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PHA321 > Respiratory System Pharmacology > Flashcards

Respiratory System Pharmacology Flashcards

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1
Q

Parasympathetic stimulation of airway smooth muscle via muscarinic M3 receptors causes…

A

Constriction of airways.

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2
Q

How do the alveoli get rid of dust and debris without cilia?

A

They contain phagocytic cells

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3
Q

Treatment of pulmonary embolism is with…

A

…anticoagulant medication.

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4
Q

Examples of URT diseases

A

Sinusitis
Tonsilitis
Laryngitis
Allergic rhinitis
Cough

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5
Q

What are the mediators of the cough reflex

A

Cough reflex is via both the afferent and efferent nerves (i.e. involving the central and peripheral nervous systems), as well as the smooth muscles of the bronchial tree.

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6
Q

Types of antitussives

A

Centrally-acting
Peripherally-acting

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7
Q

Types of centrally-acting antitussives

A

Narcotics
Non-narcotics

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8
Q

Examples of narcotics used as antitussives

A

Codeine, Pholcodeine, Hydrocodone, Morphine.
Opioid derivatives like Dextromethorphan, Levopropozyphene, Noscapine

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9
Q

Examples of non-narcotics used as antitussives

A

Benzonatate, dimemorfan, benproperine, first generation Antihistamines e.g. diphenhydramine

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10
Q

Examples of peripherally-acting antitussives

A

Diphenhydramine, Benzonatate

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11
Q

Antitussives MOA

A

Centrally:
- Depressing the medullary centre or associated higher centres.
- Increase threshold of cough centre
Peripherally:
- Interrupt tussal impulses in the respiratory tract.
- Inhibit conduction along motor pathways.

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12
Q

Pharmacological action of expectorants

A

aka Mucokinetics, they make cough more productive by loosening and liquefying bronchial secretions

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13
Q

Reflexly-acting mucokinetics examples

A

a. Ipecacuanha
b. Ammonium chloride
c. Potassium iodide

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14
Q

Directly-acting mucokinetics examples

A

Guaiphenesin

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15
Q

Pharmacological action of mucolytics

A

Break down thick mucus, making it thinner and easier to cough out. Split disulphide bonds in mucoprotein present in sputum and reduces its viscosity.

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16
Q

Examples of demulcents

A

Liquorice, Glycerin, Lozenges

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16
Q

Examples of mucolytics

A

Acetylcysteine
Carbocysteine
Methylcysteine

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17
Q

Lower respiratory tract disorders include

A

Infections
Restrictive pulmonary disorders Obstructive pulmonary disorders Lung cancer.

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18
Q

‘A nonproductive cough turns into a deep cough that will expectorate mucus and sometimes pus’ describes which condition?

A

Acute bronchitis

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19
Q

Risk factors for asthma

A

Genetic
Environmental

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20
Q

Genetic risk factors for asthma

A

Atropy
Gender
Race/ethnicity

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21
Q

Environmental risk factors for asthma

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A

Smoking
Allergens
Occupational sensitizers
Respiratory infections
Parasitic infections
Perinatal risk factors
Diet and nutrition

