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50 Cards in this Set
- Front
- Back
Name 4 classic lung diseases? |
Asthma COPD Pulmonary Oedema Cystic fibrosis |
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Name 3 centrally-mediated resp dysfunctions? |
Premature birth Opioid intoxication Rett syndrome |
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Bronchial asthma causes what 2 problems? |
acute bronchospasm and dyspnea |
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What happens to the airways in chronic asthma? |
Become inflamed |
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3 common asthma triggers? |
allergens, rapid changes in temp, drug side-effects and exercise |
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Most common symptoms (4)? |
Feeling of breathlessness tight chest wheezing coughing |
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How do you diagnose asthma? 2 |
measure the FEV1:FVC ratio Bronchoscopy |
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How do B2 adrenoceptor agonists work? |
Via activation of GPCRs and an increase in cAMP Mimic bronchodilator effect |
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Name 3 common adverse side effects of beta agonists? |
Muscle tremor Hypokalaemia Excessive = tachycardia |
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Name 2 short acting beta 2 agonists? |
Salbutamol and terbutaline |
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Name 2 longer acting beta 2 agonists? What are these intended for? |
salmeterol isoproterenol Long-term prevention of attacks rather than acute relief (delayed onset of action) |
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What are longer actin beta agonists useful for treating? |
Nocturnal asthma |
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How do muscarinic receptors anatagonists (MRAs) cause bronchodilation? |
Binding to the musc receptors in the airway smooth muscle and prevent ACH action from psymp nerves |
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MRAs also do what? |
mucus secretion |
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Which type of bronchospasm are MRAs particularly useful for? |
irritant-induced attacks |
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Problem with MRAs at the moment? |
Non-selective, block M1, 2 and 3 Blocking 2 decreased their effectiveness |
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Name 3 short acting MRAs |
atropine ipratropium bromide oxitropium bromide |
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Name a longer acting MRA |
Tiotropium bromide |
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How are anticholinergics administered? Why? |
Inhalation Speed up their onset of action and reduce systemic adverse effects |
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How long after admin does max bronchodilation occur? |
30 mins |
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What are anticholinergics usually used to treat? |
COPD |
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Where can you find naturally occurring xanthines? |
Coffee and tea caffeine and theobromine |
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How do xanthines act? |
Inhibit phosphodiesterase enzymes in airwya smooth muscle this inceases cAMP and inhibits MLCK = relaxation of smooth muscle |
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Name the main xanthine Admin? why? |
Theophylline Orally overcome short biological half-life |
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Major problem of xanthines? |
V narrow therapeutic window |
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Adverse effects of xanthines? 4 |
Nausea cardiac arrhythmias and convulsions Drug interactions problematic |
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What to AIDs treat? Not suitable for what? |
preventing inflammation do not cause bronchodilation and not suitable for treatment of acute attacks |
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Eg of class of AIDs? what do they do? Egs 2? |
Glucocorticosteroids inhibit inflam cell infiltration into the airways and reduce oedema formation by acting on the vascular endothelium Beclometasone and budesonide |
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Which 2 diseases often occur together? |
Chronic bronchitis and emphysema often can occur together |
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Genetic deficiency in the enzyme alpha 1 antitrypsin increases what? |
Susceptibility to bronchitis and and emphysema |
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Symptoms of COPD? 3 |
excessive production of sputum chronic cough breathlessness on exertion |
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Why is the airway obstructed in COPD? |
Luminal narrowing and mucus plugs May later lead to resp infection |
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What does chronic bronchitis cause? 3 |
Alveolar hypoventilation, hypercapnia and hypoxia |
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3 treatments of chronic bronchodilators? |
bronchodilators mucokinetic drugs antibiotics |
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Which 2 bronchodilators are most commonly used in COPD? |
B2 agonists and xanthines |
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Mucokinetic drugs mech of action? 2 e.gs? |
reducing viscosity of mucus by breaking disulphide bonds holding mucus glyco proteins together Acetlycysteine and ambroxol |
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What are antibiotics prescribed for in COPD? |
Combat the secondary basterial infections in sputum |
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Treatment for pul oedema based on what? |
reducing blood vol (to reduce BP and therefore reduce hydrostatic pressure forcing fluid out of pul cap.s and to reduce cardiac work) |
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what are diuretics used for in pul oedema? Give an eg? |
act to increase urinary fluid loss and blood vol inhibit reabsorp in the loop of Henle furosemide |
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name 3 types of drugs used to improve cardiac function in pul oedema? eg of each? |
cardiac glycosides - digoxin phosphodiesterase inhibitors - inamirone beta t agonists - dobutamine |
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What is the primary defect in cystic fibrosis? |
mutatio in specific proteins essential for CL- efflux from cells within the lung |
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What does the defect in CF cause? |
thick and viscous secretion in ducted organs, incl airways of the lung therefore poor ventilation of affected areas bacterial infection causes ireversible lung damage |
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What do MRAs do in CF? |
atropine reduce mucus secretions |
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What do expectorants do to help CF? |
glyceryl guaiacolate Increase the fluidity of secretions and thereby increase the productivity of coughing |
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What do mucolytic agents do to help CF? |
N-acetylcysteine Decrease viscosity of secretions |
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what does opioid intoxication do to respiration? |
Centrally-mediated depression |
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What are mew opiod receptors and mech of action? |
GPCRs activation inhibits adenylate cyclase Decrease cAMP therefore decrease neuronal excitability |
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Where can the mew receptor be found? |
expressed in neurons in resp control centres of the pons and medulla |
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Preferred treatment of accidental opioid overdose is? |
Admin opiod antagonist NALOXONE, which blocks the opiod receptors and reverses effects |
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What is used when the analgesic effect of opioids needs to be maintained? |
Stimulation of 5-HT4 receptors activate GPCRs which stim adenylate cyclase counteracts the resp depression by maintains analgesia |