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Flashcards in Pharm Respiratory Deck (18):
1

What class of drugs are diphenhydramine, demenhydrinate, and chlorpheniramine? Clinical uses? Mechanism? Toxicity?

1st generation H1 blockers (en/ine) or (en/ate)

Reversible inhibitors of H1 histamine receptors

Allergy, motion sickness, sleep aid

Sedation, antimuscarinic, anti alpha adrenergic

2

What class of drugs are loratadine, fexofenadine, desloratadine, cetirizine? Clinical uses? Toxicity? Mechanism?

2nd generation H1 blockers (-adine)

Reversible inhibitors of H1 histamine receptors

Allergy

Far less sedating than 1st generation b/c of decr. entry into CNS

3

What type of drug is guaifenesin? Actions?

expectorant: thins resp. secretions. Does not suppress cough reflex

4

What type of drug is N-acetylcysteine? Mechanism/action? Clinical uses?

Mucolytic-Can loosen mucous plugs in CF patients by disrupting Disulfide bonds

Antidote for Acetaminophen overdose

5

What type of drug is dextromethorphan? Mechanism? What drug is it like? What happens when used in excess? Antidote? Toxicity?

Antitussive (antagonizes NMDA glutamate receptors)

Synthetic codeine analog
Mild opioid effect in excess
Naloxone for overdose
Mild abuse potential

Serotonin syndrome when given with other serotonergic agents

6

What is the mechanism of pseudoephedrine (1) and phenylephrine? Clinical uses? Other uses of 1? Toxicity? of just 1?

Alpha adrenergic agonists, used as nasal decongestants

Reduce hyperemia, edema, nasal congestion
Open obstructed eustachian tubes

1 is used to make meth

Hypertension
1 can cause CNS stim/anxiety

7

What type of drug is bosentan? Mechanism? Clincal use? Toxicity?

Endothelin receptor antagonists
Competitively antagonize endothelin 1 receptors leading to decr. pulm. vasc. resistance

Pulm. hypertension

Hepatotoxic (monitor LFTs)

8

What type of drug is sildenafil? Clinical uses?

PDE-5 inhibitor

Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide.

Pulmonary hypertension
Erectile dysfunction

9

What type of drugs are epoprostenol and iloprost? Mechanisms? Side effects?

Prostacyclin analogs

PGI2 with direct vasodilatory effects on pulmonary and systemic arterial vasc. beds
Inhibit platelet aggregation

Flushing
Jaw pain

10

What are the targets of asthma drugs?

Bronchoconstriction is mediated by inflammatory process and parasympathetic tone. Therapy is directed here.

11

What kind of drugs are albuterol (1), salmeterol (2), and formoterol (3)? Mechanism (1)? 2/3? Clinical use 1? 2/3? Adverse effects 2/3?

Beta 2 agonists

1=relaxes bronchial smooth muscle. Acute exacerbation

2=same, but long acting agent. Prophylaxis.
Tremor and arrhythmia

12

What type of drugs are fluticasone and budesonide? Mechanism? Clinical use?

Corticosteroids

Inhibit synth of virtually all cytokines
Inactivate NF-kappa beta, the transcription factor that induces production of TNF-alpha and other inflamm agents.

1st line therapy for chronic asthma

13

Waht type of drug is ipratropium (1) and tiotropium (2)? Mechanism? Clinical uses? How does tiotropium differ (2)?

Muscarinic antagonist
Competetively block musc. receptors
Prevent bronchoconstriction

Asthma
COPD

2 is long acting

14

What type of drugs are montelukast, zafirlukast? Mechanism? Clinical use?

Antileukotrienes

Block LT receptor

Asthma, especially asthma induced

15

What type of drug is zileuton? Mechanism? Toxicity?

antileukotriene

5-lipoxygenase pathway inhibitor.
Blocks conversion of AA to LT

Hepatotoxic

16

What type of drug is omalizumab? Mechanism? Clinical use?

Monoclonal anti-IgE Ab
Binds mainly unbound serum IgE preventing it from binding Fc epsilon RI

Allergic asthma resistant to inhaled steroids and long acting beta 2 agonists

17

What type of drug is theophylline? Mechanisms? Toxicity? Use?

methylxanthine

Bronchodilation by inhibiting phosphodiesterase which increases cAMP which increases bronchodilation.
Blocks actions of adenosine (which is a bronchoconstrictor)

Usage limited due to narrow therapeutic index
Cardiotoxic, neurotoxic
P450

18

What type of drug is methacholine? Use?

M3 agonist. Used in bronchial challenge test for diagnosis of asthma