Respiratory Diseases and Chemical Mediators
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Questions and Answers

What is the mechanism of action for anticholinergic bronchodilators?

  • Enhance nitric oxide production
  • Block acetylcholine receptors (correct)
  • Activate gamma-aminobutyric acid receptors
  • Inhibit beta-adrenergic receptors

Which of the following drugs is classified as a selective beta-2 adrenergic agonist?

  • Albuterol (correct)
  • Isoproterenol
  • Epinephrine
  • Theophylline

What are common adverse effects of beta-2 adrenergic agonists?

  • Tremors and increased heart rate (correct)
  • Nausea and urinary retention
  • Tachycardia and anxiety
  • Dry mouth and dizziness

Which drug listed is used specifically for acute asthma and anaphylaxis?

<p>Epinephrine (A)</p> Signup and view all the answers

Inhaler and injection are dosage forms for which of the following medications?

<p>Isoproterenol (A)</p> Signup and view all the answers

What is the primary effect of histamine in the lungs during an asthma attack?

<p>Causes bronchoconstriction (C)</p> Signup and view all the answers

Which mediator is responsible for attracting eosinophils to the site of injury?

<p>ECF-A (C)</p> Signup and view all the answers

What condition is primarily associated with irreversible changes to the respiratory system?

<p>Chronic Obstructive Pulmonary Disease (COPD) (B)</p> Signup and view all the answers

What is a common symptom of Chronic Obstructive Pulmonary Disease (COPD)?

<p>Chronic cough (B)</p> Signup and view all the answers

What is the role of SRS-A in asthma-related inflammation?

<p>Acts as a potent bronchoconstrictor (C)</p> Signup and view all the answers

Which of the following is NOT a goal of COPD therapy?

<p>Reversing physical damage to the respiratory lining (B)</p> Signup and view all the answers

What effect does SRS-A have on mucosal tissue during an asthma episode?

<p>Increases mucus secretion (A)</p> Signup and view all the answers

Which type of cells primarily release ECF-A?

<p>Mast cells (B)</p> Signup and view all the answers

What are sympathomimetic bronchodilators primarily used for?

<p>Stimulating beta-adrenergic receptors (D)</p> Signup and view all the answers

Which condition is characterized by chronic productive cough?

<p>Chronic Bronchitis (D)</p> Signup and view all the answers

Which chemical mediator is primarily involved in attracting eosinophils during allergic reactions?

<p>Eosinophil Chemotactic Factor of Anaphylaxis (C)</p> Signup and view all the answers

What is the mechanism of action for xanthine derivative bronchodilators?

<p>Inhibiting phosphodiesterase (D)</p> Signup and view all the answers

What distinguishes emphysema from other forms of COPD?

<p>It involves damage to alveoli, making breathing difficult. (A)</p> Signup and view all the answers

Which drug type is used to thin mucus in respiratory conditions?

<p>Mucolytics (C)</p> Signup and view all the answers

What role do leukotrienes play in asthma?

<p>They are involved in prolonged inflammation. (B)</p> Signup and view all the answers

Which of the following is a characteristic symptom of asthma?

<p>Wheezing (B)</p> Signup and view all the answers

What is the primary role of inhaled corticosteroids in asthma and chronic bronchitis?

<p>To inhibit the inflammatory response (B)</p> Signup and view all the answers

Which of the following is NOT a potential side effect of oral inhalation steroids?

<p>Hypertension (D)</p> Signup and view all the answers

Inhaled corticosteroid dosing is generally recommended to be administered how often?

<p>Once or twice daily (D)</p> Signup and view all the answers

What effect do inhaled corticosteroids have on B2 receptor agonists?

<p>They increase the sensitivity of the receptors (D)</p> Signup and view all the answers

Which of the following is a brand name for the inhaled corticosteroid budesonide?

<p>Pulmicort (C)</p> Signup and view all the answers

What is a commonly prescribed combination inhaler that contains fluticasone and salmeterol?

<p>Advair (C)</p> Signup and view all the answers

What should be done to prevent or combat adverse side effects of inhaled steroids?

<p>Use the lowest effective dose (D)</p> Signup and view all the answers

Which leukocyte type is primarily inhibited by inhaled corticosteroids to reduce inflammation in the lungs?

<p>Eosinophils (A)</p> Signup and view all the answers

What characterizes chronic bronchitis?

