Respiratory

Question 1

Allergic Rhinitis: What is it?

Answer 1

*Inflammation of nasal mucosa
*Causes histamine release
*Characterized by sneezing, watery eyes, and nasal congestion
*Caused by exposure to antigen (allergen)

Question 2

antihistamine drug names

Answer 2

end in -ine

Question 3

Diphenhydramine

Answer 3

*Antihistamine
*MOA: Histamine (H1) receptor blocker (first-generation)
*Adverse effects: drowsiness, or paradoxical CNS stimulation and excitability, anticholinergic effects, tachycardia, mild hypotension, maybe photosensitivity

Question 4

Fexofenadine

Answer 4

*Antihistamine
*MOA: (H1) receptor blocker (2nd generation)

Question 5

how to treat acute attacks

Answer 5

AIM
A: ALBUTEROL 1st
I: Ipratropium 2nd
M: Methylprednisolone 3rd

Question 6

Intranasal corticosteroids

Answer 6

*steroids end in -sone
*drug of choice
*High efficacy and wide margin of safety
*Must be administered 2–3 weeks prior to allergen exposure
*Reduce swelling directly in resp. system
*slow onset (NOT A RESCUE DRUG)
*used 3rd in line

Question 7

intranasal corticosteroid drug names

Answer 7

end in -one, -ide or -ium

Question 8

fluticasone

Answer 8

*Intranasal corticosteroid.
*MOA: decreases inflammation in nasal passages
*Adverse: nasal irritation, epistaxis

Question 9

Oxymetazoline

Answer 9

*MOA: Decongestant/ vasoconstrictor (NOT A STEROID - it’s a nasal spray)
*Adverse effects: rebound congestion when oxymetazoline is used for 3–5 days +
*Adverse: Minor stinging and dryness in nasal mucosa

Question 10

Pseudoephedrine

Answer 10

• oral adrenergics
  *Stimulates alpha- and beta-adrenergic receptors.
  *Produces vasoconstriction in the respiratory tract mucosa (alpha-adrenergic stimulation) and possibly bronchodilation (beta2 -adrenergic stimulation).

Question 11

Antitussives

Answer 11

inhibit cough

Question 12

Opioids

Answer 12

*used to inhibit severe cough
*raise the cough threshold decreasing the frequency and intensity of the cough
*Hydrocodone and codeine
*Risk of dependency

Question 13

Tessalon pearls

Answer 13

*antitussive
*“benzonatate”
*local anesthetic

Question 14

dextromethorphan

Answer 14

*non-opiate antitussive
*MOA: acts in medulla to inhibit cough reflex
*Adverse effects: dizziness, drowsiness, GI upset

Question 15

Expectorant

Answer 15

inhibit mucous production & loosens mucous

Question 16

Guaifenesin

Answer 16

*expectorant
*loosens thick bronchial secretions and makes mucus thinner
*“Mucinex”
*drowsiness, headache, GI upset

Question 17

Mucolytics

Answer 17

loosen thick bronchial secretions (cough)

Question 18

Acetylcysteine

Answer 18

*mucolytic
*MOA: Degrades mucus, allowing easier mobilization and expectoration
*adverse: hypersensitivity reactions (including anaphylaxis)
*Used for cystic fibrosis, chronic bronchitis, or other diseases producing thick mucus

Question 19

Asthma: how to prevent?

Answer 19

Prevent asthmatic attacks (long-acting medications)

Question 20

Asthma: how to treat?

Answer 20

*Terminate attack in progress (quick-relief medications)

Question 21

Asthma what is it?

Answer 21

inflammation (plugs airway) and bronchoconstriction/ bronchospasm (narrows the airway)

Question 22

Why the inhalation route

Answer 22

*Huge amount of surface area of the bronchioles and alveoli - the rich blood supply results in quick onset of action for INHALED substances

Question 23

beclomethasone

Answer 23

*anti-inflammatory inhaled corticosteroid
*preferred for long-term
*MOA: acts by reducing inflammation
*Also for allergic rhinitis
*not used for acute attacks
*Adverse effects: oropharyngeal candidiasis

Question 24

Anticholinergics for asthma

Answer 24

*ipratropium
*drugs end in -tropium
*MOA: bronchodilation
*Adverse: cough, drying of nasal mucosa, hoarseness, bitter taste
*used in inhaled form

Question 25

salmeterol

Answer 25

*Long acting beta-adrenergic drugs *MOA: bronchodilation

Question 26

Cromolyn

Answer 26

*Mast cell stabilizer *Inhibits mast cells from releasing histamine and other chemical mediators *for prophylaxis of asthma (LONG TERM) *Not to be used for acute bronchospasm (=ineffective) *prevents ACTIVITY-INDUCED asthma

Question 27

montelukast

Answer 27

*Leukotriene modifiers *drugs end in -lukast *MOA: anti-inflammatory in airway *Use: prophylaxis of asthma *Adverse effects: HA, nausea, diarrhea *NOT a rescue drug (NOT for acute attacks)

Question 28

Terminate acute attack

Answer 28

*with a beta-adrenergic agonists (Albuterol) *MOA: bronchodilation

Question 29

albuterol

Answer 29

*Short acting beta-adrenergic *MOA: causes bronchodilation *Adverse: HA, throat irritation, nervousness, restlessness, tachycardia, chest pain, allergic reactions

Question 30

Xanthine’s/ Methylxanthines theophylline

Answer 30

*Bronchodilators related to caffeine *Narrow margin of safety *Interact with numerous drugs *Side effects: N/V, CNS stimulation *Given by IV or oral routes *Primarily used for long-term prophylaxis of asthma that is unresponsive to beta agonists or corticosteroids

Question 31

COPD: how to treat it?

Answer 31

*Relieve symptoms/avoid complications *Bronchodilators *Mucolytics *Expectorants *Oxygen therapy *Antibiotics *Roflumilast

Question 32

COPD: what is it?

Answer 32

*Obstructed airflow *Commonly caused by: chronic bronchitis, asthma *Progressive; end stage emphysema

Question 33

allergic rhinitis: how to prevent and treat?

Answer 33

*prevent with antihistamines, intranasal corticosteroids, mast cell stabilizers *treat - relieve symptoms with oral/intranasal decongestants (usually sympathomimetics)