102 Flashcards
What receptors does epinephrine stimulate?
α and β receptors
How long does the bronchodilation effect of epinephrine last?
60–90 minutes
Which β receptors does isoproterenol stimulate?
β1 and β2
Why is isoproterenol rarely used for asthma?
Due to side effects like tachycardia and arrhythmias
Name three ultra-long-acting beta agonists with bronchodilation effects lasting ≥24 hours.
Indacaterol, olodaterol, vilanterol
What is the duration of action for ipratropium bromide (SAMA)?
4 to 8 hours
How long does it take for ipratropium bromide to achieve bronchodilation?
15 minutes
Name three long-acting muscarinic antagonists (LAMA).
Tiotropium, glycopyrronium, umeclidinium
What is the mechanism of action of antimuscarinic drugs?
Inhibit acetylcholine at M3 receptors
What are two effects of blocking M3 receptors?
Blocks airway smooth muscle contraction, decreases mucus secretion
Are antimuscarinic drugs more effective than β-agonists in asthma?
No
When is ipratropium used in chronic asthma?
As an alternative reliever for β-agonist side effects
What is a common use for LAMA in asthma?
As a controller, added to ICS-LABA therapy
What are two systemic side effects of antimuscarinic drugs?
Dry mouth and bitter taste
What adverse effect is associated with nebulized ipratropium via a mask?
Worse glaucoma
What is COPD characterized by?
Chronic respiratory symptoms and persistent airflow obstruction
What causes abnormalities in COPD?
Abnormalities in airways (bronchitis, bronchiolitis) and alveoli (emphysema)
Is lung function in COPD largely fixed or reversible?
Largely fixed, but partially reversible by bronchodilators
What is the most common cause of COPD?
Tobacco smoking
Name three bronchodilators used to treat COPD.
SABA, LAMA, LABA
Which medication is used for patients with high blood eosinophils in COPD?
Inhaled corticosteroids
What is roflumilast, and its use in COPD?
Oral PDE-4 inhibitor
Name three supportive therapies for COPD.
Antibiotics, mucolytics, oxygen
What is the primary function of the cough reflex?
Expel foreign material and excess secretions from the respiratory tract
What are the five parts of the cough reflex arc?
Cough receptors, afferent nerves, brainstem cough center, efferent nerves, effector organs
Name two types of cough based on the nature of sputum.
Productive (wet) and Non-productive (dry)
How is cough classified based on duration?
Acute (<3 weeks), Sub-acute (3-8 weeks), Chronic (>8 weeks)
Name three common causes of chronic cough.
COPD, asthma, GERD
Name two types of drugs used to treat cough.
Antitussives, mucolytics
What is the mechanism of action of antitussives?
Inhibit cough through central or peripheral mechanisms
Name two centrally acting narcotic antitussives.
Codeine, morphine
What is a common side effect of narcotic antitussives?
Addiction, respiratory depression, nausea
Name a centrally acting non-narcotic antitussive.
Dextromethorphan
What is a peripheral antitussive that acts as a local anesthetic?
Benzonatate
What are demulcents, and how do they act as antitussives?
Soothing agents that reduce afferent impulses from irritated mucosa
What is the function of expectorants?
Increase mucus volume and decrease adhesivity for easier expulsion
Name two expectorants.
Guaifenesin, ammonium chloride
Front
Back
What are the main symptoms of rhinitis?
Nasal congestion, rhinorrhea (runny nose), sneezing, and itching (pruritus).
What are the three distinct subgroups of rhinitis?
Allergic rhinitis (AR), Infectious rhinitis, and Non-allergic rhinitis (NAR).
What are the subgroups of Non-allergic rhinitis (NAR)?
- Drug-induced rhinitis
- Hormone-induced rhinitis
- Senile rhinitis
- Gustatory rhinitis
- Occupational rhinitis
- Idiopathic rhinitis
- Atrophic rhinitis
What does optimal management of rhinitis involve?
Patient education, environmental controls, trigger avoidance, and pharmacotherapy.
What are examples of intranasal corticosteroids (INCS) for rhinitis?
Beclomethasone, budesonide, ciclesonide, fluticasone, mometasone, triamcinolone.
Which H1-antihistamines are used for rhinitis, and which generation is preferred?
Oral loratadine, cetirizine, fexofenadine; second-generation antihistamines are preferred.
What are examples of intranasal H1-antihistamines?
Azelastine and olopatadine.
How do H1-antihistamines work for rhinitis?
They antagonize the H1 receptor, reducing symptoms, but have a mild effect on nasal congestion.
What is the role of leukotriene receptor antagonists in rhinitis?
Montelukast is used for symptom relief.
Which medication is used intranasally for rhinorrhea?
Ipratropium.
What is the mechanism of action for decongestants in rhinitis?
They are α-sympathomimetics that act as vasoconstrictors, relieving mucosal swelling.
What are examples of oral decongestants for rhinitis?
Pseudoephedrine and phenylephrine.
What are examples of intranasal decongestants for rhinitis?
Phenylephrine, oxymetazoline, and xylometazoline.
What is a potential side effect of prolonged use of intranasal decongestants?
Rebound congestion (rhinitis medicamentosa).
What additional therapies can be used for rhinitis?
Nasal irrigation with saline or hypertonic saline.
