Respiratory and Cardiovasicular

Question 1

What are the mechanisms of pulmonary ventilation

Answer 1

Lung expansion (ribs, diaphragm) and air movement (pleural pressure)

Question 2

what and where is airway smooth muscle

Answer 2

from trachea to terminal bronchioles. contractions regulate airway diameter and airway resistance

Question 3

what is smooth muscle influence by

Answer 3

parasympathetic and sympathetic factors

Question 4

Thalidomide

Answer 4

A drug that was taken for morning sickness and was found to cause birth defects

Question 5

what are advantages of pulmonary drug delivery

Answer 5

non-invasive, large surface area, rapid absorption,

Question 6

what are the disadvantages of pulmonary drug delivery

Answer 6

accessibility- mucus, poor blood supply.

Method of delivery - MDI vs nebulizers

Question 7

what conditions are treated with inhaled drugs

Answer 7

COPD, asthma, lung infections, diabetes melltius, growth hormone deficiency, pulmonary hypertension

Question 8

what is COPD (chronic obstructive pulmonary disease) and affects

Answer 8

causes poor airflow, worsens over time, disease

Question 9

what are used to treat COPD

Answer 9

glucocorticoids (anti-inflammatory)
bronchodilators
antitussives

Question 10

What are broncodilators?

Answer 10

they are beta 2 adrenoceptor agonists. also can use xanthine drugs (coffee)

Question 11

how do Beta 2 adrenoceptor agonists work

Answer 11

have a direct action on smooth muscle - causes to relax.

are antagonists of bronchoconstrictors. inhibit inflammatory mediator release. clear muscus

Question 12

examples of beta-2-adrenoceptor agonists

Answer 12

salbutamol and terbutaline (inhaled as needed short acting) - 3 to 5 hours
clenbuterol (oral) inhaled twice daily last 8 - 12 hours

Question 13

What are xanthines?

Answer 13

caffeine, theophylline, theobromine

Question 14

what happens in the lungs due to asthma

Answer 14

the airways are inflammed with an increase amount of swelling and mucus. smooth muscle increase

Question 15

what are used to treat asthma

Answer 15

bronchodilators and anti-inflammatories

Question 16

what are glucocorticoids

Answer 16

as a natural occurring compound. act as anti-inflammatory

Question 17

How do glucocorticoids work?

Answer 17

decrease formation of cytokines, inhibit vasodilator productions,

Question 18

What are cardiomyocytes?

Answer 18

Heart muscle cells that make up a lot of the tissue in our hearts.

Question 19

what are non-cardiomyocytes

Answer 19

pacemaker cells, cardiac fibroblasts

Question 20

excitation-contraction coupling

Answer 20

events that link the action potentials inititated by Na influx into a cell, causes depolarises voltage gated Ca channels and causes Ca influx into cytosol. a small rise in Ca triggers Ca release from SR

Question 21

Cardiac excitation-contraction coupling

Answer 21

the process by which an electrical event causes an increase in calcium - then translates into muscle contraction and pumping of blood

Question 22

why is excitation contraction coupling important

Answer 22

mishandling of Ca by the myocyte is the main cause of cardiac contractile dysfunction and arrhythmias

Question 23

examples of types drugs that affect cardiac myocytes

Answer 23

anti-dysrhytmic drugs, cardiac glycosides, autonomic neurotransmitters, calcium antagonists

Question 24

what are cardiac dysrhythmias

Answer 24

abnormal rhythms of the heart’s electrical system that can affect its ability to effectively pump oxygenated blood throughout the body.

