Pulmonology

Question 1

What is the Vasoreactivity test?

When do you do this test?

A positive means what?

What if the patient with pulmonary HTN also has underlying cause of hypoxemia?

Answer 1

Inhaled bronchodilator should have pulmonary artery pressure decrease by > 10 mmHg and be < 40 mmHg.

In Pulmonary HTN.

That Calcium channel blockers will likely be useful.

Shouldn’t use drugs, should use Oxygen

Question 2

When do you start using Endothelin-1 receptor agonists?

Answer 2

Slight limitations due to Pulmonary HTN, but comfortable at rest (WHO class II)

Question 3

When do you start using Phosphodiesterase 5 inhibitors?

Answer 3

Slight limitations due to Pulmonary HTN, but comfortable at rest (WHO class II)

Question 4

When do you use Prostanoids? What are Prostanoids? What do Prostanoids do?

What are the side effects of Prostanoids?

What are the Prostanoids?

Answer 4

Dyspnea at rest which is from pulmonary cause (WHO class IV Pulmonary HTN). PGI₂ synthetic. Powerful Vasodilator/inhibit platelet aggregation.

Common vasodilator symptoms, bleeding, arthralgias** (**Jaw).

Epoprost**enol (first/permanent catheter), Tre**post**inil (3 things going for it; 3 routes of administration IV, inhale, Subcutaneous. Doesn’t need refrigeration. Can have site irritation), and Ilo**prost (Only inhaled). 123 (Epo (1^st), PGI₂, and Tre (3))

Question 5

Theophylline does a lot of things, but what is its main use? What are its main side effects?

How do I remember?

Answer 5

Blocks adenosine => alert enough to breathe (babies). Narrow therapeutic index => Cardio/Neurotoxic.

THEO Phyl in Line now, get your head out of your ass and pay attention. You got a good heart and mind, but you have to pay attention.

Question 6

What does Cromolyn do? When do you use this?

Answer 6

Prevents release of mediators from mast cells. Good prophylaxis.

Masculine men put chrome on bikes to prevent dents.

Question 7

What is Zileutin?

What do Zileutin/Zafirlukast/Montelukast do?

What are Zafirlukast/Montelukast drugs of choice for?

What is their weird side effect?

What is Guaifenesin?

What is N-acetylcysteine?

What is Pseudoephedrine?

What is Phenylephrine?

What is Methacoline?

Answer 7

5-lipoxygenase inhibitor

Blocks leukotrienes

Aspirin-induced asthma.

Can cause shakes

An Expectorant

Mucolytic** and antidote for **acetaminophen

Stimulant and α-agonist => clears congestion. SE; HTN

Above minus stimulant

Muscarinic receptor agonist. Asthma challenge test