Respiratory Pharmacology

Question 1

What are the two main autonomic neurotransmitters?

Answer 1

Noradrenaline, acetylcholine

Question 2

What overall effect does autonomic innervation have on the airway smooth muscle?

Answer 2

Parasympathic - constricts, sympathetic - dilates

Question 3

Describe, briefly, the mechanism of parasympathetic effect upon the ASM.

Answer 3

PIP2 converted to IP3 by PLC, due to GPCR activation. Calcium buildup activates calmodulin which stimulates myosin light chain kinase

Question 4

Describe, briefly, the mechanism of sympathetic effect upon the ASM.

Answer 4

Adenylyl cyclase converts ATP to cAMP. By PKA, this activates myosin phosphatase.

Question 5

Name the two myosin enzymes. Which contracts and which dilates the ASM?

Answer 5

Myosin light chain kinase (+ATP) contracts, myosin phosphatase dilates

Question 6

Which two spasmogens are primarily used in provacation tests?

Answer 6

Histamine H1, Methacholine M3

Question 7

Name the main SABA.

Answer 7

Salbutamol

Question 8

Name the main LABAs.

Answer 8

Salmeterol, formoterol

Question 9

Name the main CysLT1s.

Answer 9

Montelukast, Zafirlukast (-lukast)

Question 10

Name the main methylxanthine drugs.

Answer 10

Theophyline, aminophyline (-phyline)

Question 11

Name the main glucocorticosteroids.

Answer 11

Cortisol, prednisone

Question 12

Name the main mineralocorticosteroids.

Answer 12

Aldesterone, beclometasone, budesonide, fluticasone

Question 13

Name the main cromone.

Answer 13

Sodium cromoglicate

Question 14

Name the main monoclonal IgE antibody drug.

Answer 14

Omalizumab

Question 15

Name the main SAMA.

Answer 15

Ipatropium

Question 16

Name the main LAMAs

Answer 16

Tiotropium, glycopyronium

Question 17

Name the main PDE4 inhibitor.

Answer 17

Rofumilast

Question 18

What is the drug carbocysteine principally used for?

Answer 18

To aid in bringing up sputum

Question 19

Describe briefly the mechanism of action of CysLT1 drugs.

Answer 19

PLA2 -> arachidonic acid -> FLAP -> 5-lipoxygenase -> LTA4 -> LTB/C/D/E4 -> blocks CysLT1 receptors

Question 20

Describe briefly the mechanism of action of the methylxanthines.

Answer 20

Blocks PDE3 (which degrades cAMP), potentiating it and causing bronchodilation

Question 21

Describe briefly the mechanism of action of the corticosteroids.

Answer 21

Diffuse across cell -> complex -> glucocorticoid response elements -> transrepresses inflammatory/ transexpresses antiinflammatory

Question 22

Describe the pharmacological treatment of adults with asthma.

Answer 22

SABA + ICS, then LABA/oral steroids, then CysLT1s. Other drugs for exercise induced asthma

Question 23

Which drug should be used for rhinitis?

Answer 23

Sodium cromoglicate