asthma drugs
asthma drugs based on uni of manchester sem1year1 content
🇬🇧
In Inglés
In Inglés
Practique preguntas conocidas
Manténgase al día con sus preguntas pendientes
Completa 5 preguntas para habilitar la práctica
Exámenes
Examen: pon a prueba tus habilidades
Pon a prueba tus habilidades en el modo de examen
Aprenda nuevas preguntas
Modos dinámicos
InteligenteMezcla inteligente de todos los modos
PersonalizadoUtilice la configuración para ponderar los modos dinámicos
Modo manual [beta]
El propietario del curso no ha habilitado el modo manual
Modos específicos
Aprende con fichas
elección múltipleModo de elección múltiple
Expresión oralResponde con voz
EscrituraModo de solo escritura
asthma drugs - Marcador
asthma drugs - Detalles
Niveles:
Preguntas:
91 preguntas
| 🇬🇧 | 🇬🇧 |
| Persistent cough with mucus production | Chronic bronchitis |
| Classified as allergic, extrinsic, an exaggerated immune reaction to an antigen | Classification of asthma - atopic |
| Classified as non-allergic, intrinsic | Classification of asthma - non-atopic |
| Severe acute asthma attack, not readily reversed, can be fatal without emergency treatment | Status asthmaticus uk |
| Rings of cartilage dissapate as move down from trachea to tertiary bronchi. bronchioles have no cartilage support but have smooth muscle. | Anatomy of the airways |
| More glands. more muscle. infiltration of immune system cells. | Pathological changes to the submucosal layer in the airway wall in asthma |
| Basement membrane becomes thicker, loss of epithelium (especially ciliated cells), goblet cells may increase in number. there is hypertrophy of submucosal gland and hyperplasia (increased such as goblet cells). mucus plugs may also form. | Pathological changes to the basement membrane in airway wall in asthma |
| Respiratory epithelium was squamous before ciliated, so this is reverted due to the actions of major basic protein causing structural changes to the respiratory epithelium | Epithelial desquamation |
| Early mediator, contraction of airways smooth muscle, increased vascular permeability, increased bronchial secretions | Effect of histamine on bronchial asthma |
| Early mediator, infiltration of lung tissue by neutrophils and eosinophils, encourage migration of immune system cells. | Chemotactic factors |
| Later mediators, contraction of airways smooth muscle, increased vascular permeability, increased bronchial secretions. the late phase is similar ot early phase | Leukotrienes c4 d4 e4 and porstaglandin d2 |
| - relievers are for those with 2 or less asthma attacks a week - beta 2 adrenoceptor antagonists - theophylline - mAChR antagonists | When should relievers/bronchodilators be used and give examples |
| - more than 2 asthma attacks a week - long acting beta 2 agonists - glucocorticosteroids - monoclonal antibodies - leukotriene antagonists | When should preventors/prophylactic agents be used and give examples |
| SELECTIVE - because non-selective (propanolol) will interfere with beta adrenoceptor agonists such as salbutamol, which is needed for its therapeutic bronchodilator effects. non-selective will bind to both beta 1 and 2. | Should asthmatics be given selective or non selective beta adrenoceptor drugs |
| BAD - want to avoid the side effects of beta 1 adrenoceptors because they have major effects in the heart and metabolism, e.g. increased rate of SA node and release of renin (blood pressure effects). dobutamine. | Affects of beta1 selectivity of drugs to treat asthma. examples of beta 1 selective drugs. |
| 1) airway smooth muscle - relaxed 2) uterus - relaxed 3) all blood vessels - dilated 4) skeletal muscle - tremor and glycolysis | Effects of beta 2 adrenoceptors in the body |
| Good affinity for alpha and beta adrenoceptors. increasing the size of this substituent increases selectivity for beta receptors and then for beta 2 receptors. replacing one of the catechol -OH groups by -CH2OH or changing its ring position reduces inactivation by neuronal and non-neuronal uptake. | Adrenaline as a natural ligand for beta adrenoceptors bronchodilators and how to make it more selective to beta 2 |
| Drugs given to relieve asthma attacks. relative lipophilicity of 1 | Beta agonist bronchodilators |
| Drug dissolves into membranes and slowly leaks out, thus remaining in the tissues for longer. | Lipohilicity |
| 1) Tremor: peripheral effect involving interference with muscle spindle function 2) Tachycardia: activation of cardiac beta-adrenoceptors 3) Nervous tension: effect on CNS 4) Hypokalaemia: stimulation of Na/K ATPase in skeletal muscle - minimise using inhalation - MDI and a spacer or a nebulizer. | Unwanted effects of beta-agonist bronchodilators and how can we minimise them |
| - it shares a metabolic pathway in the liver with a vast number of drugs so if you are taken one of these drugs or smoking it can affect plasma levels - congestive heart failure and liver disease can also increase its half-life. meaning that you have to use assays to establish the right dosage for a particular patient. | Why is the half life of theophylline affected by cardiac/liver disease, smoking and many drugs |