<p>Cyanosis in advanced stages (B)</p> Signup and view all the answers

Which term is commonly associated with emphysema?

<p>Pink Puffers (A)</p> Signup and view all the answers

What is a primary cause of emphysema?

<p>Cigarette smoking (B)</p> Signup and view all the answers

What is a key symptom of chronic bronchitis?

<p>If left untreated, permanent lung damage (A)</p> Signup and view all the answers

What role does cyclic AMP play in bronchodilation?

<p>It inhibits mediators from mast cells (C)</p> Signup and view all the answers

Which type of bronchodilator increases sympathetic nervous system activity?

<p>Sympathomimetic bronchodilators (A)</p> Signup and view all the answers

What causes the lungs to lose their elasticity in emphysema?

<p>Permanent enlargement of alveoli (C)</p> Signup and view all the answers

What is a typical treatment for chronic bronchitis?

<p>Palliative care that helps with breathing (A)</p> Signup and view all the answers

Which of the following statements about xanthine derivative bronchodilators is true?

<p>They inhibit the enzyme phosphodiesterase (C)</p> Signup and view all the answers

What happens to patients with emphysema in terms of energy expenditure?

<p>They expend 15-20% of their total energy to breathe (C)</p> Signup and view all the answers

What is the primary mechanism of action for anticholinergic bronchodilators?

<p>Block the action of acetylcholine (D)</p> Signup and view all the answers

Which drug is classified as a long-acting anticholinergic bronchodilator?

<p>Tiotropium (B)</p> Signup and view all the answers

Which of the following is a side effect of anticholinergic bronchodilators?

<p>Drying of the mouth (D)</p> Signup and view all the answers

What condition are leukotriene receptor antagonists primarily used to treat?

<p>Chronic asthma management (D)</p> Signup and view all the answers

What is the main role of mucolytics in respiratory therapy?

<p>To break down mucous in the bronchioles (D)</p> Signup and view all the answers

Which of the following medications is used specifically for exercise-induced bronchoconstriction?

<p>Montelukast (D)</p> Signup and view all the answers

Which drug is NOT a common application for expectorants?

<p>Manage bronchospasms in asthma (C)</p> Signup and view all the answers

Which statement about anticholinergic bronchodilators is true?

<p>They have a delayed onset of action compared to B2-agonists. (A)</p> Signup and view all the answers

What is a common dosage form for leukotriene receptor antagonists?

<p>Tablets (C)</p> Signup and view all the answers

What is the primary therapeutic effect of expectorants?

<p>Encourage secretion production (B)</p> Signup and view all the answers

Flashcards

Chemical Mediator

Substances released by cells to influence immune and inflammatory responses.

Asthma

Chronic inflammatory disorder of the airways causing wheezing, shortness of breath, and chest tightness.

Sympathomimetic Bronchodilators

Stimulate beta-adrenergic receptors, relaxing bronchial muscles and opening airways.

Bronchoconstriction

Narrowing of the airways, making breathing difficult.

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Bronchodilator

A drug that relaxes airway muscles, opening the airways.

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Xanthine Derivative Bronchodilators

Inhibit phosphodiesterase, leading to bronchodilation and improved airflow.

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COPD

Progressive lung disease characterized by persistent respiratory symptoms and airflow limitation.

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Leukotrienes

Lipid mediators involved in inflammation, particularly in asthma.

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Anticholinergic Bronchodilators

Drugs that block acetylcholine receptors in the lungs, easing bronchoconstriction.

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Alpha- and Beta-Adrenergic Agonists (Mechanism)

Cause relaxation of bronchial smooth muscle, helping to open airways.

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Beta-2 Adrenergic Agonists (Selective)

Relaxes bronchial muscles selectively; commonly used for asthma and COPD.

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Ipratropium (Atrovent)

Common anticholinergic bronchodilator for COPD.

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Adverse Effects of Beta-Adrenergic Agonists

May include increased heart rate, tremors.

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What are chemical mediators?

Substances released by cells in response to injury or irritation, causing swelling and inflammation. They play a key role in asthma and other respiratory conditions.

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What are the main chemical mediators involved in asthma?

Histamine, ECF-A, and SRS-A are the primary chemical mediators responsible for asthma symptoms. Released from injured tissue, mast cells, and leukocytes.

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How does histamine affect asthma?

Histamine is a chemical mediator that causes bronchoconstriction (narrowing of airways), mucosal edema (swelling), and attracts eosinophils (white blood cells involved in inflammation).

