Lec 13-15: Respiratory Pharmacology

Question 1

Functions of nasal cavity

Answer 1

Warms, humidifies, and filters air

Question 2

What happens when you leave sinusitis for way too long. Like years of sinusitis (gurl u need help)

Answer 2

Mucus/pus (หนอง) is congested due to paralyzed cilia and the หนอง is acidic and will dissolve the bone and when you reach the brain it will cause meningitis oh noooo

Question 3

COPD is a combination of … and ….

Answer 3

Bronchitis and emphysema

Question 4

Another name for rhinitis is …..

It is caused by …… but sometimes complicated by superinfection with …..

Answer 4

Common cold
Virus
Bacteria

Question 5

Laryngotracheobronchitis (…..)

Most representative presentation is …..

Most of it is caused by …..

Answer 5

Croup

Barking/metallic cough

Influenza VIRUS

Question 6

Croup in adults use …

But croup in children have to use ….. because …..

Answer 6

Selective B2 agonist

Nonselective adrenergic agonist e.g. adrenaline

Not sure but they talked about steeple’s sign and how childrens larynx are more easily collapsible

Question 7

If patient is breathing and there is no wheezing but they dont look well

Answer 7

Idk if there will be rapid, labored breathing too but it is most likely bronchiolitis that is very severe because the air way is almost or completely closed

There will only be wheezing when the hole’s size is compromised but not completely

Question 8

แน่นจมูกมาก ใช่ยากลุ่มไหนดี

Answer 8

Decongestant

Question 9

น้ำมูกเยอะ ใช้ยากลุ่มไหน

Answer 9

Antihistamine

Question 10

IgE is on a ….. cell and antigen attaches onto the IgE

The cell releases 4 compounds, what are they?

What do these compounds cause?

Answer 10

Mast

NCF, ECF-A, Histamine, leukotrienes

Smooth muscle constriction, mucus hypersecretion, dilation of blood vessels and tissue edema

Question 11

Properties of antihistamines (H1)

Answer 11

Antihistamine
Antimuscarinic
Sedative

Question 12

MOA of antihistamines

Answer 12

Competitive inhibition (cannot push can only bind unoccupied)

More effective in preventing than reversing

Question 13

Antihistamines effects and side effects

Answer 13

Effects: reduce vasodilation, permeability, flare and itching

Side effects: drying (blurred vision, constipation), drowsiness (v1)

Question 14

Traditional antihistamines

Answer 14

Diphenhydramine, chlorpheniramine

ขอให้ได้เป็นโปรได้มะ

Question 15

Nonsedating peripherally acting antihistamines

Answer 15

Longer duration

Fexofenadine, loratidine, cetirizine

Question 16

Causes of nasal congestion

Answer 16

Allergies

Upper respiratory tract infection (common cold)

Question 17

Types of decongestants

Answer 17

Adrenergics - biggest, sympathomimetics
Anticholinergics - less, parasympatholytics
Corticosteroids - topical

Question 18

Is there rebound congestion in oral decongestants

Answer 18

No

Question 19

Oral decongestants

Answer 19

Pseudoephredrine (sudafed)

exclusively adrenergic

Question 20

Topical nasal decongestants

Answer 20

Adrenergics:

• vicks - desoxyephedrine
• phenylephrine

Intranasal steroids:

• beclomethasone dipropionate
• flunisolide
• fluticasone

Question 21

Nasal decongestant side effects

Answer 21

Adrenergic: nervous, insomnia, palpitations, systemic effects due to adre stim of heart bv and cns

Steroids: local mucosal dryness and irritation

Question 22

Antitussives used only for …….. coughs

Answer 22

Nonproductive!

Question 23

Types of antitussives

Answer 23

Opioid and nonopioid

Question 24

Opioids act at the ……… in the …….

Answer 24

Cough center in the medulla

Question 25

Opioids examples

Answer 25

Codeine | Hydrocodone

Question 26

Nonopioids suppress coughs by

Answer 26

Preventing cough reflex stimulation

Question 27

Examples of nonopioids

Answer 27

Dextromethorphan | Benzonatate

Question 28

Expectorants used in ....Coughs

Answer 28

Productive

Question 29

Bronchodilator groups?

Answer 29

Sympathomimetics agents (B2 selective) Methylxanthine drugs Antimuscarinic

Question 30

Sympathomimetic agents examples

Answer 30

``` Epinephrine Ephedrine Isoproterenol b1,2 Albuterol Other B2 selective ```

Question 31

Bronchodilation is increased by increasing ...... This can be done by promoting .... or inhibiting .....

Answer 31

cAMP B adrenoceptors which increases its synth by adenylyl cyclase or inhibition of PDE

Question 32

Bronchoconstriction can be inhibited by .....

Answer 32

Muscarinic and adenosine antagonists

Question 33

Methylxanthine drugs for example ..... are ineffective by ..... thus must be taken .....

Answer 33

Theophylline, theobromine and caffeine Aerosol Systemically

Question 34

MOA of methylxanthine drugs

Answer 34

Inhibti PDE enz PDE4 inhibition = inhibit release of cytokines PDE inhibition has many effects such as smooth muscle relaxation

Question 35

Methylxanthine drugs examples selective inhibitors of PDE4

Answer 35

Roflumilat, cilomilast, tofimilast

Question 36

What does adenosine do in the airway

Answer 36

Provoke contraction of airway s.m. And histamine release

Question 37

At larger doss, what can methylxanthine cause (nervous system + cardio)

Answer 37

Nervousness tremors แบบใจสั่น

Question 38

Sustained release theophylline is effective for ......... a.......

Answer 38

Nocturnal asthma

Question 39

Theophylline not first line drug for asthma because it has a n......... t......... w.........

Answer 39

Narrow therapeutic window

Question 40

Use of methylxanthines

Answer 40

Theophylline- most effective bronchodilator — ACUTE ASTHMA, also improves LONGTERMCONTROL Sustained release used for nocturnal asthma

Question 41

Chronic theophylline can cause (toxicity).....

Answer 41

Severe cardiac arrythmia and seizures

Question 42

Anticholinergics MOA

Answer 42

Muscarinic antagonists block ach released from nerve endings of vagus - block s.m. Contraction and mucus secretion

Question 43

Examples of anticholinergics

Answer 43

Ipratropium bromide and tiotropium bromide

Question 44

Why use antimuscarinic?

Answer 44

B2 agonist is more potent but some people are intolerant

Question 45

Ipratropium

Answer 45

Inhaled in high doses Poorly abs in cir Adjunctive therapy w/ B2 in acute severe asthma when B2 is not enuf la EFFECTIVE in COPD patients

Question 46

Tiotropium

Answer 46

COPD treatment Inhaled