Respiratory Pharmacology Flashcards
What are some first generation histamine blockers?
Diphenhydramine, dimenhydrinate, chlorpheniramine–Tox: sedation, antimuscarinic, anti-alpha adrenergic
What are some second generation H1 blockers
loratadine, fexofenadine, desloratadine, cetirizine; far less sedating than 1st generation given less entry into CNS
loosen mucus plugs in CF patients?
N-acetylcysteine
Dextromethorphan
antitussive that antagonizes NMDA gluatamate receptors; codeine analog with mild opioid effect, use naloxone for overdose; mild abuse potential
toxicity of pseudoephedrine/phenylephrine?
alpha agonist/sympathomimetic that can cause htn, CNS stimulation/anxiety
use during acute asthma exacerbation
Albuterol (B2 agonist), relaxes smooth muscle
Long acting B2 agonists
salmeterol, formoterol–prophylaxis, adverse effects are tremor and arrhythmia
bronchodilator with limited use given cardiotoxicity and neurotoxicity
Theophylline, inhibits PDE–increases cAMP levels, metabolized by CYP450, blocks action of adenosine
Ipatropium
competitive block of muscarinic receptors preventing bronchoconstriction; also used for COPD
first line therapy for chronic asthma
beclomethasone, fluticasone–corticosteroids that inhibit synthesis of virtually all cytokines
especially good for aspirin-induced asthma
montelukast, zafirlukast–block leukotriene receptors
blocks conversion of arachidonic acid to leukotrienes
zileuton–5 lipoxygenase pathway inhibitor
anti IgE antibody
Omalizumab–binds unbound serum IgE and prevents binding to FcRI; used in allergic asthma resistant to inhaled steroids and long acting B agonists
methacholine
muscarinic receptor agonist–used in provocation challenge to help diagnose asthma
used to treat pulmonary arterial HTN
bosentan–competitively antagonizes endothelin 1 receptors, decreased pulmonary vascular resistance+
