Untitled Flashcards Set

Acetylcholine: A neurotransmitter used by both the parasympathetic and sympathetic nervous systems. It plays a role in transmitting signals in autonomic ganglia and at parasympathetic target organs.

Acetylcholinesterase: An enzyme that breaks down acetylcholine in the synaptic cleft, terminating its action.

Adrenal glands: Endocrine glands located on top of each kidney that secrete adrenaline and noradrenaline in response to sympathetic stimulation.

Adrenal medulla: The inner part of the adrenal glands that releases adrenaline and noradrenaline directly into the bloodstream during stress.

Adrenaline: A hormone and neurotransmitter released by the adrenal medulla and some sympathetic nerves, involved in the "fight or flight" response. Also known as epinephrine

Afferent: Refers to sensory neurons that carry information from the body to the central nervous system.

Autonomic nervous system: A branch of the peripheral nervous system that regulates involuntary processes such as heart rate, digestion, and glandular secretion. It includes the sympathetic, parasympathetic, and enteric divisions.

Axon: A long projection of a neuron that transmits electrical signals from the cell body to target cells or tissues.

Catechol: A chemical structure consisting of a benzene ring with two adjacent hydroxyl groups, forming the backbone of catecholamines.

Catecholamine: A group of neurotransmitters and hormones, including dopamine, noradrenaline, and adrenaline, derived from tyrosine and containing a catechol group.

Catechol-O-methyltransferase (C⁠O⁠M⁠T): An enzyme that metabolises catecholamines by adding a methyl group, reducing their activity.

Central nervous system (CNS): The brain and spinal cord, responsible for processing and integrating sensory information and coordinating motor output.

Choline acetyltransferase: An enzyme that synthesizes acetylcholine from choline and acetyl-CoA.

Dopa decarboxylase: An enzyme that converts L-DOPA into dopamine in catecholamine biosynthesis.

Dopamine: A catecholamine neurotransmitter involved in motor control, reward, and mood regulation.

Dopamine beta hydroxylase: An enzyme that converts dopamine into noradrenaline.

Epinephrine: the US term for adrenaline

Enteric nervous system: A division of the autonomic nervous system located in the gastrointestinal tract, capable of regulating digestion independently of the CNS.

Fast synaptic transmission: Rapid communication between neurons or neurons and target cells, typically mediated by neurotransmitters like acetylcholine or glutamate.

Ganglion (plural ganglia): A cluster of nerve cell bodies in the peripheral nervous system where synapses occur between pre-ganglionic and post-ganglionic neurons.

G protein: a membrane associated protein that links G protein coupled receptors to intracellular signalling pathways

G protein coupled receptor: A type of receptor that transduces extracellular signals into cellular responses via G-proteins.

L-DOPA: A precursor to dopamine used in dopamine synthesis. Used in the treatment of Parkinson’s disease.

Monoamine: A class of neurotransmitters that includes catecholamines (dopamine, noradrenaline, adrenaline), serotonin, histamine and melatonin.

Monoamine oxidase (M⁠A⁠O): An enzyme that degrades monoamines such as dopamine, noradrenaline, and adrenaline, reducing their activity.

Motor: Refers to neurons or pathways that carry commands from the CNS to muscles or glands, enabling movement or secretion.

Muscarinic acetylcholine receptor: A type of acetylcholine receptor found on parasympathetic target tissues, responsible for slower, modulatory responses.

N⁠E⁠T: The noradrenaline transporter, which removes noradrenaline from the synaptic cleft to terminate its action.

Nicotinic acetylcholine receptors: Ion channel receptors activated by acetylcholine, found at autonomic ganglia and on skeletal muscle at neuromuscular junctions.

Noradrenaline: A neurotransmitter and hormone released by sympathetic nerves and the adrenal medulla, involved in the "fight or flight" response.

Norepinephrine: the US term for noradrenaline

Paravertebral ganglia: Sympathetic ganglia arranged in chains on either side of the vertebral column..

Parasympathetic nervous system: A branch of the autonomic nervous system responsible for "rest and digest" functions, promoting relaxation and conservation of energy.

Peripheral nervous system: All nerves outside the central nervous system, including the somatic and autonomic nervous systems.

Phenylethanolamine-N-methyltransferase: An enzyme that converts noradrenaline into adrenaline in the adrenal medulla.

Post-ganglionic neuron: A neuron in the autonomic nervous system that transmits signals from a ganglion to the target tissue.

Pre-ganglionic neuron: A neuron in the autonomic nervous system that transmits signals from the CNS to an autonomic ganglion.

Prevertebral ganglia: Sympathetic ganglia located near major abdominal arteries, innervating abdominal and pelvic organs.

Somatic nervous system: The part of the peripheral nervous system that controls voluntary movements of skeletal muscles.

Sympathetic nervous system: A branch of the autonomic nervous system responsible for "fight, fright or flight" responses, increasing heart rate, blood pressure, and energy mobilization.

Tyrosine hydroxylase: An enzyme that catalyzes the conversion of tyrosine to L-DOPA, the first step in catecholamine synthesis.

Uptake 2: A low-affinity transport mechanism for removing catecholamines from the extracellular space, primarily in non-neuronal tissues.

• Adenylyl cyclase: An enzyme that converts ATP to cyclic AMP (cAMP), a second messenger involved in signalling pathways.

• Agonist: a ligand that binds to a receptor and activates it. Usually it will bind to the same site as the neurotransmitter or hormone that the receptor recognises.

• Antagonist: a ligand that binds to a receptor and stops it from activating. This may be because it blocks the agonist binding site, or it may act at a different site.

• cAMP: cyclic adenosine monophosphate. An important intracellular second messenger.

• DAG: Diacylglycerol, a second messenger that along with calcium, activates protein kinase C.

• Enzyme-linked receptor: A type of receptor that has intrinsic enzymatic activity or is associated with an enzyme and transduces signals via catalysis.

• G protein: A molecular switch that transduces signals from G protein coupled receptors to intracellular signalling pathways.

• G protein coupled receptor: A large superfamily of membrane receptors that interact with G proteins to transduce signals from extracellular stimuli.

• Ionotropic glutamate receptors: A superfamily of ligand gated ion channels that mediate fast synaptic transmission in the central nervous system by binding glutamate.

• IP3: Inositol 1,4,5-trisphosphate, a second messenger that mobilizes calcium from intracellular stores.

• IP3 receptor: An intracellular receptor that binds IP3 and mediates the release of calcium from the endoplasmic or sarcoplasmic reticulum.

• Kinase: An enzyme that transfers phosphate groups from high-energy molecules, such as ATP, to specific substrates, a process called phosphorylation.

• Ligand: any molecule that binds to a receptor

• Ligand gated ion channel: A type of receptor that opens an ion channel in response to the binding of a specific chemical ligand.

• Nuclear receptor: A type of receptor located within the cell nucleus or cytoplasm that binds to hormones and other ligands to regulate gene expression.

• Orphan receptor: A receptor whose natural ligand is unknown.

• Pentameric ligand gated channel: A superfamily of ligand gated ion channels composed of five subunits arranged symmetrically around a central pore.

• Phosphodiesterase: An enzyme that breaks down cyclic nucleotides like cAMP and cGMP, regulating signal transduction pathways.

• Phospholipase C: An enzyme that cleaves phospholipids to generate second messengers such as IP3 and DAG.

