pharm

Question 1

antihistamine smechanism of action

Answer 1

reversible inhibitors of H1 histamine recepotrs

Question 2

Diphenyhydramine, dimenhydrinate, chlorpheniramine are

Answer 2

first generation anti histamines

Question 3

clinical uses of first gen hitstamine

Answer 3

allergy, motion sickness, sleep aid, increase depth of sleep

Question 4

SE of first generation histamine

Answer 4

significant sedation, antimuscarininc, anti adrenergic (postural dizziness, falls); anti serotonergic: appetite stimulation, wt gain

Question 5

avoid these in elderly pt’s

Answer 5

first generation anti histamines

Question 6

second generation histamines

Answer 6

loratadine, fexofenadine, desloratadine, cetirizine

Question 7

use of second gen histamine

Answer 7

allergy

Question 8

Second gen antihistamines SE

Answer 8

have far less sedating than 1st generation because of decrease entry into CNS

Question 9

Guaifenesin use

Answer 9

expectorant - thins respiratory secretions, does not suppress cough reflex

Question 10

N-acetylcysteine

Answer 10

Mucolytic; liquifies mucus in chronic bronchopulmonary diseases (COPD, CF) by disrupting disulfide bonds. a

Question 11

used as an antidote for acetaminophen overdose

Answer 11

n-acetylcysteine

Question 12

Dextromethorphan use

Answer 12

antitussive; has mild opiod effect when used in excess

Question 13

an antitussive that antagonizes NMDA glutaamte receptors

Answer 13

dextromethorphan

Question 14

pseudoephrine, phenylephrine mechanism

Answer 14

a-adrenergic agonists, used as nasal decongestants

Question 15

Use of psuedoephrine, phenylephrine

Answer 15

reduce hyperemia, edema, nasal congestion; open obstructed eustachian tubes.

Question 16

this is illicilty used to make methamephetamine

Answer 16

pseudoephedrine

Question 17

SE of psuedoephrine, phenylephrine

Answer 17

hypertension. reboudn congestion if used more than 4-6 days. can also cause CNS stimulation/anxiety (pseudoephrine)

Question 18

Pulm htn drugs:

Answer 18

bosentan, sidenafil, esoprostenol, iloprost

Question 19

Bosentan mechanism

Answer 19

competitively antagonizes ENdothelin-1 receptors: decreases pulm vasc resistance

Question 20

bosENtan SE

Answer 20

hepatotoxic

Question 21

sildenafil mechainsm

Answer 21

inhibits pde5 : increase cGMP: prolonged vasodilatory effect of NO

Question 22

epoprostenol, iloprost mechanism

Answer 22

PGI2 (prostacylin) w direct vasodilatory effects on pulmonary and systemic arterial vascular beds. inhibits platelet aggregation

Question 23

SE of esoprostenol, iloprost

Answer 23

jaw pain, flushing

Question 24

cromolyn and nedocromil mechanism of action

Answer 24

inhibit mast cell degranulation and prevents release of preformed chemical mediators.

Question 25

use for cromolyn and nedocromil

Answer 25

2nd line treamtent for asthma, allergic rhinitis, prevent acute attacks

Question 26

brocnchoconstriction in astham mediated by

Answer 26

inflammatory processes, and parasympatehtic tone

Question 27

B2 agonists:

Answer 27

albuterol, salmeterol, formoterol

Question 28

Albuterol use

Answer 28

relaxes bronchial smooth muscle (short acting B2 agonist). Used during acute exacerbation

Question 29

Salmeterol, formoterol

Answer 29

long acting agents for prophylaxis;

Question 30

SE of salmeterol, formoterol

Answer 30

tremor, arrhytmia

Question 31

Inhaled corticosteroids

Answer 31

fluticasone, budesonide

Question 32

fluticasone, budesonide

Answer 32

inhibit synthesis of virtually all cytokines. inactivaes nfkb, transcription factor that induces prodcution of tnfa and other inflammatory agents.

Question 33

1st line therapy for chronic asthma

Answer 33

fluticasone, budesonide

Question 34

muscarininc antagonists:

Answer 34

tiotropium, ipratroprium

Question 35

tiotropium, ipratropium mechanism

Answer 35

compettively block muscarinic receptors, preventing bronchoconstriction

Question 36

which of muscarininc antagonists is long acting

Answer 36

tiotropium

Question 37

Tiotropium and ipratropium also used for

Answer 37

COPD ( remember these are asthma drugs)

Question 38

which asthma drug causes oral thrus

Answer 38

inhaled corticosteroids

Question 39

asthma drug that blocks leukotriene receptors (CysLT1)

Answer 39

montelukast, zafirlukas

Question 40

antileukotrienes

Answer 40

montelukast, zafirlukast, zileuton

Question 41

aspirin induced and exercised induced asthma can be treated w

Answer 41

montelukast, zafirlukast

Question 42

5 lipoxygenase pathway inhibiotr. blocks conversion of arachidonic acid to leukotrienes

Answer 42

zileuton

Question 43

zileuton SE

Answer 43

hepatotoxic

Question 44

Anti IgE monocolonal therapy

Answer 44

omalizumab

Question 45

omalizumab mechanism

Answer 45

binds mostly unbound serum IgE and blocks binding to FceRI.

Question 46

used in allergic astham w Increased IgE levels resistant to inahled steroids and long acting B2 agnosits

Answer 46

omalizumab

Question 47

uncontrolled symptoms of asthma

Answer 47

omalizumab

Question 48

inhibits proinflammatory substance release (histamine and leukotriense) decreasing airway inflammation

Answer 48

omalizumab

Question 49

theophylline mechainsm

Answer 49

likely causes bronchodilation by inhibiting phosphodiesterase, increase camp levels due to decrease camp hydrolysis

Question 50

theophyline usage is limited becuase

Answer 50

narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by cytochrome p450

Question 51

SE of theophyllinee

Answer 51

CNS: tremors, insomnia, seizure CV: hypotension, tachycardia, cardiac arrhytmias

Question 52

metacholine

Answer 52

nonselective muscarinic receptor (M3) agonist. used in bronchial challenge test to help diagnose asthma

Question 53

magnesium sulfate mechainsm

Answer 53

inhibits Ca influx into airway smooth muscle and promotes bronchodilation when giving IV during acute asthma flare up. also decreases inflammation by stabilziign T cells and inhibitng mast cell degranulation

Question 54

SE of inahled corticosteroids;

Answer 54

thrush, dysphonia: myopathy of laryngeal muscles and mucosal irritation

Question 55

CFTR modulating medications

Answer 55

lumacaftor and ivacaftor

Question 56

lumacaftor and ivacaftor mechanism

Answer 56

restoring CFTR proteins to membrane and by enhacnign protein function