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RCR1 Pharmacology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What type of receptors are involved in Sympathetic actvity?

A

Adrenergic

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2
Q

What neurotransmitter generally works on Adrenergic receptors?

A

NA

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3
Q

What receptor is involved in Parasympathetic activity?

A

Muscarinic

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4
Q

What neurotransmitters usually work on Muscarinic receptors?

A

Acetycholine

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5
Q

What is asthma defined as?

A

A reversible airway obstruction caused by bronchoconstriction and inflammation in response to an allergen.

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6
Q

What are the two main causes of obstruction in asthma?

A

Bronchoconstriction and Inflammation

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7
Q

What is the purpose of Asthma relievers?

A

To stop bronchoconstriction

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8
Q

Do Asthma relievers have any impacts upon inflammation?

A

No

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9
Q

What do Asthma preventers do?

A

Reduce airway inflammation

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10
Q

What affect does sympathetic activity have on the bronchi?

A

Bronchodilation

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11
Q

With an Asthma patient, would you want to activate the sympathetic or parasympathetic system?

A

Sympathetic

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12
Q

What type of Adrenergic receptors are found in the lung?

A

Beta 2`

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13
Q

What do beta 2 agonists do for Asthma patients?

A

Stimulates the sympathetic nervous system causing bronchodilation

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14
Q

How would you decrease Parasympathetic activity in an Asthma patient?

A

Anti-Muscarinics

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15
Q

Name a SABA

A

Salbutamol

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16
Q

Name a LABA

A

Salmeterol

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17
Q

What is useful about LABAs?

A

They can be used over night!

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18
Q

When a beta 2 receptor is activated, what is the mechanism of action for bronchodilation?

A

Beta 2 activation causes Adenylate cyclase to be released, which catalyses ATP–>cAMP

cAMP causes bronchodilation

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19
Q

What is cAMP broken down by?

A

Phosphodiesterase

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20
Q

What is cAMP broken down into?

A

AMP

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21
Q

What are the side effects of beta 2 agonists?

A

restlessness, hypokalaemia, possible tacchyphylaxis

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22
Q

What do Methylxanthines do?

A

Block phosphodiesterase, causing an increase in cAMP.

This causes bronchodilation

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23
Q

How do Methyxanthines work?

A

Block phosphodiesterase, causing an increase in cAMP

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24
Q

Give an example of a Methylxanthine

A

Theophylline

Aminophylline

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25
Q

When is Aminophylline used?

A

In Status Asthmaticus

26
Q

How do anti-muscarinics work?

A

Reduce Parasymathetic activity by antagonistically binding to Muscarinic receptors.

27
Q

Are anti-muscarinics better for Asthma or for COPD?

A

COPD

28
Q

Give an example of an Anti-muscarinic

A

Ipratropium

29
Q

How is Ipratropium taken?

A

Inhaled

30
Q

What does a Glucocorticosteoid do?

A
  1. Reduced pro-inflammatory gene expression
  2. Increases the number of beta 2 receptors
  3. Regulated Leukocyte activity
31
Q

How do Glucocorticosteroids work?

A

GCSs bind to receptors to form a GCS-r complex. This complex binds to promoters in DNA.

32
Q

Give some examples of GCS drugs.

A

Fluticosone (daily inhaler)
Beclomethasone (daily inhaler)

Oral Prednisolone (Severe Asthma)
IV Hydrocortisone (Status Asthmaticus)
33
Q

Why is the compliance of GCS drugs very poor?

A

Steroid phobia - Cushingoid possibility.

34
Q

When may steroids cause Cushingoid features?

A

When taken ORALLY.

35
Q

Why is Adrenaline used in Status Asthmaticus?

A

Activates beta 2 receptors, causes bronchodilation

36
Q

What type of adrenergic antagonist favours beta more than alpha?

A

Isoprenaline

37
Q

What is the problem with giving Isoprenaline to an asthmatic patient?

A

Isoprenaline isn’t beta specific, so it will cause sympathetic activity in the heart (inc. HR, contractility etc.)

38
Q

Why are inhalers used for adrenergic agonist drugs?

A

Reduces systemic side effects

39
Q

Why can’t beta blockers be given to an Asthmatic?

A

It causes bronchoconstriction

40
Q

What drugs are used for COPD?

A

Anti-muscarinics such as Ipratropium
Beta 2 agonists
GCS
Antibiotics

41
Q

What is a precursor to GCS naturally in the body?

A

Cholesterol

42
Q

What GCS is made naturally in the body?

A

Cortisol

43
Q

How long do steroids take to work?

A

Hours

44
Q

How long does it take to remove steroids from the system?

A

days

45
Q

What do mineralcorticoids do?

A

Increase gene transcription of epithelial Sodium channels

46
Q

Give a natural example of a mineralcorticoid?

A

Aldosterone

47
Q

Name a synthetic aldosterone-mimic drug

A

Spironolactone

48
Q

What are Chromones used for in Asthma?

A

Prophylaxis - reduces frequency of acute attacks

49
Q

What reliever drugs are there for Asthma?

A

Beta agonists
Anti-Muscarinics
Methylxanthines
GCS

50
Q

What preventer drugs are there for Asthma?

A

Chromones
Anti-IgE
Anti-leukotrienes (Montelukast)

51
Q

How do Anti-IgE’s work for Asthma?

A

Reduces Mast cell degranulation

52
Q

Give an example of an Anti-leukotriene

A

Montelukast

53
Q

Is a higher does needed for oral or for inhaled Asthma drugs?

A

Oral

54
Q

Which has better compliance - oral or inhaled drugs?

A

Oral

55
Q

What would you give for mild intermittent Asthma?

A

SABA

56
Q

What would you give for mild persistent Asthma?

A

SABA and low GCS inhaled dose

57
Q

What would you give for moderate persistent asthma?

A

SABA/LABA, Methyxanthines, anti-muscarinics and higher inhaled GCS dose

58
Q

What would you give for severe persistent Asthma?

A

Oral GCS

59
Q

How would you treat a patient in status asthmaticus?

A

Nebulised Salbutamol
50% O2
Oral prednisalone/IV hydrocortisone

(Nebulised Ipratropium can be added if condition is not improving)

60
Q

How would you treat COPD?

A 
Anti-muscarinics
Beta 2 agonists
Methylxanthines
GCS
Antibiotics
Surgery

RCR1 Pharmacology (3 decks)

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