H1 blocker 1st generation (-en/ine or en/ate) Use allergy motion sickness sleep aid Toxicity sedation antimuscarinic hot as hare red as beet dry as a bone blind as a bat mad as a hatter anti alpha adrenergic

H1 blocker 1st generation en/ine or en/ate Use allergy motion sickness sleep aid Toxicity sedation antimuscarinic how as a hare red as a beet blind as a bat dry as a bone mad as a hatter anti alpha0 adrenergic

H1 blocker 1st generation en/ine or en/ate Use allergy motion sickness sleep aid Toxicity sedation antimuscarinic hot as hare blind as bad dry as bone red as beet mad as hatter anti- alpha- adrenergic

H1 blocker 2nd generation - adine use allergy toxicity less sedation than 1st generation decreased entry into CNS

H1 blocker 2nd generaion -adine Use allergy Toxicity less sedating than 1st generation decreased CNS entry

H1 blocker 2nd generation adine use allergy toxicity less sedation than 1st generation decreased CNS entry

H1 blocker 2nd generation only one not ending in -adine use allergy toxicity less sedation than 1st generation decreased CNS entry

B2 agonist Asthma acute exacerbation Bronchodilator increase cAMP

B2 agonist Asthma prophylaxis long acting Bronchodilator increase cAMP Toxicity tremor arrhythmia (increase heart rate and contractility)

B2 agonist Asthma prophylaxis long acting Bronchodilator increase cAMP Toxicity tremor arrhythmia (increase heart contractility and rate)

Methylxanthine Asthma Bronchodilator inhibits phosphodiesterase decreases cAMP hydrolysis blocks adenosine actions Narrow therapeutic index Metabolized by CYP Low doses insomnia and arousal Toxicity abdominal pain vomiting, diarrhea cardiac arrhythmias (cardiotoxicity) Tachyarrhythmias = major concern but usually does not cause prolonged QT seizures (neurotoxicity) Seizures = most likely morbidity adn mortality

Muscarinic antagonist Asthma COPD Tiotropium (long acting muscarinic antagonist) Prevent bronchoconstriction Competitively blocks muscarinic receptors

Corticosteroid Asthma chronic asthma (1st line) Inhibit synthesis of all cytokines Inactivates NK-kB transcription factor that induces TNF-alph production

Corticosteroids Asthma Chronic (1st line) Inhibit cytokine synthesis Inactive NF-kB transcription factor that induces production of TNF-alpha

Antileukotriene Asthma aspirin induced asthma Bock leukotriene receptors

Pulm Flashcards by Hillary Raab

Diphenhydramine

H1 blocker

1st generation
- (-en/ine or en/ate)
Use
- allergy
- motion sickness
- sleep aid
Toxicity
- sedation
- antimuscarinic
  - hot as hare
  - red as beet
  - dry as a bone
  - blind as a bat
  - mad as a hatter
- anti alpha adrenergic

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Dimenhydrinate

H1 blocker

1st generation
- en/ine or en/ate
Use
- allergy
- motion sickness
- sleep aid
Toxicity
- sedation
- antimuscarinic
  - how as a hare
  - red as a beet
  - blind as a bat
  - dry as a bone
  - mad as a hatter
- anti alpha0 adrenergic

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Chlorpheniramine

H1 blocker

1st generation
- en/ine or en/ate
Use
- allergy
- motion sickness
- sleep aid
Toxicity
- sedation
- antimuscarinic
  - hot as hare
  - blind as bad
  - dry as bone
  - red as beet
  - mad as hatter
- anti- alpha- adrenergic

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Loratadine

H1 blocker

2nd generation
- - adine
use
- allergy
toxicity
- less sedation than 1st generation
  - decreased entry into CNS

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Fexofenadine

H1 blocker

2nd generaion
- -adine
Use
- allergy
Toxicity
- less sedating than 1st generation
  - decreased CNS entry

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Desloratadine

H1 blocker

2nd generation
- adine
use
- allergy
toxicity
- less sedation than 1st generation
  - decreased CNS entry

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Cetirizine

H1 blocker

2nd generation
- only one not ending in -adine
use
- allergy
toxicity
- less sedation than 1st generation
  - decreased CNS entry

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Albuterol

B2 agonist

Asthma
- acute exacerbation
Bronchodilator
- increase cAMP

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Salmeterol

B2 agonist

Asthma
- prophylaxis
- long acting
Bronchodilator
- increase cAMP
Toxicity
- tremor
- arrhythmia (increase heart rate and contractility)

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Formoterol

B2 agonist

Asthma
- prophylaxis
- long acting
Bronchodilator
- increase cAMP
Toxicity
- tremor
- arrhythmia (increase heart contractility and rate)

