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Summary of respiratory drugs

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All the respiratory drugs you need for astma and COPD

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  • August 14, 2023
  • 9
  • 2023/2024
  • Summary
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Respiratory Drugs
Muscarinic receptors




 A type of G protein receptors
 Parasympathetic: rest and digest
 Parasympathetic nerves start in the brain and travel to the lung via the vagus nerve.
 Synapse appears at the parasympathetic ganglia in the trachea.
 Ganglia: nerve clusters
 The impulse then travels to the airway smooth muscle.
 Causing bronchoconstriction by releasing acetylcholine.
 This acts on M3 receptors.
 M3 receptors activate G protein-coupled pathways.
 Causing the release of calcium ions
 To cause contraction.
 M2 receptors inhibit acetylcholine.
 The sympathetic nervous system does not affect airway smooth muscle.
 Only glands and blood vessels.

Airway smooth muscle




Contraction:
 Ca2+ interacts with calmodulin to form a Ca2+-calmodulin complex.
 This activates myosin light chain kinase (MLCK)
 The kinase phosphorylates myosin.
 This leads to muscle contraction.
Or Dilation:
 B2 adrenoceptors are found on airway smooth muscle.

,  These stimulate adenyl cyclase leading to Increased cAMP.
 cAMP activates protein kinase A.
 this phosphorylates several proteins which reduce intracellular Ca2+
 reducing MLCK activity causing muscle relaxation.

Asthma
 airway inflammation
 can improve with age.
 hyper-responsiveness to stimuli
 causing bronchoconstriction and increased mucus secretion.
 caused by:
o allergens
o cold
o exercise
o respiratory infection
o atmospheric pollutants
o NSAIDs
o Stress
o SCAANER -remember
COPD vs Asthma
COPD Asthma
Middle age childhood
Cause: smoking Allergens and exercise
Non-reversible reversible
Gradually progressive Can improve
neutrophils eosiniophils
 Lung epithelial cells release factors that activate neutrophils.
 In response to cigarette smoke or infection.
 Causing these neutrophils and other inflammatory cells to accumulate
o CD8+ cytotoxic T cells
o B cells
o Macrophages
 These cells become activated and trigger an inflammatory cascade.
 Triggering the release of tumour necrosis factor-a and other interleukins
 These mediators sustain the inflammatory process and lead to tissue damage.
 This inflammation can lead to structural changes in the lung to block airflow.
Allergens in the body
 An allergen encounters a mast cell.
 IgE antibodies are found on its surface.
 When the allergen binds it causes the release of histamine, LTB4 and PGD2
(prostaglandin).
 These are all bronchoconstrictors.
 Chemokines are released by surrounding macrophages to attract other immune cells
and leukocytes to the area.

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