FA Respiratory Flashcards

1
Q

H1 Blockers

A

1st generation: Diphenhyrdamine, dimenhydrinate, chlorpheniramine
2nd generation: Loratadine, fexofenadine, desloratadine, cetirizine

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2
Q

Diphenhydramine, Dimenhydrinate, Chlorpheniramine Mechanism

A

H1 Blocker, first generation - reversible inhibitors of H1 histamine receptors

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3
Q

Diphenhydramine, Dimenhydrinate, Chlorpheniramine Use

A

Allergy, motion sickness, sleep aid

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4
Q

Diphenhydramine, Dimenhydrinate, Chlorpheniramine Toxicity

A

Sedation, antimuscarinic, anti-α-adrenergic

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5
Q

Loratadine, Fexofenadine, Desloratadine, Cetirizine Mechanism

A

H1 Blocker, second generation - reversible inhibitors of H1 histamine receptors

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6
Q

Loratadine, Fexofenadine, Desloratadine, Cetirizine Use

A

Allergy

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7
Q

Loratadine, Fexofenadine, Desloratadine, Cetirizine Toxicity

A

Far less sedating that 1st generation because of ↓ entry into CNS

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8
Q

Expectorants

A

Guaifenesin, N-acetylcysteine

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9
Q

Guaifenesin Use

A

Expectorant - thins respiratory secretion; does not suppress cough reflex

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10
Q

N-acetylcysteine Use

A

Mucolytic - can loosen mucous plugs in CF patients. Also used as an antidote for acetaminophen overdose.

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11
Q

Dextromethorphan Use

A

Antitussive

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12
Q

Dextromethorphan Mechanism

A

Antagonizes NMDA glutamate receptors. Synthetic codeine analog.

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13
Q

Dextromethorphan Toxicity

A

Mild opioid effect when used in excess. Naloxone can be given for overdose. Mild abuse potential.

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14
Q

Pseudoephedrine Mechanism

A

Sympathomimetic α-agonistic nonprescription nasal decongestant

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15
Q

Pseudoephedrine Use

A

Reduce hyperemia, edema, and nasal congestion; open obstructed eustachian tubes. Also illicitly used to make methamphetamine.

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16
Q

Pseudoephedrine Toxicity

A

Hypertension. Can also cause CNS stimulation/anxiety.

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17
Q

Phenylephrine Mechanism

A

Sympathomimetic α-agonistic nonprescription nasal decongestant

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18
Q

Phenylephrine Use

A

Reduce hyperemia, edema, and nasal congestion; open obstructed eustachian tubes.

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19
Q

Phenylephrine Toxicity

A

Hypertension

20
Q

β2-agonists

A

Albuterol, salmeterol, formoterol

21
Q

Albuterol Mechanism

A

Relaxes bronchial smooth muscle (β2)

22
Q

Albuterol Use

A

Acute asthma exacerbation.

23
Q

Salmeterol, Formoterol Use

A

Long-acting agents for asthma prophylaxis.

24
Q

Salmeterol, Formoterol Toxicity

A

Tremor and arrhythmia

25
Q

Methylxanthines

A

Theophylline

26
Q

Theophylline Mechanism

A

Likely causes bronchodilation by inhibiting phosphodiesterase → ↑ cAMP levels due to ↓ cAMP hydrolysis.

27
Q

Theophylline Use

A

Asthma; usage limited because of narrow therapeutic index.

28
Q

Theophylline Toxicity

A

Usage limited because of narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by cytochrome P-450. Blocks actions of adenosine.

29
Q

Ipratropium Mechanism

A

Competitive block of muscarinic receptors, preventing bronchoconstriction

30
Q

Ipratropium Use

A

Asthma, COPD.

31
Q

Muscarinic Antagonists [Asthma]

A

Ipratropium, Tiotropium (long-acting)

32
Q

Corticosteroids [Asthma]

A

Beclomethasone, fluticasone

33
Q

Corticosteroids Mechanism [Asthma]

A

Inhibit the synthesis of virtually all cytokines. Inactivate NF-κB, the transcription factor that induces the production of TNF-α and other inflammatory agents.

34
Q

Corticosteroid Use [Asthma]

A

1st-line therapy for chronic asthma.

35
Q

Antileukotrienes

A

Montelukast, zafirlukast, zileuton

36
Q

Montelukast, Zafirlukast Mechanism

A

Block leukotriene receptors

37
Q

Montelukast, Zafirlukast Use

A

Asthma, especially for aspirin-induced asthma.

38
Q

Zileuton Mechanism

A

5-lipoxygenase pathway inhibitor. Blocks conversion of arachidonic acid to leukotrienes.

39
Q

Zileuton Use

A

Asthma

40
Q

Omalizumab Mechanism

A

Monoclonal anti-IgE antibody. Binds mostly unbound serum IgE and blocks binding to FcεRI.

41
Q

Omalizumab Use

A

Used in allergic asthma resistant to inhaled steroids and long-acting β2-agonists.

42
Q

Methacholine Mechanism

A

Muscarinic receptor agonist. Stimulates muscarinic receptors in airway when inhaled.

43
Q

Methacholine Use

A

Used in bronchial provocation challenge to help diagnose asthma.

44
Q

Bosentan Use

A

Used to treat pulmonary arterial hypertension.

45
Q

Bosentan Mechanism

A

Competitively antagonizes endothelin-1 receptors, ↓ pulmonary vascular resistance.