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Flashcards in Respiratory Drugs Deck (45)
1

Name the 1st generation H1 blockers

"-en/-ine" or "-en/-ate"

diphenhydramine, dimenhydrinate, chlorpheniramine

2

Uses of 1st gen H1 blockers

allergy, motion sickness, sleep aid

3

Toxicity of 1st gen H1 blockers

sedation, antimuscarinic, anti-alpha-adrenergic

4

Name the 2nd gen H1 blockers

"-adine"

loratadine, fexofenadine, desloratidine

5

Uses of 2nd gen H1 blockers

allergy

6

Toxicty of 2nd gen H1 blockers

far less sedating than 1st gen because of decreased CNS entry

7

Guaifenesin use

expectorant
things respiratory secretions; does NOT suppress cough reflex

8

N-acetylcysteine use

mucolytic - can loosen mucus plugs in CF patients by disrupting disulfide bonds
also used as antidote for acetaminophen overdose

9

Mechanism of of dextromethorphan

antitussive (antagonizes NMDA glutamate receptors)
synthetic codeine analog

10

Use of dextromethorphan

has mild opioid effect when used in excess

11

Toxicity of detromethorphan

naloxone can be given for overdose
mild abuse potential
may cause serotonin syndrome if combined with other serotonergic agents

12

Mechanism of pseudoephedrine, phenylephrine

alpha-adrenergic agonist

13

Use of pseudoephedrine, phenylephrine

nasal decongestant (reduce hyperemia, edema)
open obstructed eustachian tubes

14

Toxicity of pseudoephedrine, phenylephrine

hypertension
can also cause CNS stimulation/anxiety (pseudoephedrine)

15

Name the pulmonary HTN drug classes

Endothelin receptor antagonists
PDE-5 inhibitors
prostacyclin analogs

16

Name the endothelin receptor antagonists

bosentan

17

Mechanism of endothelin receptor antagonists

competitively antagonize endothelin-1 receptors --> decrease pulmonary vascular resistance

18

Toxicity of endothelin receptor antagonists

hepatotoxic (monitor LFTs)

19

Name the PDE-5 inhibitors

Sildenafil

20

Mechanism of sildenafil/PDE-5 inhibitors

inhibit PDE5 from breaking down cGMP so it lasts longer and prolongs the vasodilatory effect of nitric oxide

21

Use of sildenafil/PDE-5 inhibitors

pulmonary HTN
erectile dysfunction

22

Name the prostacyclin analogs

epoprostenol, iloprost

23

Mechanism of prostacyclins

PGI2 with direct vasodilatory effects on pulmonary and systemic arterial vascular beds
inhibit platelet aggregation

24

Toxicity of prostacyclins

flushing, jaw pain

25

Asthma drugs target pathways

1. inflammatory processes
2. parasympathetic tone

26

Classes of asthma drugs

Beta2-agonists
corticosteroids
muscarinic antagonists
antileukotrienes
Omalizumab
Methylxanthines
Methacholine

27

Short-acting beta2 agonists

albuterol

28

Mech and use of albuterol for asthma

relaxes bronchial smooth muscle
used for acute exacerbation

29

Long-acting beta2 agonists

salmeterol and formoterol

30

Mech and use of salmeterol and formoterol

long-acting for prophylaxis

31

Adverse effects of long-acting beta2 agonists

tremor and arrhythmia

32

Name the corticosteroids for asthma

Fluticasone, budesonide

33

Use of corticosteroids for asthma

1st-line therapy for chronic asthma

34

Mech of corticosteroids for asthma

inhibit synthesis of virtually all cytokines
inactivate NF-kappaB, the transcription factor that induces production of TNF-alpha and other inflammatory agents

35

Mech of ipratropium

competitively inhibits muscarinic receptors, preventing bronchoconstriction

36

Use of ipratropium

asthma and for COPD

tiotropium is same but long acting

37

Mech of montelukast, zafirlukast

block leukotriene receptors (CysLT1)

38

Use of montelukast, zafirlukast

good for aspirin-induced asthma

39

Mech of zileuton

5-lipooxygenase pathway inhibitor
blocks conversion of AA to leukotrienes

40

Toxicity of zileuton

hepatotoxic

41

Mech of Omalizumab

monoclonal ab against IgE
binds unbound serum IgE and blocks binding to Fc receptor

42

Use of omalizumab

allergic asthma resistant to inhaled steroids and long-acting beta2-agonists

43

Mech of theophylline

likely causes bronchodilation by inhibiting PDE --> increase in cAMP levels doe to decreased cAMP hydrolysis (via PDE)

44

Use of theophylline

limited due to narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by cytochrom p-450
blocks the action of adenosine

45

Methacholine Challenege Test

muscarinic receptor (M3 agonist), used in bronchial challenge to help diagnose asthma