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What is ECF-A?

ECF-A (Eosinophilic Chemotactic Factor of Anaphylaxis) is released by mast cells and attracts eosinophils to the injury site, increasing inflammation.

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What is SRS-A and how does it contribute to asthma?

SRS-A (Slow Reacting Substance of Anaphylaxis) is a potent bronchoconstrictor that causes long-lasting airway narrowing, mucosal edema, and increased mucus secretion.

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What is the goal of COPD therapy?

COPD therapy aims to reduce dyspnea (shortness of breath), minimize impairment and physical limitations, and reduce the frequency and severity of exacerbations (worsening periods).

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Why can't COPD be reversed?

COPD is caused by irreversible changes to the respiratory system due to emphysema and chronic bronchitis.

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How do chemical mediators relate to asthma treatment?

Treating asthma involves blocking or reducing the effects of these harmful chemical mediators. This is the basis of most asthma medications.

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Cyclic GMP

A chemical messenger in the body that can trigger bronchoconstriction by causing the release of inflammatory mediators.

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Ipratropium

A short-acting anticholinergic bronchodilator medication used primarily to maintain breathing in patients with COPD.

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Tiotropium

A long-acting anticholinergic medication used to manage COPD. Offers sustained bronchodilation for extended periods.

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Montelukast

A medication that blocks the action of leukotrienes, preventing inflammation and bronchoconstriction, particularly effective for chronic asthma.

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N-acetylcysteine

A medication used by inhalation in COPD, capable of breaking down thick mucous secretions in the airways.

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Guaiphenesin

A medication that encourages the production of respiratory tract secretions while making them thinner, easing their expulsion from the airways.

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Expectorants

A group of medications designed to thin and promote the clearance of mucus from the airways.

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Mucolytics

Medications that break down and liquefy thick mucus, primarily used in patients with respiratory illnesses.

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Inhaled Corticosteroids: When are they Adjunct?

Inhaled corticosteroids are used when bronchodilators alone can't effectively treat asthma or chronic bronchitis, or to reduce the need for high doses of bronchodilators.

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Inhaled Corticosteroids: How do they Work?

They directly target inflammation in the airways, reducing the inflammatory response by modulating chemical mediators, limiting leukocyte buildup, and enhancing the effectiveness of bronchodilators.

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Inhaled Corticosteroids: Direct Effect on Airway Muscles?

Inhaled corticosteroids don't directly relax airway muscles.

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Inhaled Corticosteroids: Dosing Frequency?

Inhaled corticosteroids are typically taken once or twice daily.

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Inhaled Corticosteroids: Do they have Side Effects?

Inhaled corticosteroids have fewer side effects than oral steroids but can still cause hoarseness, oral fungal infections, and potential long-term issues like osteoporosis and glaucoma.

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Inhaled Corticosteroids: When to Use Lowest Dose?

Use the lowest effective dose of inhaled corticosteroids based on severity of disease and the specific steroid chosen.

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Inhaled Corticosteroids: Device Matters?

The type of device used to deliver inhaled corticosteroids affects their effectiveness, with MDIs (metered-dose inhalers) being more effective than DPIs (dry powder inhalers).

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How to Manage Side Effects of Inhaled Corticosteroids?

Patients should be advised on techniques to minimize side effects: rinsing mouth after use, proper inhaler technique, and regular dental checkups.

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Chronic Bronchitis

A condition where the airways in the lungs become inflamed and irritated, leading to excessive mucus production and difficulty breathing. It's often caused by long-term exposure to irritants like cigarette smoke.

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Emphysema

A chronic lung disease where the tiny air sacs in the lungs (alveoli) are damaged, leading to shortness of breath and difficulty breathing out. It's mainly caused by smoking and genetic factors.

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What causes the difficulty breathing in Chronic Bronchitis?

The thickened mucus caused by inflammation blocks the airways, making it hard to breathe. Also, the damaged respiratory lining makes gas exchange less efficient.

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What happens to the lungs in Emphysema?

The air sacs in the lungs lose their elasticity, meaning they can't expand and contract as well, making it difficult to breathe out completely.

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What is the main difference between Chronic Bronchitis and Emphysema?

Chronic Bronchitis involves inflammation and excess mucus production, while Emphysema damages the air sacs in the lungs, making breathing difficult.

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How do Sympathomimetic Bronchodilators work?