• PIP2: Phosphatidylinositol 4,5-bisphosphate, a membrane phospholipid that is a precursor for second messengers like IP3 and DAG.

• Protein kinase A: A serine/threonine kinase activated by cyclic AMP (cAMP) that regulates various cellular processes.

• Protein kinase C: A family of serine/threonine kinases activated by DAG and calcium, involved in regulating various cellular processes.

• Receptor: A protein molecule that receives chemical signals from outside a cell and initiates a cellular response.

• Receptor tyrosine kinases: A superfamily of enzyme-linked receptors that phosphorylate tyrosine residues on target proteins to propagate signals.

• Ryanodine receptor: An intracellular calcium channel that releases calcium from the sarcoplasmic or endoplasmic reticulum in response to signals.

• Second messenger: A small intracellular molecule that transmits signals from receptors to target molecules within the cell.

• Signal transduction: The process by which a signal from a receptor is converted into a cellular response, often involving a series of molecular events.

• Superfamily: A large group of related proteins that share structural and functional characteristics.

• Subunit: a component protein of a receptor (and other types of protein). Receptors are frequently made up of a number of subunits that are held together by (usually) non-covalent bonds. The arrangement of subunits in the protein complex defines its quaternary structure.

  • monomer (monomeric): a single subunit

  • dimer (dimeric): a structure that contains two subunits

  • trimer (trimeric): a structure that contains three subunits

  • tetramer (tetrameric): a structure that contains four subunits

  • pentamer (pentameric): a structure that contains five subunits

  • hexamer (hexameric): a structure that contains six subunits

• α2δ (alpha 2 delta) subunit: An accessory subunit of voltage-gated calcium channels that helps modulate their function and trafficking.

• Accessory subunit: A protein subunit that associates with a primary channel subunit to modulate its properties or localization.

• Activation gate: The part of an ion channel that opens to allow ion flow in response to a stimulus.

• Active transport: The movement of ions or molecules across a membrane against their concentration gradient, requiring energy input, often from ATP.

• Alpha (α) subunit (voltage gated channel): The main subunit of a voltage-gated ion channel, forming the pore and responsible for the channel's primary functions.

• Carrier protein: A membrane protein that facilitates the transport of specific substances across the cell membrane by binding and releasing them.

• Ca_V: Short for voltage-gated calcium channel.

• Chemical gradient: A difference in the concentration of a specific substance across a membrane.

• Closed state: A state of an ion channel in which the channel is not conducting ions, even though it may be ready to open.

• Conductance: A measure of how easily ions flow through an ion channel, influenced by the channel's properties and ion concentration.

• Cryo-electron microscopy: A technique used to visualize molecular structures at high resolution by freezing samples and imaging them with electrons.

• Current: The flow of electric charge, in this context, caused by the movement of ions through ion channels.

• Dendrogram: A tree-like diagram that shows the relationships between different proteins, often used to compare ion channel families.

• Electrical gradient: A difference in electric charge across a membrane, which influences the movement of ions.

• Electrochemical gradient: The combined effect of the chemical gradient and electrical gradient that drives the movement of ions.

• Electrophysiology: The study of electrical properties of biological cells and tissues, often involving the measurement of ion channel activity.

• Gating: The process by which ion channels open or close in response to stimuli such as voltage, ligands, or mechanical forces.

• Hydration shell: A layer of water molecules surrounding an ion, affecting its size and interaction with ion channels.

• Inactivated state: A state of an ion channel in which it cannot conduct ions, typically occurring after opening.

• Inactivation gate: A structure within an ion channel that blocks the pore to stop ion flow during the inactivated state.

• Ion channel: A protein that forms a pore in the cell membrane, allowing specific ions to pass through down their electrochemical gradient.

• Ion pump: A membrane protein that uses energy to actively transport ions across a membrane against their gradient.

• Knock on: A mechanism of ion permeation where an incoming ion displaces another ion already in the channel.

• K_V: Short for potassium voltage-gated channels.

• L type calcium channels: A type of voltage-gated calcium channel involved in long-lasting calcium currents, important in muscle contraction and neurotransmission.

• Ligand gated: Refers to ion channels that open or close in response to the binding of a chemical ligand, such as a neurotransmitter.

• Membrane dipping domain: A structural domain of an ion channel that enters the membrane on one side but re-emerges on the same side without fully crossing.

• Membrane potential: The voltage difference across a cell membrane due to ion distribution.

• Na_V: Short for sodium voltage-gated channels.

• Open state: A state of an ion channel in which the channel is conducting ions.

• Passive transport: The movement of ions or molecules across a membrane without energy input, driven by the electrochemical gradient.

• Pseudo-subunit: A structural domain that mimics a separate subunit but is part of the same polypeptide chain.

• Rectification: The property of some ion channels to preferentially allow ion flow in one direction.

• Resistance: The opposition to ion flow through a channel, inversely related to conductance.

• Resting membrane potential: The electrical potential difference across the cell membrane in a resting, unstimulated state.

• Resting state: A state of an ion channel where it is not conducting ions and is ready to be activated. Also known as the closed state

• Selective permeability: The ability of an ion channel to allow certain ions to pass while excluding others.

• Selectivity filter: The part of an ion channel that determines which ions can pass through based on size and charge.

• Transmembrane domain: A portion of a protein that spans the cell membrane.

• Transporter: A protein that facilitates the movement of ions or molecules across the cell membrane..

• Voltage gated (also known as voltage sensitive): Refers to ion channels that open or close in response to changes in membrane potential.

• Voltage sensor: A structural domain of a voltage-gated ion channel that detects changes in membrane potential and triggers channel opening or closing.

• Affinity: the tightness of binding of a drug to its target. It is normally measured using KD. As K_D goes down, affinity goes up.

• Aliquot: A small, measured quantity of a sample. Often used in the context of tissue samples.

• B⁠⁠_max: the maximum binding of a drug in a sample of tissue. It is a measure the number of binding sites and is usually expressed as an amount e.g. femtomoles, normalized to the total amount of protein in the tissue sample e.g. fmol/mg protein.

• Competition binding assay: An experiment where a labelled ligand and an unlabelled competitor ligand compete for binding to a target, used to measure binding affinity and specificity.

• Compound library: a large collection of drugs maintained by a pharmaceutical company

• Hill-Langmuir Equation: the central equation governing the interaction of a drug with its target

• K_D:  the equilibrium dissociation constant for a drug. It is a measure of affinity and has units of concentration. K_D can also be defined as the concentration of drug that produces 50% of maximum binding.

• K⁠⁠_m:the Michaelis constant. It is one of the parameters in the Michaelis-Menten Equation and is a measure of an enzyme's affinity for its substrate.

• Law of Mass Action: A principle stating that the rate of a chemical reaction is proportional to the product of the concentrations of the reactants, applied in drug binding to describe ligand-receptor interactions.

• Liquid scintillation counting: A method for measuring radioactivity in a sample by detecting light emitted from a scintillation cocktail when radioactive particles interact with it.

• Michaelis-Menten Equation: a version of the Hill-Langmuir Equation that describes how the rate of an enzyme-catalyzed reaction varies with substrate concentration.

• Non-specific binding: binding to the non-receptor sites in the assay.

• Radioligand: a drug that has had a radioisotope added to it so it can be used as a probe to measure binding at a target protein.

• Rectangular hyperbola: A mathematical curve that describes the relationship between ligand concentration and binding in saturation binding assays for a single class of binding sites. It is characterized by a steep rise from the origin after which the curve plateaus.