| - an alkylxanthine - in chocolate - bronchial dilating effect - problems with metabolism can lead to toxicity | Theobromine - basic facts |
| M3 - muscarinic acetylcholine receptors (M3 produces contractions which lead to asthma) | Which receptors are best to target in asthma with antagonists |
| - muscarinic receptors on goblet cells, increasing the secretion of mucus - muscarinic receptors that cause constriction of smooth muscle | Relative to asthma, what two sites does acetylcholine work at in the bronchial tract |
| - binds to M1 and M3 subtypes of mAChR, these receptors are coupled to the phospholipase C signalling system via Gq. | What type of receptor does acetylcholine bind to relative to asthma within the bronchial tract |
| - dry mouth - rare cases of urinary retention, blurring of vision and constipation - antagonism at OTHER mAChR receptors | Unwanted effects of ipratropium |
| - 'lukast' - e.g. montelukast | What do the names of all competitive antagonists at (cysteinyl - leukotriene) CysLT receptors end in |
| - given orally - add on, prophylactic therapy in mild to moderate asthma - reduces exercise induced asthma - reduces aspirin induced asthmma | Montelukast relative to asthma |
| - abdominal pain, nausea - head ache - psychiatric effects - generally well tolerated with few side effects out of the oral cavity and bronchial tract | Unwanted effects of montelukast in asthma |
| Mineralcorticosteroids and glucocorticosteroids are synthesized in the adrenal cortex using cholesterol as a starting point. | Where are adrenocorticosteroids synthesized |
| Aldosterone for water and electrolyte balance | Example of mineralcorticosteroid |
| Hydrocortisone | Example of glucocorticosteroid |
| Modulation of protein and carbohydrate metabolism | What does low concentrations of glucocorticosteroids illicit |
| Suppression of inflammation and immune responses | What does high concentration of glucocorticosteroids illicit |
| Increase capillary permeability and mucus secretion, and bronchoconstriction | Effect of leukotrienes in asthma |
| Increase capillary permeability | Effect of prostaglandin E in asthma |
| Bronchoconstrictor | Effect of prostaglandin F2a in asthma |
| Bronchoconstrictor | Effect of thromboxane A2 in asthma |
| They prevent cytokine release from T helper cells (activated lymphocytes). this will impinge on the activation of other immune system cells. | How to glucocorticosteroids affect the immune system in asthma |
| - immunosupressant - can be both desirable and undesirable - metabolic effects - but its wanted effect is that it is anti-inflammatory | Unwanted effects of hydrocortisone |
| - cushings syndrome: buffalo hump, hypertension, muscle wasting, osteoperosis, moon face, increased abdominal fat, thinning of skin, poor wound healing | Unwanted effects of systemic glucocorticoids |
| 4 ring structure | What is the basic structure of a steroid |
| 2) hydrocorisone (mainly mineral effect) and fludrocortisone 2) prednisolone 3) dexamethasone (mainly gluco effect) | Order hydrocortisone, dexamethasone, fludrocortisone and prenisolone in order of duration of action from short to long |
| - anti-inflammatory effects of the glucocorticoids must be mediated by transrepression - side of effects seem to be mediated by transactivation | Basic NHR revision - how are some of the anti-inflammatory effect and side effects of glucocorticoids mediated |
| Used in long term prohylaxis/prevention | What is the most common use of glucocorticosteroids in asthma |
| - prescribed to patients who can't control their asthma well - general structure: long acting beta agonist reliever (LABA) and steroid | When are combination inhalers prescribed and what is their general structure |
| A combination drug used in asthma when patients can't control their asthma well. it is made up of a LABA and a steroid. these are: formeterol and beclomethasone. | What is fostair used as and what makes up this drug |
| Seretide is a combination drug used for patients who can't control their asthma well. it is made up of a LABA and a steroid. these are salmeterol and fluticasone. | What is seretide used for and what makes up this drug |
| Symbicort is a combination drug used in patients with asthma that is not well controlled. it is made up of a LABA and a steroid. these are formeterol and budesonide | What is symbicort used for and what makes up this drug |
| Omalizumab - based on monoclonal antibody technology and thus requires a complicated purification process, therefore very expensive. but mechanism is to stop IgE binding to mast cells and eosinophils so is effective in moderate/sever asthma. | What is an antibody based treatment of asthma and what is general mechanism of it |
| Hydrocortisone Hydrocortisone has both gluco- and mineralo-corticoid activities and is NATURALLY occuring | What is a naturally occuring adrenocorticosteroid that has mineralcorticosteroid affects |
| In the bronchial tract, muscarinic receptors (M1 and M3) are coupled to the PLC/IP3 pathway via Gq. | In the bronchial tract, muscarinic receptors interact with what G signalling pathway |