BMS12-1050 - Respiratory Pharmacology

Description

Describe the pathophysiology of asthma Describe the pharmacology of directly-acting bronchodilators (e.g. salbutamol) and indirectly-acting bronchodilators (e.g. ipratropium bromide) Describe the pharmacology of anti-inflammatory drugs (e.g. glucocorticosteroids, xanthines, cromones) outline any major side effects and toxicities associated with pulmonary drugs
Evian Chai
Flashcards by Evian Chai, updated more than 1 year ago
Evian Chai
Created by Evian Chai almost 4 years ago
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Resource summary

Question Answer
Which test is used to diagnose asthma? FEV1, which measures the maximum exhale
What is the chemical structure of B2 agonists? How does te long acting one differ from the short acting one structurally? Structure is similar to adrenaline Long acting ones have long chain
What is the chemical structure of a glucocorticosteroid? Variation of a steroid 4 carbon ring structure
What are two types of bronchodilators? 1. Beta 2 agonists 2. Muscarinic antagonists
What are two examples of muscarinic antagonists? Ipratropium bromide (6 hours) and Tiotropium bromide (24 hours)
What are the two types of B2 Agonists, and examples of each? 1. Short acting eg. Salbutamol 2. Long acting eg. Salmeterol
What are the two mechanisms through which glucocorticoids stop inflammatory cell activation, recruitment, and adhesion? 1. Transactivation of annexin, Beta2 receptor 2. Transrepression of NFkB/AP-1 that normally initiates transcription for: - cytokines - chemokines - adhesion molecules - inflammatory enzymes
3 Phases of Asthma 1. Immediate phase -... after exposure - bronchospasm due to ... 2. Delayed phase - ... after - Due to ....narrowing airways 3. Airway/Bronchial hyperresponsiveness to ANY irritant - ... after - combination of ... 1. 5-15mins 2. Mast cells causing SM to contract 3. 2-8 hours 4. Mucosal swelling/oedema 5. 2-8 days 6. Bronchospasm on combined oedematous
Side effects of glucocorticosteroids Fungal infections, hoarse voice, bruising, osteoporosis
What are the 5 types of anti-inflammatory agents? 1. Glucocorticosteroids 2. Xanthines 3. Cromones 4. Leukotriene antagonists 5. Anti LgE
What are the 4 main reactions in asthma? 1. Smooth muscle bronchoconstriction 2. Inflammation 3. Oedema 4. Mucus
What are common side effects of muscarinic antagonists? Dry mouth, urinary retention, constipation, glaucoma
What are common side effects of B2 agonists? Tremor, increased HR, hypokalemia
Salbutamol: B2 agonist, ... acting Salmeterol: B2 agonist, ... acting Fluticasone Propionate: inhaled ... Montelukast: ...receptor antagonist Theophylline: Xanthine, inhibit ... Cromoglycate: Cromone, ...mast cells Omalizumab: ... Ipratropium Bromide: Muscarinic antagonist/prevent PNS ...hr Tiotropium Bromide: Muscarinic antagonist/ prevent PNS ...hr Salbutamol: Short Salmeterol: Long Fluticasone Propionate: Steroid Montelukast: Leukotriene Theophylline: Xanthine, inhibits phosphodiesterase Cromoglycate: Cromone, stabilise mast cells Omalizumab: bind to free lgE Ipratropium Bromide: 6 hr Tiotropium Bromide: 24 hour
Leukotriene receptors antagonists work by 1. Block leukotrienes from arachodonic acid 2. This prevents bronchoconstriction/oedema/mucus
How does Omalizumab work? 1. Binds to free LgE 2. This reduces the amount of LgEs open to bind to mast cells/trigger inflammatory response
How do xanthines work? Give an Example of one 1. Inhibits phosphodiesterase, which normally breaks down cAMP 2. Increases cAMP+MLCK phosphorylation 3. More SM relaxation
How do muscarinic antagonists work? What do they mainly treat? Muscarinic receptors normally activate PNS, causing SM contraction and bronchoconstriction Blocks this to achieve bronchodilation Mainly treats COPD
How do glucocorticosteroids work? 1. Steroid is in cytosol along with steroid receptor that is stuck to a chaparonin 2. Steroid binds to receptor, releasing receptor from chaparonin 3. Steroid+receptor enters the nucleus, affects gene transcription
How do cromones work? Stabilise mast cells to lower inflammatory cell activation/recruitment
How do B2 agonists work? 1. B agonists binds to B2 receptor on SM 2. G protein attached to receptor disassosiates, activates {{c1::adenylyl cyclase }} 3. {{c2::Cyclic AMP}} made from ATP Cyclic AMP converted to AMP 4. PKA activated 5. Myosin light chain kinase ...in SM cells 6. Relaxation In SM, cAMP-->relaxation. What are the different mechanisms of b2 agonists/xanthines? 1. Adenylyl cyclase 2. Cyclic AMP 3. Phosphorylated B2 agonists promote cAMP formation, while xanthines prevent its breakdown-->SM Relaxation
B2 agonists are administered via... Inhalation
Asthma/bronchitis affects the ...zone COPD/Emphysema affects the ... zone 1. Conducting 2. Transitional/respiratory
5-LO inhibitors such as Zileuton work by... Preventing 5-LO from causing bronchoconstriction/oedema/mucus
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