• Saturable: A characteristic of binding where all available binding sites can be occupied at high ligand concentrations, reflecting a finite number of binding sites.

• Saturation binding assay: An experiment that measures the binding of increasing concentrations of a labelled ligand to a target, used to determine the total number of binding sites and the affinity of the ligand.

• Selectivity: the relative affinity of a drug for one receptor type compared to another. It is usually expressed as the ratio of the two K_D values. For example if drug X is 50-fold selective for receptor A vs receptor B, its K_D value at receptor B will be 50 times higher than its K_D at receptor A.

• Specific binding: binding to the receptor sites in the assay

• Total binding: the sum of the specific and non-specific binding

• V⁠⁠_max: the maximal velocity of an enzyme-catalysed reaction. It is the product of the enzyme concentration and the catalytic constant for the enzyme.

• Cheng-Prusoff Equation: an equation used to convert IC₅₀ to K_⁠⁠i

• Competition Binding Equation: an equation used to plot competition binding data

• Gaddum Equation:  an extension of the Hill-Langmuir Equation that describes competitive binding.

• IC₅₀: the concentration of a competing ligand that reduces radioligand binding to 50% of control

• K_⁠⁠i: the equilibrium dissociation constant for a competing ligand. It is a measure of affinity and is equivalent to K_D. The only difference is the method used to determine it.

• pK⁠⁠_i, pK_D: -log K⁠⁠_i and -log K_D, respectively  

• Antagonist: a drug that binds to a receptor but has zero efficacy

• Competitive antagonist: a drug that binds to the same site as agonists but does not activate the receptor

• Dose: the amount of drug given to an animal or human volunteer. It is usually measured in mg of drug per kg of body weight

• EC₅₀, ED₅₀: the concentration or dose of a drug that is required to give 50% of the maximal effect that drug can achieve. These parameters are measures of potency

• Efficacy: the tendency of a drug to activate  a receptor once it has bound to it. 

• Full agonist: a drug whose efficacy is the same as that of the natural agonist at the receptor

• Functional Gaddum Equation:  a version of the Gaddum Equation that describes the actions of a competitive antagonist in a functional assay

• Functional Hill-Langmuir Equation:  a version of the Hill-Langmuir Equation that describes receptor activation.

• Insurmountable antagonism: antagonism that cannot be overcome by increasing the agonist concentration

• K_i: the equilibrium dissociation constant for a competitive antagonist. It is a measure of affinity and is equivalent to K_D. The only difference is the method used to determine it.

• Non-competitive antagonist: a drug that binds to a site different to the agonist and blocks receptor activation via an allosteric mechanism

• Orthosteric antagonist: another name for a competitive antagonist

• Partial agonist: a drug whose efficacy is less than that of the natural agonist at the receptor

• pK_i, pEC₅₀, pED₅₀: -log K_i, -log EC₅₀ and -log ED₅₀, respectively  

• Potency: the concentration or dose of a drug required to produce a specified effect

• Spare receptors: when a system has more receptors than are needed to achieve maximum effect

• Surmountable antagonism: antagonism that can be overcome by increasing the agonist concentration

• Tone: the underlying level of activation of a signalling system

• Peptide bond: the basic chemical bond that holds amino acids together in a protein

• Pharmacophore: the minimum set of chemical features a drug must have in order to bind to its target protein.

• Primary structure: the linear amino acid sequence of a protein

• Quaternary structure: the assembly of protein monomers to form a functional protein

• R group: the side chain of an amino acid that determines its chemical properties

• Secondary structure: the folding of sections of the protein into regular patterns like alpha helices

• Tertiary structure: the overall folding pattern of a protein monomer

• Covalent bond: a strong bond in which atoms share electrons. It is uncommon in drug-target interactions

• Dipole: a molecule in which the electrons are unevenly distributed, resulting in one part of the molecule having a slight positive charge and another region having a slight negative charge.

• Hydrogen bond: an interaction between a hydrogen covalently bonded to an electronegative atom such as oxygen, and the lone pairs of electrons of another electronegative atom such as nitrogen.

• Hydrogen bond acceptor: the electronegative atom that supplies the lone pair in a hydrogen bond

• Hydrogen bond donor: the electronegative atom that supplies the hydrogen in a hydrogen bond

• Hydrophobic bond: an weak interaction between two hydrophobic molecules. It arises due to a gain in entropy

• Ionic bond: an interaction between a cation (an atom that has lost an electron) and an anion (an atom that has gained an electron)

• Van der Waals forces: weak interactions between dipoles.

• +/− system: a classification system based on the direction an optical isomer rotates polarized light. (+) enantiomers rotate light clockwise and (−) enantiomers, anticlockwise.

• Cahn-Ingold-Prelog system (CIP): a method for classifying the configuration of atoms at a chiral centre. Enantiomers are designated as R or S using this system.

• Chiral carbon: a carbon atom that is a chiral centre

• Chiral centre: an atom, usually a carbon, that has four different groups attached to it. Chiral centres are what give rise to chirality. 

• Chiral: describes a molecule that cannot be superimposed on its mirror image. It comes from the Greek word kheir meaning hand. 

• Cis-trans isomerism: where stereoisomers differ in how groups are orientated either side of a double bond.

• Configurational isomerism: where stereoisomers of a molecule that cannot be interconverted by rotation of bonds. The main examples are optical isomerism and cis-trans isomerism

• Conformational isomerism: where stereoisomers of a molecule that can be interconverted solely by the rotation of bonds.

• D/L system: a method for classifying stereoisomers of molecules based on their relationship to glyceraldehyde. It is mainly applicable to sugars and amino acids

• Diastereomers: a pair of stereoisomers that contain chiral centres but are not mirror images of each other.

• Enantiomers: also known as optical isomers. These are pairs of compounds that are mirror images of each other and rotate polarized light in opposite directions. This is a type of configurational isomerism. Optical isomerism arises due to the presence of chiral centres.

• Racemic mixture: a mixture that contains equal amounts of two enantiomers of a chiral molecule. It is optically inactive as the two isomers rotate light in opposite directions and cancel each other out.

• Stereogenic centre: an atom that gives rise to stereoisomerism

• Stereoisomers: molecules that have the same sequence of atoms in their structure, but differ in the 3D arrangement of bonds at one or more atoms

• ACE inhibitor (ACEi): a drug that inhibits angiotensin converting enzyme

• AHA/ACC: the American Heart Association and the American College of Cardiology. US professional bodies that have collaborated to produce guidelines on treating cardiovascular disorders.

• ALL-HAT: Antihypertensive and Lipid Lowering treatment to prevent Heart Attack. A clinical trial that heavily influenced US guidelines on how hypertension is treated

• Alpha blocker (α-blocker): an antagonist of alpha adrenoceptors

• Amlodipine: a dihydropyridine L-type calcium channel blocker used as an antihypertensive

• Angina: a heart disorder that occurs when arteries are blocked and heart muscle does not receive enough oxygen. It is a warning sign that the person may have a heart attack.

