asthma treatments are relievers and what are they used for

Answer 16

SABAs, LABAs, CysLT1 antagonists

used for the initial relief of bronchospasm

Question 17

which types of asthma treatments are preventers and what are they used for

Answer 17

Glucocorticoids, Chromoglicate

anti-inflammatory agents used to reduce chronic inflammation

Question 18

what are SABAs and give an example

Answer 18

short acting beta-adrenoceptor agonists, increase smooth muscle relaxation within 5 minutes
eg salbutamol

Question 19

what are LABAs and give an example

Answer 19

long acting beta-adrenoceptor agonists, increase smooth muscle relaxation but no immediate relief
eg salmeterol

Question 20

what is the route of administration of SABAs and LABAs

Answer 20

inhalation - avoids systemic circulation

Question 21

when are LABAs used most effectively

Answer 21

as nocturnal therapy - last for up to 8 hours

Question 22

should LABAs be used as monotherapy

Answer 22

no as not effective

must be combined with corticosteroid

Question 23

when is an oral route of administration more effective in asthma

Answer 23

when asthma is more severe

Question 24

what is the route of administration of CysLT1 antagonists

Answer 24

oral administration

Question 25

name some examples of CysLT1 antagonists

Answer 25

montelukast | zafirlukast

Question 26

do glucocorticoids relieve bronchospasm

Answer 26

no - reduce inflammation

Question 27

how do corticosteroids reduce inflammation in ASM

Answer 27

reduce number or eosinophils and mast cells | reduce number of cytokines in T lymphocytes and macrophages

Question 28

name an example of an inhaled corticosteroid

Answer 28

beclometasone

Question 29

what are the side effects of beclometasone

Answer 29

hoarse voice | oral thrush

Question 30

name an example of an oral corticosteroid

Answer 30

prednisolone

Question 31

COPD is made up of which two conditions

Answer 31

chronic bronchitis and emphysema

Question 32

what are the symptoms of chronic bronchitis

Answer 32

cough + clear sputum

Question 33

what are the symptoms of emphysema

Answer 33

breathlessness due to destruction of alveolar air spaces

Question 34

how does the main COPD treatment work

Answer 34

reduces parasympathetic transmission of smooth muscle contraction using muscarinic antagonists

Question 35

name an example of short acting muscarinic antagonists

Answer 35

ipratropium

Question 36

name an example of a long acting muscarinic antagonist

Answer 36

tiotropium and glycopyronium

Question 37

SAMAs are more effective in COPD treatment than LAMAs true/false - why

Answer 37

false - LAMAs only act on M3 whereas SAMAs act on M1, 2, 3

Question 38

why is a selective muscarinic antagonist better than a non-selective one

Answer 38

M2 works to reduce the release of ACh - this function is desirable

Question 39

are corticosteroids an effective treatment for severe COPD when combined with a LAMA

Answer 39

yes - useful for frequent and severe exacerbations

Question 40

which drug classification blocks activation by ACh preventing contraction

Answer 40

muscarinic antagonists

Question 41

which drug classification causes relaxation of smooth muscle

Answer 41

B2-adrenoceptor agonists