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Flashcards in Pharmacology Deck (19)
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What are the general treatment strategies for asthma?

Omalizumab is an anti-IgE, Steroids inhibit cytokine release and inflammation, antileukotrienes inhibit inflammation, b-agonists theophylline and muscarinic antagonists are used to block bronchoconstriction

1

How does theophylline work for asthma (2 ways)

1) inhibits phosphodiesterase hydrolysis of cAMP --> increased cAMP --> bronchodilation
2) blocks actions of adenosine, a vasoconstrictor

2

What are the toxic effects of theophylline?

Narrow therapeutic index. Cardiotoxicity (arrythmias), neurotoxicity (seizures), abdominal pain. Metabolized by p450

3

What are some b2 agonists used for asthma treatment?

Albuterol (used in acute exacerbation)
Salmeterol, formoterol: prophylaxis. Toxicity = tremor, arrythmia

4

Ipatropium

Muscarinic antagonist, prevents bronchoconstriction. Can be used for COPD.

5

What steroids are used for asthma tx?

Beclomethasone, fluticasone

6

Beclomethasone, fluticasone

Corticosteroids. Inactivate NF-kB, reducing TNF-a and other cytokines/inflammatory agents. Also reduce mucus production.

7

Most common side effect for inhaled steroids

Oropharyngial candida infection

8

Antileukotrienes

Montelukast, zafirlukast: block leukotriene receptors
Sileuton: 5-lipoxygenase inhibitor, blocks conversion of arachadonic acid to leukotrienes.
Prevent inflammation and bronchoconstriction

9

Omalizumab

Monoclonal anti-IgE. Used for allergic asthma resistant to steroids and b2 agonists.

10

Provocation test for asthma

Methacoline (muscarinic agonist) test

11

Bosentan

Endothelin-1 (vasoconstrictor) antagonist --> tx for pulmonary hypertension

12

Mast cell stabilizers

Cromolyn, nedocromil

13

First generation antihistamines: examples, uses, toxicity

Diphenhydramine, dmenhydrinate, chlorpheniramine
Allergy, motion sickness, sleep.
Crosses BBB --> sedation, antimuscarinic, anti-a-adrenergic

14

Second generation antihistamines: examples, uses, toxicity

Loratadine, fexofenadine, desloratadine, certirizine (-adine)
Allergy
Far less sedating than first generation. Mild anticholinergic effects

15

Guaifenesin

Thins respiratory secretions --> decreases mucus viscosity.

16

N-acetyl cysteine

Mucolytic agent, often used in CF.
Also antidote for acetominophen OD

17

Dextromethorphan

Decreases sensitivity of cough receptors, antagonizes NMDA glutamate receptors. Mild opioid effect.

18

Pseudoephedrine, phenlephrine

Nasal decongestants. Sympathomimetic a-agonist. Vasoconstriction -- > less congestion

Can cause hypertension and CNS stimulation/anxiety