• Angiotensin converting enzyme (ACE): an enzyme that cleaves angiotensin I (inactive) to yield angiotensin II (active)

• Angiotensin II type 1 receptor (AT1R): the main receptor for angiotensin II

• Angiotensin II: a peptide hormone that causes vasodilation and salt and water retention

• Angiotensin receptor blocker (ARB): an antagonist of angiotensin II type 1 receptors

• ASCOT trial: the Anglo Scandinavian Cardiac Outcomes Trial. A clinical trial that heavily influenced NICE guidelines on how hypertension is treated

• Atenolol: a selective beta adrenoceptor antagonist used as an antihypertensive

• Atherosclerosis: clogging of the arteries with cholesterol

• Bendroflumethiazide: a thiazide diuretic used as an antihypertensive

• Beta blocker (β-blocker): an antagonist of beta adrenoceptors

• Bisoprolol: a selective beta adrenoceptor antagonist used as an antihypertensive

• Bradykinin: A peptide that causes blood vessels to dilate (expand), leading to a reduction in blood pressure. It is involved in the inflammatory response and is broken down by angiotensin-converting enzyme (ACE). A build up of bradykinin can cause a cough.

• Calcium channel blocker (CCB): a drug that inhibits L-type calcium channels

• Candesartan: an angiotensin receptor blocker used as an antihypertensive

• Captopril: an angiotensin converting enzyme inhibitor used as an antihypertensive

• Cardiac dysrhythmia: a disorder of heart rhythm. Also known as an arrhythmia.

• Cardioselective: Refers to drugs, typically calcium channel blockers, that primarily affect the heart rather than other parts of the body

• Chlortalidone: a thiazide-like diuretic used as an antihypertensive

• Diastolic blood pressure: the blood pressure when the heart is relaxed and filling. The second of the two numbers given when blood pressure is reported

• Dihydropyridines: a group of drugs that inhibit vascular L-type calcium channels

• Diltiazem: A calcium channel blocker that is used to treat high blood pressure and certain types of angina by relaxing blood vessels and reducing the workload on the heart.

• Doxazosin: an alpha 1 adrenoceptor antagonist used as an antihypertensive

• Dysrhythmias: Abnormalities in the rhythm of the heartbeat, which can include irregular, too fast, or too slow heartbeats

• Essential hypertension: another term for primary hypertension

• First line treatment: the recommended first choice treatment for a patient

• Hyperlipidaemia: too much cholesterol in your blood

• Hypertension: high blood pressure

• Hypotension: abnormally low blood pressure

• Idiopathic hypertension: another term for primary hypertension

• Juxtaglomerular apparatus: A specialized structure in the kidney that regulates blood pressure by releasing renin, an enzyme that activates the renin-angiotensin-aldosterone system (RAAS).

• Lisinopril: an angiotensin converting enzyme inhibitor used as an antihypertensive

• Losartan: an angiotensin receptor blocker used as an antihypertensive

• L-type calcium channel: a voltage gated calcium channel important in the heart and vascular smooth muscle

• mm Hg: millimetres of mercury. The pressure units used for blood pressure.

• Nicardipine: a dihydropyridine L-type calcium channel blocker used as an antihypertensive

• NICE: the National Institute of Health and Care Excellence. A UK organisation funded by the Government that formulates guidance about which treatments should be used.

• Nifedipine: a dihydropyridine L-type calcium channel blocker used as an antihypertensive

• Normal blood pressure: generally assumed to be around 120/80 mm Hg

• Polypharmacy: when someone is taking a lot (>5) of medications

• Postural hypotension: low blood pressure brought on by a sudden change of posture. Causes dizziness

• Prazosin: an alpha 1 adrenoceptor antagonist used as an antihypertensive

• Primary hypertension: High blood pressure with no identifiable underlying cause, accounting for the majority of hypertension cases.

• Propranolol: a non-selective beta adrenoceptor antagonist formerly used as an antihypertensive

• Ramipril: an ACE inhibitor

• Renin angiotensin aldosterone system (RAAS): a hormone cascade important in the long term control of blood pressure

• Renin: an enzyme that catalyses the first step in the renin angiotensin aldosterone system cascade

• Resistance arteriole: Small arteries and arterioles that regulate blood flow and systemic vascular resistance, playing a significant role in determining blood pressure.

• Second-line treatment: an alternative treatment that is tried when a first choice treatment has not worked or the patient cannot tolerate the side effects.

• Secondary hypertension: High blood pressure caused by an identifiable condition, such as kidney disease, endocrine disorders, or certain medications.

• Stage 1 hypertension (UK): blood pressure values from 140/90 to 159/99 mm Hg (mercury)

• Stage 2 hypertension (UK): blood pressure values from 160/100 to 180/120 mm Hg

• Stage 3 hypertension (UK): systolic blood pressure above 180 mm Hg or diastolic above 120 mm Hg. It is a medical emergency

• Systolic blood pressure: the blood pressure when the heart is contracting. This first of the two numbers given when blood pressure is reported

• Thiazide/Thiazide-like diuretic: drugs that inhibit sodium and chloride transport out of the urine, resulting in more water being retained in the urine. These drugs are used as antihypertensives

• Thrombosis: The formation of a blood clot (thrombus) within a blood vessel, which can obstruct blood flow and lead to complications such as stroke or heart attack.

• Vasoselective: Refers to drugs, particularly calcium channel blockers, that specifically target blood vessels to cause dilation, with minimal effects on the heart.

• White coat hypertension: an increase in blood pressure due to anxiety when in a medical environment

• Angina - a group of heart disorders characterized by left sided, severe chest pain. They are all caused by ischaemia of cardiac muscle

• ApoB-100 - the main apolipoprotein in LDL

• Apolipoprotein - proteins present in lipoproteins that help the body identify the type of lipoprotein

• Atheroma - a fatty plaque in an artery

• Atherosclerosis - the formation of fatty plaques on the walls of blood vessels that blocks them. Commonly known as "clogging" or "furring up" of the arteries.

• Beta blockers - beta 1 adrenoceptor antagonists e.g. atenolol. These drugs reduce the heart rate and force of contraction, thereby lowering cardiac oxygen demands.

• Bile acids - a group of cholesterol derivatives produced by the liver and secreted into the GI tract. They emulsify dietary lipids to aid in their absorption.

• CABG - coronary artery bypass graft. A surgical procedure in which a non-vital blood vessel is transplanted taken from one part of the body and is used to generate an alternative blood supply for ischaemic tissue in the heart, by bypassing a blocked vessel. It can be used to treat angina.

• Calcium channel blockers - these can either be cardiac selective drugs such as verapamil or vasoselective (affect peripheral blood vessels) drugs such as amlodipine. Cardioselective drugs reduce the heart rate and force of contraction. Vasoselective drugs dilate peripheral blood vessels, reducing cardiac workload.

• Cholesterol ester - cholesterol esterified with a fatty acid

• Cholesterol - the most common structural steroid in mammalian cells. It is the starting point for the synthesis of a wide range of signalling molecules as well as the bile acids

• Chylomicron - a type of lipoprotein formed in the cells lining the GI tract.

• Claudication - pain caused by ischaemia of muscles in the leg. It is due to atherosclerosis of arteries supplying the leg.

• Ezetimibe - a drug that blocks dietary uptake of cholesterol

• Fibrates - drugs such as gemfibrozil and fenofibrate that act on nuclear receptors to modulate genes involved in lipid metabolism.

• Foam cell - a cell that forms part of an atheroma. Foam cells are formed from macrophages.

• Hepatic portal vein - the vein that carries nutrients and other substances absorbed from the GI tract to the liver.

