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USMLE Step 1 > Pulmonary > Flashcards

Flashcards in Pulmonary Deck (12):
1

Beta 2 agonists

Albuterol- relaxes bronchial smooth mm (via Beta 2 receptors). Use during ACUTE asthma exacerbation.

Salmeterol, formoterol- long-acting agents for asthma PROPHYLAXIS. Adverse effects: tremor & arrhythmia

2

Methylxanthines

(Asthma Tx)

Theophylline- likely causes bronchodilation by inhibiting phosphodiesterase, thereby decreasing cAMP hydrolysis. Usage is limited b/c of narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by P-450. Blocks action of adenosine.

3

Muscarinic antagonists

(Asthma Tx)

Ipratropium- competitive block of muscarinic receptors, preventing bronchoconstriction. Also used for COPD, as is tiotropium, a long-acting muscarinic antagonist.

4

Corticosteroids

(Asthma Tx)

Beclomethasone, fluticasone- inhibit the synthesis of virtually all cytokines. Inactivate NF- kappa B, the transcription factor that induces the production of TNF- alpha, among other inflamm agents. 1st-line therapy for chronic asthma.

5

Antileukotrienes

(Asthma Tx)

Montelukast, zafirlukast- block leukotriene receptors. Esp good for aspirin-induced asthma.

Zileuton- 5-lipoxygenase pathway inhibitor. Blocks conversion of arachidonic acid to leukotrienes.

6

Omalizumab

(Asthma Tx)

Monoclonal anti-IgE antibody. Binds mostly unbound serum IgE. Doesn't work on IgE already on mast cell surface. Used in allergic asthma resistant to inhaled steroids & long-acting Beta2- agonists.

7

Guaifenesin

Expectorant- thins respiratory secretions; does not suppress cough reflex.

8

N-acetylcysteine

Mucolytic- can loosen mucous plugs in CF pts. Also used as an antidote for acetaminophen overdose.

9

Bosentan

Used to Tx pulmonary HTN. Competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance.

10

Dextromethorphan

Antitussive (antagonizes NMDA glutamate receptors). Synthetic codeine analog. Has mild opioid effect when used in excess. Naloxone can be given for overdose. Mild abuse potential.

11

Pseudoephedrine, phenylephrine

MoA: Sypathomimetic alpha-agonistic nonprescription nasal decongestants

Use: reduce hyperemia, edema, & nasal congestion; open obstructed eustachian tubes. Pseudoephedrine also used as a stimulant

Toxicity: HTN. Can also cause CNS stimulation/ anxiety (pseudoephedrine)

12

Metacholine

Muscarinic receptor agonist. Used in asthma challenge testing.