Question 25

what cause cardiac dysrhythmias

Answer 25

delayed after depolarisation, re-entry, ectopic pacemaker activity, heart block

Question 26

Anti-dysrhythmic Drugs

Answer 26

``` class I drugs: sodium channel blockers class II drugs: beta blockers class III drugs: potassium channel blockers class IV drugs: calcium channel blockers other ```

Question 27

Class 1 anti dysrythmics MOA

Answer 27

bind the alpha subunit of Na channels. inhibits action potential propagation, reduces max depolarisation rate at phase 0

Question 28

example of Class 1 antidysrhythmics

Answer 28

lidocaine, flecainide, ecnaidide, quinidine

Question 29

Class 2 anti-dysrhythmics MOA

Answer 29

beta 1- adrenoceptor antagonists, (doesnt relax) prevents increased sympathetic activity, increases refractory period of a-v node.

Question 30

what type of drug is propranolol and metoprolol

Answer 30

Class 2 anti-dysrhythmic, Beta 1- adrenoceptor antagonists (doesnt relax) propranolol is non selective and metoprolol is selective

Question 31

Class IV antiarrhythmics

Answer 31

calcium channel blockers, specfically L-type channels, slow conduction in S-A and A-V nodes, reduce force of contraction

Question 32

what type of drug is verapamil and diltiazem

Answer 32

calcium channel blocker, Class IV anti-dysrhytmia, affect Ca

Question 33

what are calcium antagonists

Answer 33

block entry of Ca into the cell, cause AV block and slow heart rate

Question 34

what are calcium antagonists used for

Answer 34

hypertension and preventing angina

Question 35

drugs that increase myocardial contraction

Answer 35

cardiac glycosides

Question 36

what are cardiac glycosides

Answer 36

drugs that effect pumping action of heart, slow conduction through AV node, increase force of contraction, inhibit the Na/K pump in cardiac myocytes, increase vagal outflow

Question 37

what type of drug is digoxin

Answer 37

cardiac glycoside, affects pumping of the heart

Question 38

what does digoxin do

Answer 38

slows conduction, increase contractility

Question 39

sympathetic drive

Answer 39

acts on Beta 1 adrenoceptors, increase force of contraction, increase rate of contraction, increase automaticity, repolarisation, decreased cardiac efficeincy

Question 40

parasympathetic drive

Answer 40

acts on M2-muscarinic receptors, no effect on contractility, decreased rate

Question 41

parasympathetic nervous system increases heart rate (T/F)

Answer 41

false

Question 42

drugs that affect cardiac function indirectly

Answer 42

calcium antagonists, vasodilators and vasoconstrictors, angiotensin-converting enzyme inhibitors, diuretics

Question 43

What are vasoconstrictors?

Answer 43

Pharmacologic agents that cause blood vessels to constrict, reduce vessel volume and flow, increase blood pressure,

Question 44

What are vasodilators?

Answer 44

agents that widen the blood vessels, increase vessel volume and flow, reduce blood pressure, calcium antagonists,

Question 45

What are the RAAS inhibitors used for?

Answer 45

used for hypertension, congestive heart failure,

Question 46

RAAS inhibitors

Answer 46

``` -ACE inhibitors reduce cardiac load and arterial BP -Angiotensin II receptor blockers reduce BP -Aldosterone antagonists Monitor K+ levels for hyperkalemia example is diuretics ```

Question 47

ACE inhibitors

Answer 47

example is benazepril (prodrug), inhibit acction of angiotensin converting enzyme, reduce blood vessels and decrease blood volume

Question 48

Diuretics

Answer 48

hypertension, oedema, inhibit Na resorption in the nephron, inhibit water resorption.

Question 49

what are the different phases of asthma

Answer 49

acute and delayed phase

Question 50

what occurs in the acute phase of asthma

Answer 50

triggered by interaction of allergen with mast cells. release of Ige causes mast cell degranulation\ release of mediators --> bronchoconstrictor and activation of inflammation

Question 51

what occurs in the delayed phase of asthma

Answer 51

activation of TH2 lympocytes, promotes cytokine production.

Question 52

why is the different phases of asthma important

Answer 52

depending on the type that people have drugs would need to be taken, eg salbutamol (short-acting) vs clenbuterol (long Acting)

Question 53

MOA of xanthine and the side effects

Answer 53

MOA • Unclear - inhibits phosphodiesterase enzymes to relax smooth muscle (↑ cAMP) • Also adenosine receptor antagonist • May have some anti-inflammatory effect • Stimulate the CNS (useful in horses where expiration in active) Adverse effects • Narrow therapeutic window • Cardiac dysrhythmia, seizures, GIT upset, anxiety