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Flashcards in Resp Pharm from FA Deck (18):
1

How do H1 blockers work?

Reversible inhibition of H1 histamine receptors

2

Diphenhydramine, dimenhydrinate, chlorpheniramine

Class? Mech? Use? Tox?

First generation H1 blockers

Mech: reversible inihibition of H1 histamine receptors

Use: allergy, motion sickness, sleep aid

Tox: sedation, antimuscarinic, anti-alpha-adrenergic

Notes: names contain "en/ine" or "en/ate"

3

Loratidine, fexofenadine, desloratidine, cetirizine

Class? Mech? Use? Tox?

second generation H1 blockers

Mech: reversible inhibition of H1 histamine receptors

Use: allergies

Tox: far less sedating than 1st generation due to decreased entry into CNS

Note: names usually end in "adine"

Or, "Less Feeling of CEntral DESpression"

4

Guaifenesin

Class? Mech?

Expectorant

Mech: thins respiratory secretions. Does not suppress cough reflex

5

N-acetylcysteine

Class? Mech?

Expectorant

Mucolytic: loosens mucous plugs in CF patients. Also an antidote for acetaminophen OD.

6

Dextromethorphan

Class? Mech?

Antitussive.

Antagonizes NMDA receptors.

Synthetic codeine analog. Mild opioid effect if used in excess. Naloxone can be given for overdose. Mild abuse potential.

A image thumb
7

Pseudoephedrine, Phenylephrine

Class? Mech? Use? Tox?

Class: nasal decongestant (over the counter)

Mech: Sympathomimetic alpha-agonist

Use: reduce hyperemia, edema and nasal congestion. Open obstructed eustacian tubes. (Pseudoephedrine illicitly used to make methamphetamine.)

Tox: HTN. Pseudoephedrine can cause CNS stim/anxiety.

8

General mechanisms of asthma drugs?

Bronchoconstriction mediated in two ways:

1. inflammatory processes

2. parasymphatic tone

so Tx is directed at those pathways.

9

Albuterol

Class? Mech?

Asthma drug, Beta-2 agonist

Mech: Relaxes bronchial smooth muscle (beta2).

Use: acute exacerbation

10

Salmeterol, Formoterol

Class? Mech? Use? SEs?

Asthma drugs, beta-2 agonists

Use: long-acting agents for prophylaxis

SEs: tremor, arrhythmia

11

Theophylline

Class? Mech? Use?

Asthma drug, Methylxanthine

Mech: likely causes bronchodilation by inhibiting phosphodiesterase --> increases cAMP levels due to decreased cAMP hydrolysis.

Use: limited due to narrow therapeutic index.

AE: cardiotoxic, neurotoxic

Metabolized by cytochrome P-450

Blocks actions of adenosine

12

Ipratropium

Class? Mech? Use?

Asthma drug, Muscarinic antagonist

Mech: competitive block of muscarinic receptors, prevents bronchoconstriction. 

Use: asthma, COPD

Tiotropium is a long-acting muscarinic antagonist also used for COPD.

13

Beclomethasone, Fluticasone

Class? Mech? Use?

Asthma drugs, Corticosteroids

First line for chronic asthma

Inhibit the synthesis of virtually all cytokines. Inactivates NF-KB (transcription factor that induces production of TNF-alpha and other inflammatory agents). 

14

Montelukast, Zafirlukast

Class? Mech? Use?

Asthma drugs, Antileukotrienes

Block leukotriene receptors. Especially good for aspirin-induced asthma.

15

Zileuton

Class? Mech? Use?

Asthma drugs, Antileukotriene

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

16

Omalizumab

Class? Mech? Use?

Asthma drug, monoclonal anti-IgE antibody.

Binds unbound serum IgE, blocks binding to FCeRI. 

Used in allergic asthma resistant to inhaied steroids and long-acting B2-agonists.

17

Methacholine

Class? Mech? Use?

Asthma drug

Muscarinic receptor agonist

Used in bronchial provocation challenge to help diagnose asthma

18

Bosentan

Class? Mech? Use?

Asthma drug

Competitively antagonizes endothelin-1 receptors, decreases pulm vascular resistance.

Used for pulmonary artery hypertension.