22
Q

Asthma symptoms

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A

Cough
Wheezing
Shortness of breath
Chest tightness

23
Q

Phases of allergic induction in asthma

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A
  1. Induction of allergic reaction involving antigen uptake, processing and presentation
  2. Early-phase asthmatic reaction (EAR),
  3. Late-phase asthmatic reactions (LAR), and
  4. Chronic allergic inflammation.
24
Which acute signs and symptoms are associated with EAR
- Mild rhinitis - Anaphylactic shock - Vasodilation - Contraction of the bronchial smooth muscle (producing airflow obstruction and wheezing) - Increased mucus secretion (exacerbating airflow obstruction in the lower airways).
25
Granule basic proteins synthesised by eosinophils
- Major basic proteins (MBP) - Eosinophil cationic protein (ECP) - Eosinophil peroxidase (EPO) - Eosinophil-derived neurotoxin (EDN)
26
Lipid mediators generated by eosinophils
Prostaglandins and cysteinyl leukotrienes)
27
Cytokines produced by eosinophils
Tumour necrosis factor and transforming growth factor beta (TNF, TGF-β), IL-4 and IL-13 and chemokines.
28
Cytokines produced by eosinophils
Tumour necrosis factor and transforming growth factor beta (TNF, TGF-β), IL-4 and IL-13 and chemokines.
29
Categories of Asthma
1. Mild intermittent (occasional attacks) 2. Mild persistent (> 2 attacks/week) 3. Moderate persistent (daily attacks) 4. Severe persistent
30
Classes of drugs used for asthma treatment
Bronchodilators Corticosteroids Mediator antagonists Mast cell stabilizers Anti-IgE antibody
31
Types of bronchodilators
Sympathomimetics-β2-receptor agonists Xanthine derivatives Anticholinergic drugs Monoclonal antibodies Prophylactic agents
32
Examples of Sympathomimetics-β2-receptor agonists
i. Short-acting: salbutamol, pirbuterol, terbutaline ii. Long-acting: salmeterol, formoterol
33
Examples of Xanthine derivatives
Theophylline (water insoluble) Theophylline + Ethylene Di-Amine = Aminophylline
34
Anticholinergic drugs examples
Short-acting: ipratropium Long-acting: tiotropium
35
Anti-inflammatory drugs
Corticosteroids Systemic drugs
36
Corticosteroids examples
Corticosteroids: 1. Topical/inhalation: - betamethasone - beclomethasone 2. Systemic: - oral: predisone, prednisolone - i.v: hydrocortisone
37
Example of monoclonal antibodies
Omalizumab
38
Classes of prophylactic agents
Mast cell stabilisers Mediator antagonists Leukotriene pathway inhibitors
39
Examples of mast-cell stabilizers
i. Cromones: Na cromoglycate, Nedocromil Na ii. Ketotifen
40
Examples of antihistamines
Azelastine, cetirizine
41
Leukotriene pathway inhibitors
- 5-lipoxygenase enzyme inhibitor - Leukotriene-receptor antagonists
42
Examples of 5-lipoxygenase enzyme inhibitors
Zileuton
43
Mild intermittent asthma treatment
Use short-acting inhaled β2-adrenoceptor agonists
44
Moderate persistent asthma treatment
inhaled steroids + long-acting bronchodilator; antileukotriene drug
45
Severe persistent asthma treatment
high dose inhaled steroids; oral steroids and if very severe give i.v steroids + bronchodilator. Very severe (status asthmaticus) will require hospitalization and oxygen gas.
46
Among the symptoms of COPD are:
cough, wheeze, excessive secretion, shortness of breath, chest tightness.
47
What causes breathing difficulties in COPD
1. the airways and air sacs lose their elastic quality. 2. the walls between many of the air sacs are destroyed. 3. the walls of the airways become thick and inflamed. 4. the airways produce more mucus than usual, which can clog them.
48
Pharmacological action of analeptics
They antagonize drug-induced depression of the central nervous system. They act primarily on the medullary center and stimulate the central nervous system, which act to increase the action of the respiratory system
49
How are analeptics used?
- Acute exacerbations of chronic lung diseases with hypercapnia, drowsiness and inability to cough. - Apnea in premature infants. - Obesity-hypoventilation syndrome. - In some patients with COPD and alveolar hypoventilation.
50
Examples of clinically used analeptics
Doxapram and Amphifinazole
51
Clinical uses of doxapram
For treating respiratory depression in patients who have taken excessive doses of drugs such as buprenorphine (an opioid for treating opioid addiction and pain), which may fail to respond adequately to treatment with naloxone.
52
Other analeptics:
- Picrotoxin - Biccuculline - Strychnine - Pentylenetetrazol (leptazol) - Nikethamide

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