• Hepatocyte - a liver cell

• HMG CoA reductase - an enzyme that converts HMG CoA to mevalonate. It is the rate-limiting enzyme in the cholesterol biosynthesis pathway.

• HMG CoA - hydroxymethylglutaryl coenzyme A. One of the intermediate compounds in the biosynthetic pathway for cholesterol. You only need to know the abbreviation.

• Hypercholesterolaemia - high serum levels of cholesterol, usually referring to high LDL cholesterol

• Hyperlipidaemia - high serum levels of lipids. It often refers to high LDL cholesterol levels but can also mean high triglyceride levels

• Ischaemia - when tissue does not have enough oxygen to meet its needs

• Ischaemic heart disease - also known as coronary heart disease. A disorder in which blood vessels supplying the heart become clogged. This reduces oxygen supply to cardiac muscle.

• LDL receptor - a transmembrane protein that recognizes the ApoB-100 protein on LDL and facilitates LDL uptake

• Lifestyle interventions - changes you can make to your diet and habits that improve cardiovascular health. For example, losing weight, eating less saturated fat and stopping smoking

• Lipoprotein - a particle that contains proteins and lipids and is involved in the transport and metabolism of triglycerides and cholesterol.

• Lipoproteins: VLDL, LDL, IDL,  HDL - different classes of lipoprotein that are named according to density (very low density lipoprotein, low density lipoprotein, intermediate density lipoprotein, high density lipoprotein. HDL is commonly called "good cholesterol" and the others are lumped together as "bad cholesterol"

• Non-HDL cholesterol - cholesterol in the circulation that is not in HDL particles. In other words, "bad cholesterol".

• NPC1L1 - Niemann-Pick C1-Like 1 is a cholesterol transporter in the GI tract that absorbs dietary cholesterol. You only need to know the abbreviation.

• Organic nitrates - drugs used to treat angina. Examples include glyceryltrinitrate (GTN) which is a short acting nitrate and isosorbide mononitrate (a long acting nitrate). They work by dilating blood vessels in the periphery, which reduces cardiac workload and by improving blood supply to cardiac muscle

• PCI - percutaneous coronary intervention. Another surgical procedure in which a thin tube is threaded into a blocked coronary artery. The end of the tube is inflated to push open the artery. This topic is covered in more detail in the next module (ACS and stroke).

• PCSK9 - proprotein convertase subtilisin/kexin type 9. A protein secreted by hepatocytes that regulates recycling of LDL receptors. You only need to know the abbreviation.

• Prodrug - a drug that must be metabolized to an active form before it is therapeutically useful

• Stable angina - also known as angina of effort. The least serious type of angina. It is typically caused by exertion and relieved by rest.

• Statins - the most important group of drugs used to treat hypercholesterolaemia. Example: atorvastatin. These drugs inhibit cholesterol synthesis in the liver

• Steroid - a class of lipids with a characteristic four ring structure

• Thrombosis - the formation of a pathological blood clot. Thrombosis can block an artery

• Triglyceride - glycerol esterified with three fatty acids

• Acute coronary syndromes: A spectrum of conditions caused by reduced blood flow to the heart, including unstable angina, NSTEMI, and STEMI.

• Alteplase: A recombinant tissue plasminogen activator (tPA) used to dissolve blood clots in conditions like stroke and (sometimes) myocardial infarction.

• Angioplasty: A procedure to restore blood flow by inflating a small balloon inside a narrowed or blocked artery. PCI is a particular type of angioplasty

• Anticoagulant (drug): A medication that reduces blood clotting by inhibiting various parts of the coagulation cascade.

• Antiplatelet drug: A medication that prevents platelets from activating and aggregating, reducing the formation of blood clots.

• Antithrombin III: A protein that inhibits thrombin and factor Xa, helping to regulate blood coagulation.

• Atrial fibrillation: An irregular, rapid heart rhythm that increases the risk of stroke and blood clots.

• Clopidogrel: An antiplatelet drug that inhibits platelet aggregation by blocking the P2Y12 receptor on platelets.

• COX (Cyclooxygenase): An enzyme that produces prostanoids, including thromboxane A2 and prostacyclin, important in inflammation and clotting.

• Common pathway: The final phase of the coagulation cascade where Factor Xa activates thrombin, leading to fibrin formation.

• Coagulation cascade: A series of enzymatic reactions that lead to the formation of the fibrin mesh.

• Cyclooxygenase: See COX.

• CYP2C19: A liver enzyme that metabolizes several drugs, including clopidogrel. Clopidogrel must be metabolised by CYP2C19 to become active.

• Dabigatran: A direct acting oral anticoagulant that inhibits thrombin to prevent blood clots.

• Direct (acting) oral anticoagulants (DOACs): A class of anticoagulants that directly inhibit specific clotting factors like thrombin or Factor Xa. The "acting" part of their name is sometimes left out, so don't be concerned if you see that.

• Electrocardiogram (ECG/EKG): A test that records the electrical activity of the heart to detect abnormalities.

• Embolism: The obstruction of a blood vessel by a clot or other substance that travels through the bloodstream.

• Embolus: A detached blood clot or other material that travels through the bloodstream and may cause an embolism.

• Enoxaparin: A low molecular weight heparin used as an anticoagulant to prevent and treat blood clots.

• Excitotoxicity: Cell damage and death caused by excessive stimulation by glutamate, commonly seen in stroke.

• Extrinsic pathway: The part of the coagulation cascade triggered by external trauma.

• Factor II: Also known as prothrombin, it is a precursor to thrombin (factor IIa) in the coagulation cascade.

• Factor X: A key enzyme in the coagulation cascade. Active factor X (Xa) converts prothrombin to thrombin.

• Fibrin: A fibrous protein formed from fibrinogen, which forms the mesh structure of a blood clot.

• Fibrinogen: A soluble plasma protein that is converted into fibrin during blood clot formation.

• Fibrinolysis: The process of breaking down fibrin in blood clots, primarily mediated by plasmin.

• Fondaparinux: A synthetic anticoagulant that inhibits Factor Xa via antithrombin III to prevent blood clotting.

• Glycoprotein receptor: A protein on the platelet surface that plays a key role in platelet aggregation.

• Haemostasis: The process of stopping bleeding through clot formation and blood vessel constriction.

• Haemorrhagic stroke: A type of stroke caused by bleeding in or around the brain.

• Heparin: An anticoagulant that enhances the activity of antithrombin III, inhibiting thrombin and other clotting factors.

• INR (International Normalized Ratio): A standardized measure of blood clotting used to monitor patients on warfarin.

• Intrinsic pathway: The part of the coagulation cascade initiated by damage inside the blood vessel.

• Ischaemic stroke: A stroke caused by a blockage in a blood vessel supplying the brain, leading to reduced blood flow.

• Low molecular weight heparin (LMWH): A form of heparin used to prevent and treat blood clots with more predictable dosing than regular heparin.

• Non ST-elevated myocardial infarction (NSTEMI): A type of heart attack where blood flow to the heart is reduced but the ECG shows no ST elevation.

• Percutaneous coronary intervention (PCI): A non-surgical procedure to open narrowed coronary arteries, often involving angioplasty and stenting.

• Plasmin: An enzyme that breaks down fibrin in blood clots during fibrinolysis.

• Plasminogen: The inactive precursor of plasmin, activated during fibrinolysis to dissolve clots.

• Platelet: A type of blood cell that plays a central role in clot formation by aggregating at injury sites.