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Theophylline

Methylxanthine

Asthma
Bronchodilator
- inhibits phosphodiesterase
- decreases cAMP hydrolysis
- blocks adenosine actions
Narrow therapeutic index
Metabolized by CYP
Low doses
- insomnia and arousal
Toxicity
- abdominal pain
- vomiting, diarrhea
- cardiac arrhythmias (cardiotoxicity)
  - Tachyarrhythmias = major concern but usually does not cause prolonged QT
- seizures (neurotoxicity)
  - Seizures = most likely morbidity adn mortality

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Ipratropium

Muscarinic antagonist

Asthma
COPD
- Tiotropium (long acting muscarinic antagonist)
Prevent bronchoconstriction
- Competitively blocks muscarinic receptors

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Beclomethasone

Corticosteroid

Asthma
- chronic asthma (1st line)
Inhibit synthesis of all cytokines
Inactivates NK-kB
- transcription factor that induces TNF-alph production

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Fluticasone

Corticosteroids

Asthma
- Chronic (1st line)
Inhibit cytokine synthesis
Inactive NF-kB
- transcription factor that induces production of TNF-alpha

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Montelukast

Antileukotriene

Asthma
- aspirin induced asthma
Bock leukotriene receptors

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Zafirlukast

Antileukotrienes

Asthma
- aspirin induced asthma
Block leukotriene receptors

Zileuton

Antileukotriene

Asthma
5 lipoxygenase pathway inhibitor
- Blocks conversion of arachidonic acid –> leukotrienes

Omalizumab

Monoclonal antibody

Asthma
- allergic asthma resistant to inhaled steroids and long acting B2 agonist
Monclonal anti-IgE antibody
- binds unbound serum IgE

Guaifenesin

Expectorant

Thins respiratory secretions
Does NOT suppress cough

N-acetylcysteine

Expectorant

Mucolytic
- loosen mucous plugs in CF patient
- Cleaves disulfide bonds within mucous glycoproteins
Antidote for acetaminophen overdose

Bosentan

Expectorant

Competitively antagonizes endothelin 1 receptors
- Decreases pulomonary vascular resistance
- Endothelin 1 produced by vascular endothelium
Use
- pulmonary arterial HTN

Dextromethorphan

Expectorant

Antagonise NMDA glutamate receptors
- Antitussive
Synthetic codeine analog
Mild opiod effect when used in excess
Nalaxone for overdose
mild abuse tendency

Pseudoephedrine

Sympathomimetic alpha agonist

Nonprescription nasal decongestant
Use
- reduce hyperemia
- reduce edema
- reduce nasal congestion
- open obstructed eustachian tubes
- stimulant
Toxicity
- HTN
- CNS stimulation/ anxiety

Phenylephrine

Sympathomimetic alpha agonist

nonprescription nasal decongestant
Use
- reduce hyperemia
- reduce edema
- reduce nasal congestion
- open obstructed eustachian tibes
Toxcity
- HTN

Methacholine

Muscarine receptor agonist * asthma challenge test

Inspiratory Reserve Volume | (IRV)

* Amount of air that can still be breathed in after _normal_ inspiration

Tidal Volume | (TV)

* Amount of air that moves into lungs after _quiet_ inspiration * 500 mL

Expiratory Reserve Volume | (ERV)

* Amount of air that can still be breathed out after _normal_ expiration

Residual Volume | (RV)

* Amount of air left in lung after _max_ _expiration_

Capacity

2 or \> volumes

Inspiratory Capacity | (IC)

* Total amount of air that can be inspired after normal expiration * TV + IRV

Functional Residual Capacity | (FRC)

* Volume in lungs after normal expiration * ERV + RV * Determined by elastic force of chest wall (outward force) + lung compliance (inward force) * increased = obstructive lung disease * decreased = restrictive lung disease

Vital Capacity | (VC)

* Maximum volume that can be expired after max inspiration * TV + IRV + ERV * Decreases: Age * Increases: body size, male, physical activity

Total Lung Capacity | (TLC)

* Volume of gas in lungs after max inspiration * IRV + TV + ERV + RV

Anaphylactic shock

* epinephrine * alpha-1 receptors: counteracts vasodilation, increase BP * Beta-1 receptors: increase CP and increase BP * Beta-2 receptors: bronchodilation * Characteristics * vasodilation * increased vascular permeability * bronchoconstriction

inhaled corticosteroids Flunisolide Fluticasone

Inhale corticoseroid * Most commonly used prophylactic therapy for patients with persistent bronchial asthma * Treatment goals * prevention of symptoms * maintenance of near normal pulm function * maintenance of normal activity level * Toxicity * oropharyngeal candidiasis * use spacer adn rinse mouth to prevent * dysphonia * myopathy of laryngeal muscles

Cromolyn Nedocromil

Asthma * MOA: inhibit mast cell degranulation * Use: * prevent acute asthma attacks