Respiratory- Pharmacology Flashcards
Histamine-1 blockers (First generation)
- Names
- Clinical use
- Adverse effects
Diphenhydramine, dimenhydrinate, chlorpheniramine
Allergy, motion sickness, sleep aid.
Sedation, antimuscarinic, anti-α-adrenergic.
Histamine-1 blockers (Second generation)
- Names
- Clinical use
- Adverse effects
Loratadine, fexofenadine, desloratadine, cetirizine.
Allergy
Far less sedating than 1st generation
Guaifenesin
- Clinical use and function
Expectorant—thins respiratory secretions; does not suppress cough reflex.
N-acetylcysteine
- Clinical use and function
Mucolytic—liquifies mucus in chronic bronchopulmonary diseases (eg, COPD, CF) by disrupting disulfide bonds.
Dextromethorphan
- Clinical use and mechanism
- Adverse effects
Antitussive (antagonizes NMDA glutamate receptors). Synthetic codeine analog.
Has mild opioid effect when used in excess. Naloxone can be given for overdose. serotonin syndrome if combined with other serotonergic agents.
Pseudoephedrine, phenylephrine
- Mechanism
- Clinical use
- Adverse effects
α-adrenergic agonists,
used as nasal decongestants
Hypertension. Rebound congestion if used more than 4–6 days. Can also cause CNS stimulation/ anxiety (pseudoephedrine).
Pulmonary hypertension drugs
Endothelin receptor antagonists (bosentan): hepatotoxic
PDE-5 inhibitors,
Prostacyclin analogs: Iloprost, epoprostenol
Asthma drugs
β2-agonists: Albuterol, Salmeterol, formoterol
Inhaled corticosteroids: Fluticasone, budesonide
Muscarinic antagonists: Tiotropium, ipratropium
Antileukotrienes: Montelukast, zafirlukast, Zileuton
Anti-IgE monoclonal therapy: Omalizumab
Methylxanthines: Theophylline
Mast cell stabilizers: Cromolyn, nedocromil
Antileukotrienes
- Montelukast, zafirlukast
- Zileuton
Block leukotriene receptors (CysLT1). Especially good for aspirin-induced and exercise-induced asthma.
5-lipoxygenase pathway inhibitor. Blocks conversion of arachidonic acid to leukotrienes. Hepatotoxic.
Methylxanthines
- Theophylline
causes bronchodilation by inhibiting phosphodiesterase increase cAMP levels due to cAMP hydrolysis.
Narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by cytochrome P-450. Blocks actions of
adenosine.
Mast cell stabilizers
- Cromolyn, nedocromil
Prevent release of inflammatory mediators from mast cells.
Used for prevention of bronchospasm, not for acute bronchodilation
Methacholine
Nonselective muscarinic receptor (M3) agonist.
Used in bronchial challenge test to help diagnose
asthma