• Primary haemostasis: The initial response to blood vessel injury, involving platelet adhesion and aggregation.

• Primary prevention: Measures taken to prevent disease before it occurs, such as lifestyle changes and medications.

• Prasugrel: An antiplatelet drug that irreversibly inhibits the P2Y12 receptor, reducing platelet aggregation.

• Prodrug: A medication that is inactive until it is metabolized in the body into its active form.

• Prostacyclin: A molecule that inhibits platelet aggregation and causes vasodilation, balancing the effects of thromboxane A2.

• Pulmonary embolism: A blood clot that travels to the lungs, causing blockage of the pulmonary arteries.

• Reteplase: A recombinant tPA used to dissolve blood clots in the treatment of acute myocardial infarction.

• Rivaroxaban: A direct oral anticoagulant that inhibits Factor Xa, used to prevent and treat blood clots.

• Secondary haemostasis: The formation of a stable blood clot through the activation of the coagulation cascade and fibrin formation.

• Secondary prevention: Measures taken to prevent the recurrence of disease after an initial event, such as using medications after a heart attack.

• ST-elevated myocardial infarction (STEMI): A severe heart attack where blood flow to the heart is completely blocked, and the ECG shows ST elevation.

• Thromboembolism: A condition where a blood clot forms in one part of the body and travels to another, causing obstruction.

• Thrombosis: The formation of a blood clot inside a blood vessel, which can obstruct blood flow.

• Thrombolysis: The breakdown of blood clots using medication, such as tPA.

• Thromboxane A2 (TXA2): A molecule produced by platelets that promotes platelet aggregation and vasoconstriction.

• Thrombus (plural thrombi): technically, a thrombus is simply a blood clot i.e. can be both a physiological haemostatic plug or a pathological clot that causes thrombosis. However, in the context of this module (and for consistency with BIOL10811) I will refer to "good" blood clots as haemostatic plugs/blood clots and "bad" blood clots as thrombi.

• Ticagrelor: An antiplatelet drug that reversibly inhibits the P2Y12 receptor on platelets, reducing clot formation.

• Tissue factor: a protein that plays a major role in activating the extrinsic pathway for coagulation.

• Tissue plasminogen activator (tPA): A protease that cleaves plasminogen to yield active plasmin, promoting the breakdown of blood clots.

• Transient ischaemic attack (TIA): A temporary reduction in blood flow to the brain, causing stroke-like symptoms that resolve without lasting damage.

• TXA2: See Thromboxane A2.

• Unstable angina: A type of chest pain caused by reduced blood flow to the heart, indicating a high risk of heart attack. It is characterized by sudden, unpredictable episodes of pain, often occurring at rest or with minimal exertion, and does not cause permanent heart damage.

• Vitamin K: A fat-soluble vitamin essential for the synthesis of clotting factors in the liver.

• Warfarin: An oral anticoagulant that inhibits vitamin K-dependent clotting factors, used to prevent blood clots
  

• Accessory pathway: a congenital, abnormal conducting pathway that allows signals to pass from one part of the heart to another, potentially leading to dysrhythmias. The most common type is Wolff-Parkinson-White syndrome.

• Adenosine: A drug used to treat certain types of supraventricular tachycardia by slowing conduction through the atrioventricular (AV) node.

• After depolarization: Abnormal depolarizations that occur during or after repolarization, potentially triggering dysrhythmias. Caused by excess calcium in the cell.

• Amiodarone: a class III antidysrhythmic drug that acts by blocking potassium channels. However, it has a complex mechanism of action and also acts on sodium and calcium channels and beta 1 adrenoceptors.

• Arrhythmia: A general term for any irregularity in the heart's rhythm, encompassing both too fast (tachycardia) and too slow (bradycardia) rhythms. Technically, arrhythmia means absence of rhythm but it is used synonymously with dysrhythmia

• Atrioventricular (AV) node: A part of the cardiac conduction system that delays the electrical impulse from the atria to the ventricles, ensuring they don't contract simultaneously.

• Atropine: a muscarinic acetylcholine receptor antagonist that can be used to treat bradycardia

• Block: An abnormal delay or interruption in the conduction of electrical impulses in the heart, commonly seen in AV block.

• Bradycardia: A slower-than-normal heart rate, typically less than 60 beats per minute.

• Bundle of Kent: An abnormal accessory pathway seen in Wolff-Parkinson-White syndrome that allows electrical signals to bypass the AV node, leading to tachycardia.

• Cardiac ablation surgery: A procedure used to treat dysrhythmias by destroying small areas of heart tissue that are causing abnormal electrical signals.

• Cardiac conduction system: The system of electrical pathways in the heart that controls the timing of heartbeats, including the SA node, AV node, bundle of His, and Purkinje fibers.

• Cardioversion (pharmacological or electrical): A treatment for dysrhythmias where drugs or electric shocks are used to restore a normal heart rhythm.

• CYP3A4: A liver enzyme that metabolizes many drugs, including those used in the treatment of heart conditions. Inhibition or induction of this enzyme can affect drug levels e.g. verapamil

• Defibrillation: A procedure that delivers a high-energy electric shock to the heart to stop life-threatening dysrhythmias like ventricular fibrillation or pulseless ventricular tachycardia.

• Diltiazem: a cardioselective calcium channel blocker in Vaughan Williams class IV

• Dysrhythmia: A disturbance in the normal rhythm of the heart, synonymous with arrhythmia.

• ECG Lead: One of 12 different combinations of the 10 electrodes that are used to measure an ECG.

• Electrocardiogram (ECG/EKG): A test that records the electrical activity of the heart, used to diagnose various dysrhythmias.

• Ectopic pacemaker: A site outside the sinoatrial node that generates premature heartbeats or dysrhythmias.

• Fibrillation: A rapid, irregular, and unsynchronized contraction of muscle fibers, particularly in the atria (atrial fibrillation) or ventricles (ventricular fibrillation).

• Flutter: A type of dysrhythmia where the heart beats in a fast but regular rhythm, commonly seen in the atria (atrial flutter).

• Funny current: An inward current that contributes to the pacemaker activity of the sinoatrial node, crucial in generating spontaneous heartbeats. It is largely carried by HCN channels.

• HCN channels: Hyperpolarization-activated cyclic nucleotide-gated channels involved in the generation of the heart's pacemaker activity.

• Lidocaine: a local anaesthetic that is also used to treat dysrhythmias. It acts by blocking voltage gated sodium channels

• Paroxysmal: Refers to dysrhythmias that begin and end suddenly (in attacks), often seen in conditions like paroxysmal atrial fibrillation.

• Paroxysmal supraventricular tachycardia (PSVT): a dysrhythmia in which the person experiences episodes of rapid heart rate. It is relatively common.

• Pacemaker: Something that sets the heart's rate. It can refer to the SA node (the heart's natural pacemaker) or implanted electrical devices that replace the function of the SA node.

• Pacemaker potential/current: a slow depolarization of the membrane in SA and AV node cells that brings the cell to threshold at regular intervals

• Phase 0: The phase in the cardiac action potential where rapid depolarization occurs.

• Phase 1: A brief phase of repolarization following depolarization, marked by a slight outward flow of potassium ions.

• Phase 2: The plateau phase of the cardiac action potential, where calcium ions enter the cell, balancing the outward flow of potassium.

• Phase 3: The phase of rapid repolarization in the cardiac action potential due to the continued outward flow of potassium ions.

