Respiratory Conditions

Question 1

How is airway resistance normally controlled?

Answer 1

By ANS and its subdivisions,
parasympathetic nervous system
sympathetic nervous system.
(Involuntary)

Question 2

Sympathetic Nervous System in airway resistance

Answer 2

B2 ARs on smooth muscle of bronchioles. Stimulation by noradrenaline causes relaxation.

Question 3

B2 ARs Agonist Example

Answer 3

Salbutamol

Question 4

Parasympathetic Nervous System in airway resistance

Answer 4

Stimulation of mAChRs, M1 or M5 by ACh.
Causes contraction of bronchial muscle.

Question 5

mAChRs Antagonist Example

Answer 5

Ipratropium (antimuscarinic)
More for COPD

Question 6

Other NTs Effecting ANS air way resistance

Answer 6

Leukotrienes = bronchoconstriction
Substance P = bronchoconstriction
Nitric Oxide = bronchodilation
Histamine = bronchoconcstriction

Question 7

What is asthma?

Answer 7

Chronic inflammatory disorder of the airways. Hyper reactivity to trigger factors

Question 8

Asthma triggers

Answer 8

Allergens, chemicals, drugs, foods, smoking, cold air, excercise, stress.

Question 9

Relivers of Asthma

Answer 9

Bronchodilators = reverse bronchospasm

mAChR antagonists, B2 agonists.

Question 10

Long term, preventative treatment for Asthma

Answer 10

Anti inflammatory agents, corticosteroids.

Question 11

Delivery of Asthma treatment

Answer 11

Inhalers for:
lower doses less side effects
faster onset with bronchodilators
more protective from bronchoconstriction

Question 12

Short Acting B2 Agonist

Answer 12

Salbutamol and terbutaline (pro drug of bambuterol)
(Rapid onset, 3-5 hours lasting

Question 13

Long Acting B2 Agonist

Answer 13

Salmeterol, formoterol
Preventative (8 - 12 hours lasting)

Question 14

Methylxanthines for COPD and Asthma

Answer 14

e.g aminophylline
Inhibit phosphodiesterase, reducing inflammation.

Question 15

Weak anti inflammatory drug for asthma?

Answer 15

Cromoglicate / nedocromil

Question 16

Leukotriene Antagonists

Answer 16

e.g montelukast,

anti inflammatory block inflammatory cascade leukotrienes involved with in asthma. (prophylactic, exercise induced asthma)

Question 17

Corticosteroids Examples

Answer 17

Inhaled
Budesonide
Mometason

IV : hydrocortisone

Question 18

Chronic Obstructive Pulmonary Disease (COPD)

Answer 18

-small airway fibrosis - obstruction or destruction of alveoli
-Irreversible
-Smoking

Less responsive to B2 agonists, use anti muscarinics, ipratropium

Question 19

Hayfever

Answer 19

In appropriate immune response.
Mast cells and basophils release histamine.
Antihistamines treat by blocking action of histamine on its receptors

Question 20

Antihistamines examples

Answer 20

Promethazine

Question 21

Mucolytics for COPD

Answer 21

Break down thick sticky mucus on mucosa by changing composition reducing viscosity.

e.g. carbocisteine (chronic bronchitis)

Question 22

Treating general respiratory conditions?

Answer 22

How is air way resistance normally controlled?
ANS, SNS and PNS

B2 agonist and mAChRs antagonists bronchodilation. B2 for asthma more and ipratropium anti muscarinic for COPD.

What is asthma? = chronic inflammation and hyper-reactivity. Bronchodilators and anti inflammatory drugs.

What is COPD? Small air way fibrosis and obstruction or destruction of alveoli.

What is hayfever? inappropriate immune response. Anti histamines.