Respiratory Pharmacology Flashcards
(50 cards)
1
Q
antihistamines–mechanism
A
- reversible inhibitors of H1 histamine receptors
2
Q
name 3 first generation antihistamines
A
- diphenhydramine
- dimenhydrinate
- chlorpheniramine
- names contain “-en/-ine” or “-en/-ate”
3
Q
first generation antihistamines–use
A
- allergy
- motion sickness
- sleep aid
4
Q
first generation antihistamines–toxicity
A
- sedation
- antimuscarinic
- anti alpha adrenergic
5
Q
name 4 2nd gernation antihistamines
A
- loratadine
- fexofenadine
- desloratadine
- ceterizine
- names usually end in “-adine”
6
Q
2nd generation antihitamines–use
A
- allergy
7
Q
why are 2nd generation antihistamines less sedating than 1st generation?
A
- b/c of dec entry into CNS
8
Q
name 2 expectorants
A
- guaifenesin
- N-acetylcysteine
9
Q
guaifenesin–mechanism/use
A
- expectorant–thins respiratory secretions
- does not suppress cough reflex
10
Q
N-acetylcysteine–mechanism/use
A
- mucolytic–liquefies mucus in COPD pts by disrupting disulfide bonds
- also used as an antidote for acetaminophen overdose
11
Q
dextromethorphan–mechanism
A
- antitussive–antagonizes NMDA glutamate receptors
- synthetic codeine analog
12
Q
dextromethorphan–toxicity
A
- has mild opiod effect when used in excess
- mild abuse potential
- may cause serotonin syndrome if combined with other serotonergic agents
13
Q
dextromethorphan–antidote
A
- naloxone can be given for overdose
14
Q
pseudoephedrine, phenyephrine–mechanism
A
- alpha adrenergic agonists
- used as nasal decongestants
15
Q
pseudoephedrine, phenyephrine–use
A
- reduce hypermia, edema, nasal decongestion
- open obstrucated eustachian tubes
- pseudoephedrine can be used illicitly to make methamphetamine
16
Q
pseudoephedrine, phenyephrine–toxicity
A
- HTN
- can be used to cause CNS stimulation/anxiety
- pseudophedrine
17
Q
name 4 pulmonary hypertension drugs
A
- Bosentan
- sildenafil
- epoprostenol
- iloprost
18
Q
BosENtan–mechanism
A
- competitively antagonizes ENdothelin-1 receptors –> decrease pulmonary vascular resistance
19
Q
Bosentan–toxicity
A
- hepatotoxicity
- monitor LFTs
20
Q
Sildenafil–mechanism
A
- inhibits cGMP PDE-5
- prolongs vasodilatory effect of nitric oxide
21
Q
what is another use for Sildenafil beside pulmonary hypertension?
A
- erectile dysfunction
22
Q
epoprostenol, isoprost–mechanism
A
- PGI2 (prostacyclin) with direct vasodilatory effects on pulmonary and systemic arterial vascular beds
- inhibits platelet aggregation
23
Q
epoprostenol, isoprost–toxicity
A
- flushing
- jaw pain
24
Q
how is bronchoconstriction mediated?
A
- inflammatory processes
- parasympathetic tone
25
classes of asthma drugs
* beta 2 agonists
* inhaled corticosteroids
* muscarinic antagonists
* antileukotrienes
* anti-IgE monoclonal therapy
* methylxanthines
26
what are 3 asthma drugs that are beta 2 agonists?
* albuterol
* salmeterol
* formoterol
27
Albuterol--mechanism
* (beta 2 agonist asthma drug)
* relaxes bronchial smooth muscle--short acting beta 2 agonist
28
albuterol--use
* (beta 2 agonist asthma drug)
* acute exacerbation
29
salmeterol, formoterol--use
* (beta 2 agonist asthma drug)
* long acting agent for prophylaxis
30
salmeterol, formoterol--toxicity
* tremor
* arrhythmia
31
name 2 inhaled corticosteroids used for asthma
* fluticasone
* budesonide
32
inhaled corticosteroids--use
* first line for chronic asthma
* fluticasone, budesonide
33
inhaled corticosteroids--mechanism
* (fluticasone, budesonide)
* inhibit the synthesis of virtually all cytokines
* inactivate NK-kappa B--transcription factor that induces production of TNK-alpha and other inflammatory agents
34
name the muscarinic antagonist used to treat asthma
* ipratropium
35
ipratropium--use
* asthma
* COPD
36
muscarinic antagonists--mechanism
* (ipratropium)
* competitively blocks muscarinic receptors, preventing bronchoconstriction
37
what is a muscarinic antagonist used for asthma that is long acting?
* tiotropium
38
name 3 antileukotrienes that are used to treat asthma
* montelukast
* zafirlukast
* zileuton
39
montelukast, zafirlukast--mechanism
* (antileukotrienes asthma drug)
* block leukotriene receptors (CysLTI)
40
montelukast, zafirlukast--use
* (antileukotriene)
* aspirin induced astham
41
zileuton--mechanism
* (antileukotriene)
* 5 lipoxygenase pathway inhibitor
* blocks conversion of arachidonic acid to leukotrienes
42
zileuton--toxicity
* (antileukotrienes)
* hepatotoxic
43
name the anti IgE monoclonal therapy used to treat asthma
* omalizumab
44
omalizumab--mechanism
* (anti IgE monoclonal therapy for asthma)
* binds mostly unbound serum IgE and blocks binding to FcERI
45
omalizumab--use
* (anti IgE monoclonal therapy)
* used in allergic asthma with increased IgE levels resistant to inhaled steroids and long acting beta 2 agonists
46
name the methylxanthine used to treat asthma
* theophylline
47
theophylline--mechanism
* (methylxanthine asthma drug)
* likely causes bronchodilation by inhibiting phosphodiesterase --\> inc cAMP levels due to dec cAMP hydrolysis
* metabolized by cytochrome P-450
* blocks action of adenosine
48
why is the use of theophylline limited?
* (methylxanthine)
* limited b/c of narrow therapeutic index
* cardiotoxicity
* neurotoxicity
49
methacholine--mechanism
* muscarinic receptor (M3) agonist
50
methacholine--use
* used in bronchial challenge test ot help diagnose asthma