• Phase 4: The resting phase of the cardiac action potential, during which the heart is between beats. It is not a steady state in SA node cells due to the pacemaker potential

• P wave: The part of an ECG that represents atrial depolarization, or the electrical activity that causes the atria to contract.

• QRS complex: The part of an ECG that represents ventricular depolarization, or the electrical activity that causes the ventricles to contract.

• Re-entry circuit: A common mechanism for dysrhythmias where an electrical impulse continues to travel in a loop within the heart, reactivating tissue and causing dysrhythmias.

• Sino⁠atrial node (S⁠A node): The heart’s natural pacemaker, located in the right atrium, responsible for initiating each heartbeat.

• Sinus: Refers to the normal rhythm generated by the sinoatrial node, known as sinus rhythm. It can also be used in the context of dysrhythmias, to indicate that the dysrhythmia originates in the SA node.

• Supra⁠ventricular: Refers to dysrhythmias that originate above the ventricles, typically involving the atria or AV node.

• T wave: The part of an ECG that represents ventricular repolarization, or the electrical recovery of the ventricles after contraction.

• Tachycardia: A faster-than-normal heart rate, typically over 100 beats per minute.

• Vaughan Williams classes I-IV: A classification system for antidysrhythmic drugs based on their mechanism of action, divided into four main categories:

  • Class I: Sodium channel blockers

  • Class II: Beta-blockers

  • Class III: Potassium channel blockers

  • Class IV: Calcium channel blockers

• Wolff-Parkinson-White syndrome: A condition characterized by an extra electrical pathway in the heart (the Bundle of Kent), leading to episodes of tachycardia.

• Allergen: A substance that can trigger an allergic reaction in susceptible individuals, often leading to asthma symptoms.

• Allergy: An immune response to normally harmless substances, such as pollen or pet dander, that can trigger asthma symptoms.

• Alveolus: Tiny air sac in the lungs where gas exchange (oxygen and carbon dioxide) occurs between air and blood.

• Anti-inflammatory drug: A drug that reduces inflammation, often used to manage chronic conditions like asthma.

• Antigen-presenting cell: Immune cell that processes and presents antigens to T cells, initiating an immune response.

• Arachidonic acid: A fatty acid that is the precursor of inflammatory mediators, such as prostaglandins and leukotrienes.

• Atopy: Genetic tendency to develop allergic conditions like asthma, often associated with high IgE levels.

• Beclometasone: A glucocorticoid drug used as an inhaled corticosteroid to reduce inflammation in asthma.

• B cell: A type of white blood cell that produces antibodies as part of the immune response.

• Bronchial asthma: A chronic respiratory condition characterized by inflammation, bronchoconstriction, and increased mucus, leading to symptoms like wheezing and shortness of breath.

• Bronchiole: A small airway in the lungs that branches off from the bronchus and leads to alveoli.

• Bronchitis: Inflammation of the bronchi, the main air passages to the lungs, often causing coughing and mucus production. It can be acute (short-term) or chronic, as seen in chronic obstructive pulmonary disease (COPD).

• Bronchoconstriction: Narrowing of the airways due to smooth muscle contraction, often triggered in asthma.

• Bronchodilator: A drug that relaxes airway smooth muscles, widening the airways to improve airflow and relieve asthma symptoms.

• Bronchospasm: Sudden constriction of the muscles in the walls of the bronchioles, causing difficulty breathing.

• Bronchus: A major airway that branches from the trachea into the lungs, leading to smaller airways.

• Budesonide: An inhaled corticosteroid that reduces inflammation and helps control asthma symptoms.

• Chemotactic factor: A signalling molecule that attracts immune cells, such as neutrophils, eosinophils, or macrophages, to the site of inflammation by creating a chemical gradient.

• Chronic obstructive pulmonary disease: A group of lung diseases, including chronic bronchitis and emphysema, that cause airflow limitation and breathing difficulties.

• Clonal expansion: The process by which immune cells (like T or B cells) rapidly multiply after recognizing an antigen, enhancing the immune response.

• Corticosteroid: A class of anti-inflammatory drugs that includes glucocorticoids; commonly used to manage asthma.

• Cortisol: A natural glucocorticoid hormone produced by the adrenal glands, involved in metabolism and immune regulation.

• Cytokine: Small proteins released by cells that help regulate the immune response, including inflammation.

• Dendritic cell: A type of antigen-presenting cell that initiates immune responses by presenting antigens to T cells.

• Dexamethasone: A powerful corticosteroid used to reduce inflammation in severe asthma and other inflammatory conditions.

• Early phase: The initial phase of an asthma response, occurring within minutes of allergen exposure, characterized by bronchoconstriction and the release of mediators like histamine.

• Eicosanoid: A group of signaling molecules, derived from arachidonic acid, involved in inflammation and immunity, including prostaglandins and leukotrienes.

• Emphysema: A condition where alveoli are damaged, reducing lung surface area and causing breathing difficulties; often part of COPD.

• Eosinophil: A type of white blood cell involved in the immune response, especially in allergic reactions and asthma, releasing inflammatory substances.

• Extrinsic: Refers to asthma triggered by external allergens, such as pollen or pet dander.

• Fluticasone: A commonly used inhaled corticosteroid for asthma control, reducing airway inflammation.

• Forced expiratory volume in 1 second (FEV1): The volume of air a person can forcibly exhale in one second, used in spirometry to assess lung function.

• Forced vital capacity (FVC): The total volume of air a person can forcibly exhale after a full inhalation, also measured in spirometry.

• Formoterol: A long-acting beta agonist used in asthma to provide prolonged bronchodilation, often in combination with a corticosteroid.

• Glucocorticoid: A type of corticosteroid that reduces inflammation and is commonly used in asthma treatment.

• Goblet cells: Cells in the airway lining that produce mucus, which traps particles and pathogens.

• Granule: Small packets inside cells, such as mast cells, that contain chemicals (like histamine) released during an immune response.

• Hygiene hypothesis: Theory suggesting that a lack of early-life exposure to microbes may increase the risk of allergies and asthma by suppressing immune tolerance.

• IgE: An antibody involved in allergic reactions; elevated levels are associated with asthma and allergic responses.

• Inflammation: Body’s response to injury or infection, involving immune cells, cytokines, and increased blood flow, often causing redness, swelling, and pain.

• Intrinsic: Refers to asthma that is not triggered by allergens but by internal factors like stress, exercise, or infections.

• Interleukin: A type of cytokine involved in immune cell communication and regulating inflammation.

• Late phase: A delayed phase of asthma response occurring hours after allergen exposure, involving inflammation, mucus production, and bronchoconstriction.

• Leukotriene: Inflammatory molecules derived from arachidonic acid that cause bronchoconstriction and are involved in asthma symptoms.

• Leukotriene receptor antagonist: A drug that blocks leukotriene receptors, reducing inflammation and bronchoconstriction in asthma.

• Long-acting beta agonist (LABA): A bronchodilator with prolonged effects, often combined with a corticosteroid for asthma maintenance.

• Long-acting muscarinic antagonist (LAMA): A drug that blocks muscarinic receptors, providing long-lasting bronchodilation, mainly used in COPD and in asthma that is difficult to control.

• Major basic protein: A protein released by eosinophils that is toxic to cells and contributes to tissue damage in asthma.