They activate beta-2 receptors in the lungs, which causes the muscles in the airways to relax, opening up the airways.

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What is the main difference between Sympathomimetic and Xanthine Bronchodilators?

Sympathomimetic bronchodilators activate beta-2 receptors, while Xanthine bronchodilators increase cyclic AMP levels to achieve the same effect.

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Study Notes

Chemical Mediators

  • Substances released by cells to influence immune and inflammatory responses
  • Examples: prostaglandins, histamine, ECF-A, SRS-A, leukotrienes

Disease States and Symptoms

  • Asthma: Chronic inflammatory airway disorder causing wheezing, shortness of breath, and chest tightness
  • COPD (Chronic Obstructive Pulmonary Disease): Progressive lung disease with persistent respiratory symptoms and airflow limitation
  • Chronic Bronchitis: Type of COPD marked by chronic productive cough and bronchial tube inflammation
  • Emphysema: COPD form where alveoli are damaged, causing shortness of breath and difficulty breathing

Mechanisms of Action

  • Sympathomimetic Bronchodilators: Stimulate beta-adrenergic receptors, relaxing bronchial muscles, opening airways
  • Xanthine Derivative Bronchodilators: Inhibit phosphodiesterase, leading to bronchodilation and improved airflow
  • Anticholinergic Bronchodilators: Block acetylcholine receptors, reducing bronchoconstriction

Drug Types and Subclasses

  • Sympathomimetic Bronchodilators: Alpha- and Beta-Adrenergic Agonists (e.g., Epinephrine, Isoproterenol, Albuterol, Salmeterol)
  • Xanthine Derivative Bronchodilators: Theophylline
  • Anticholinergic Bronchodilators: Ipratropium, Tiotropium
  • Leukotriene Receptor Antagonists: Montelukast, Zafirlukast
  • Other Products: Inhaled Corticosteroids (e.g., Fluticasone), Mast Cell Stabilizers (e.g., Cromolyn), Long-Acting Beta Agonists (e.g., Salmeterol)
  • Combination Products: Fluticasone/Salmeterol (Advair), Budesonide/Formoterol (Symbicort)

Additional Information

  • Chemical mediators in asthma: Histamine, ECF-A, SRS-A
  • Prostaglandins widely distributed substances, released by cell membranes in response to injury or irritation, causing swelling
  • MOA of bronchodilators: Bronchiole smooth muscle tone and mucous production under autonomic nervous system control
  • Sympathetic activation leads to bronchodilation
  • Parasympathetic activation leads to bronchoconstriction and increased mucous secretion
  • Classification of drugs as short-acting (rescue) and longer-acting (controller/maintenance) is important.
  • Side Effects: Many medications have side effects. Attention is needed to these effects, and knowledge about them is important.
  • Inhalation devices such as inhalers and dry powder inhalers, and how they are used
  • Combination therapies: Combining different types of drugs (e.g., inhalers) to treat conditions like asthma and COPD.
  • Important auxiliary labels: "Rinse mouth after use", and warnings/cautions relating to side effects, duration and dosage
  • Technique: Proper inhaler use technique and patient education
  • Role of the technician: Technician's role in dispensing, training, and managing patients with inhalers (including assessing if a combination inhaler is better than separate treatments). Awareness of when and when not to use, and when to flag for further treatment options

COPD Therapy and Goals

  • Drug therapy offers some relief but cannot fully reverse physical damage.
  • Goals include reducing/eliminating dyspnea, decrease impairment and disability, reducing frequency and severity of exacerbations, and improving quality of life.

Chronic Bronchitis and Emphysema

  • Chronic Bronchitis (Blue Bloaters): Chronic irritation and inflammation of the respiratory tract
  • Emphysema (Pink Puffers): Permanent enlargement of alveoli and destruction of alveolar walls, often caused by smoking. Irreversible lung damage from smoking and hereditary factors.

Oral Inhalation Steroids

  • General information about oral inhalers
  • Generic and brand names of different oral inhalers
  • Different types and mechanisms involved

Combination Inhalers

  • Information about combination inhalers (i.e., combining different classes of drugs into a single device)

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Lecture 4: Respiratory Medications PDF

Description

This quiz covers the role of chemical mediators in immune responses, focusing on diseases such as asthma, COPD, chronic bronchitis, and emphysema. Learn about the mechanisms of action for various bronchodilators and their effects on respiratory function.

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