• MART: Maintenance and reliever therapy, a treatment approach combining a long-acting beta agonist and corticosteroid for both control and relief of asthma.

• Mast cell: Immune cell containing granules with inflammatory mediators like histamine, which play a role in allergic reactions and asthma.

• Metered dose inhaler (MDI): A device that delivers a specific dose of medication to the lungs in aerosol form.

• MHC II: A molecule on antigen-presenting cells that presents antigens to T cells, initiating an immune response.

• Montelukast: A leukotriene receptor antagonist used to reduce inflammation and bronchoconstriction in asthma.

• Mucus: A sticky substance produced by goblet cells that traps particles and pathogens in the airways.

• Peak expiratory flow rate (PEFR): The maximum speed of exhalation, used to monitor asthma control.

• Phospholipase A2: An enzyme involved in the production of arachidonic acid, a precursor to inflammatory mediators.

• Prednisolone: An oral corticosteroid used to reduce inflammation in severe asthma attacks or chronic asthma.

• Preventer: A medication, usually an inhaled corticosteroid, taken daily to reduce inflammation and prevent asthma symptoms.

• Prostaglandin D2: An eicosanoid involved in inflammation and bronchoconstriction in asthma.

• Reliever: A medication, typically a SABA, taken to quickly relieve asthma symptoms by relaxing the airway muscles.

• Salbutamol: A short-acting beta agonist (SABA) used as a reliever for rapid relief of asthma symptoms.

• Salmeterol: A long-acting beta agonist (LABA) used for asthma maintenance therapy, often in combination with an inhaled corticosteroid.

• Short-acting beta agonist (SABA): A bronchodilator with rapid effects, used for immediate relief of asthma symptoms.

• Spacer: A device used with an inhaler to improve medication delivery to the lungs and reduce side effects.

• Spirometry: A test that measures lung function, including parameters like FEV1 and FVC, to assess and monitor asthma.

• Status asthmaticus: A severe, life-threatening asthma attack that does not respond to standard treatment.

• Submucosal gland: Glands in the airways that produce mucus, helping to keep the airways moist and trap particles.

• T cell: A type of immune cell that plays a central role in immune response, especially in recognizing and responding to antigens.

• Th₂ cell: A subtype of T cell involved in allergic and inflammatory responses, often associated with asthma.

• Terbutaline: A short-acting beta agonist used as a reliever to quickly alleviate asthma symptoms.

• Theophylline: A bronchodilator that relaxes airway muscles and reduces inflammation, used for asthma and COPD.

• Tiotropium: A long-acting muscarinic antagonist (LAMA) used primarily in COPD but also in severe asthma for long-term bronchodilation.

• TNF-α: A pro-inflammatory cytokine involved in immune responses and inflammation, contributing to asthma symptoms.

• Trachea: The windpipe, a major airway that connects the larynx to the bronchi and conducts air to the lungs.

11 beta-hydroxysteroid dehydrogenase Type 2 - An enzyme that converts active cortisol into the inactive cortisone, important for preventing excessive activation of mineralocorticoid receptors.

Adrenal Crisis - A severe and potentially life-threatening condition due to insufficient levels of cortisol. It requires immediate treatment with hydrocortisone.

Adrenocorticotrophic Hormone (ACTH) - A hormone produced in the anterior pituitary gland that stimulates the production of cortisol by the adrenal cortex.

Aldosterone - A steroid hormone produced by the adrenal glands. It plays a central role in regulating blood pressure and electrolyte balance by increasing the reabsorption of sodium and the secretion of potassium in the kidneys.

Biased agonism - when a receptor has two potential signalling pathways and one of these pathways is favoured by a particular agonist.

Corticosteroid - A steroid hormone produced by the adrenal cortex. Includes both cortisol and aldosterone

Corticosterone - The main glucocorticoid in rodents.

Corticotrophin Releasing Hormone/Factor (CRH/CRF) - A peptide hormone secreted by the hypothalamus that stimulates the synthesis of ACTH by the pituitary gland.

Cortisol - The primary glucocorticoid in humans, crucial for glucose metabolism, immune response modulation, and stress response.

Cortisone - An inactive metabolite of cortisol.

Cushing’s Disease - A specific form of Cushing’s syndrome where a pituitary tumour leads to excessive production of ACTH.

Cushing’s Syndrome - A condition caused by excessive cortisol levels in the blood, typically due to long-term use of corticosteroid drugs or a tumour that increases ACTH production.

Cushingoid - Describes the appearance of someone who has features similar to those of Cushing’s syndrome.

Dexamethasone - A synthetic steroid used as an anti-inflammatory and immunosuppressant.

Dexamethasone Suppression Test - A diagnostic test to assess adrenal gland function by measuring how cortisol levels in the blood are affected by dexamethasone, a synthetic glucocorticoid.

Fludrocortisone - A synthetic corticosteroid with potent mineralocorticoid properties and moderate glucocorticoid effects, used primarily to treat conditions of adrenal insufficiency such as Addison’s disease.

Glucocorticoid (Receptor) - Receptors that specifically bind glucocorticoids, a type of steroid hormone involved in the regulation of metabolism and immune response. These receptors, when activated, can regulate the expression of key genes controlling development, metabolism, and immune function.

Glucocorticoid Response Element (GRE) - Specific DNA sequences recognized and bound by glucocorticoid receptors to regulate the transcription of target genes involved in various physiological functions, including the immune response and metabolism.

Heat Shock Protein 90 (HSP90) - A chaperone protein that assists in the correct folding, stabilization, and function of protein clients, including steroid receptors.

Hormone Response Element (HRE) - Specific DNA sequences within a gene promoter that hormone receptors bind to, initiating transcription in response to hormonal signals.

Hydrocortisone - Another term for cortisol, specifically when used as a medication.

Importin - A protein that transports other proteins into the nucleus of the cell, crucial for the function of transcription factors and nuclear receptors.

Inverted Repeat - A sequence of nucleotides that consists of two reverse complementary sequences separated by a spacer; often found in DNA response elements where receptors bind.

Mineralocorticoid (Receptor) - Receptors that bind mineralocorticoids such as aldosterone. They are primarily involved in maintaining electrolyte balance and water homeostasis in the body.

Moon Face - A side effect of chronic steroid use, characterized by a round face due to fat redistribution.

nGRE - Negative glucocorticoid response element; a DNA sequence where the glucocorticoid receptor binds to inhibit the expression of certain genes.

Prednisolone - The active metabolite of prednisone, used in similar conditions for its anti-inflammatory and immunosuppressive properties.

Prednisone - A synthetic glucocorticoid drug used as an anti-inflammatory and immunosuppressant. It is a prodrug and must be metabolized to prednisolone. It is used because it has better pharmacokinetic properties than prednisolone.

Selective Glucocorticoid Receptor Agonist (SEGRA) - A drug designed to selectively activate certain beneficial effects of the glucocorticoid receptor while minimizing undesirable effects.

Steroid Emergency Card - A card carried by patients on long-term steroids to alert medical staff in an emergency situation about their steroid use and need for possibly life-saving treatment.

Steroid Treatment Card - A card that provides information about a patient’s steroid prescription to ensure proper ongoing management of their treatment.

Transactivation - A mechanism where binding of a receptor to a DNA response element directly activates the transcription of target genes.

Transrepression - The process by which glucocorticoid receptors indirectly inhibit the expression of certain genes, typically by interfering with other transcription factors without binding directly to DNA.