Asthma/PE PBL Drugs Flashcards
Aminophylline
MOA
PK
Tox
MOA: adenosine antagonist, phosphodiesterase inhibitor at high concentrations
increases cAMP → AMP
⇒ bronchodilation
PK: very low TI, soluble salt of theophylline
Tox: arrhythmias, nervousness, GI bleed, tremors, insomnia, adrenergic stimulation due to phosphodiesterase inhibition
Zileuton
MOA
Tox
MOA: inhibits 5-lipoxygenase
blocks AA → leukotrienes
Tox: hepatotox, CYP450 drug interactions
Salmeterol
MOA
PK
TU
Tox
MOA: β2 agonist
PK: long-acting
TU: asthma prophylaxis
Tox: tremors, overuse may lead to tolerance (long-term)
Warfarin
MOA
MOA: inhibits VKORC that converts vit K to carboxylate factors, decreases synthesis of vit K-dependent clotting Factors II, VII, IX, X, and protein C
⇒ protein C is anti-clotting, so need to have heparin bridge before starting warfarin
otherwise you increase risk of clotting
Fondaparinux
MOA
PK
MOA: cofactor for ATIII
⇒ inactivates Xa ONLY
⇒ inhibits prothrombin → thrombin
PK: no serial monitoring
**chemically related but distinct of LMW heparins
Theophylline
MOA
PK
Tox
MOA: adenosine antagonist, phosphodiesterase inhibitor at high concentrations
increases cAMP → AMP
⇒ bronchodilation
PK: very low TI
Tox: arrhythmias, nervousness, GI bleed, tremors, insomnia, adrenergic stimulation due to phosphodiesterase inhibition
Epinephrine
MOA
MOA: non-selective α and β agonist
β1: increased HR and contractility
β2: vasodilates and bronchodilates
α1: peripheral vasoconstriction
overall vasoconstriction
LMW heparin
(enoxaparin, dalteparin)
MOA
Labs
PK
MOA: cofactor for ATIII
⇒ inactivates Xa (and others)
Labs: lengthens PTT
PK: sub-Q, does not require constant administration or serial monitoring
Betamethasone
Dexamethasone
Methylprednisolone
Prednisone
MOA
MOA: induce lipocortin to inhibit PLA2
→ reduces AA
inhibit NF-kB
→ reduces TNF-α, IL-1, IL-2, IFN-γ
⇒ inhibits degranulation of mast cells and basophils + blocks neutrophil migration
Montelukast
MOA
TU
Tox
MOA: leukotriene receptor antagonist
prevents bronchoconstriction, microvascular leakage, increased eosinophils
TU: aspirin-induced asthma
Tox: CYP450 drugs
Pseudoephredrine
MOA
TU
MOA: α1 and α2 agonist
→ vasoconstriction
decreases hyperemia, edema, congestion
TU: nasal congestion
Unfractionated Heparin
MOA
Labs
PK
MOA: cofactor for ATIII
⇒ inactivation of Xa (and others)
Labs: lengthens PTT
PK: short t1/2, need to give constant infusion
Cromolyn
MOA
MOA: opens Cl- channels
→ hyperpolarization
⇒ stabilizes mast cells and eosinphils
Pirbuterol
MOA
PK
Tox
MOA: selective β2 agonist
PK: short-acting, max dilation in 15-30 minutes
Tox: tremors, tachycarida, overuse leads to tolerance (long term)
Omalizumab
MOA
MOA: monoclonal antibody against circulating IgE
very expensive
Bivalirudin
MOA
TU
MOA: direct thrombin inhibitor
TU: heparin-induced thrombocytopenia
Formoterol
MOA
PK
TU
Tox
MOA: full β2 agonist
PK: long-acting
TU: asthma prophylaxis w/ corticosteroids
Tox: tremors, overuse may lead to tolerance (long-term)
Albuterol
MOA
PK
Tox
MOA: selective β2 agonist
PK: short-acting, max dilation in 15-30 minutes
Tox: tremors, tachycarida, overuse leads to tolerance (long term)
Triamcinolone
Beclamethasone
Flunisolide
Budesinide
Fluticasone
MOA
MOA: inhaled corticosteroids
Zafirlukast
MOA
TU
Tox
MOA: leukotriene receptor antagonist
prevents bronchoconstriction, microvascular leakage, increased eosinophils
TU: aspirin-induced asthma
Tox: CYP450 drugs
Argatroban
MOA
TU
MOA: direct thrombin inhibitor
TU: heparin-induced thrombocytopenia
Diphenhydramine
Chlorphenhydramine
MOA
PK
Tox
MOA: 1st generation H1 antagonist, anti-muscarinic, 5-HT, and α-adrenergic receptors
PK: crosses BBB and not substrate for P-glycoprotein
Tox: sedation, anti-muscarinic effects: drying of secretions, GI distrubances
Phenylephrine
MOA
TU
MOA: α1 agonist
→ vasoconstriction
decreases hyperemia, edema, congestion
TU: nasal congestion
Fexofenidine
Certirizine
Loratidine
MOA
MOA: 2nd gen H2 antagonists
PK: crosses BBB but substrate for P-glycoprotein
actively pumped out, less drowsiness
Apixaban
MOA
MOA: direct Xa inhibitor
⇒ inhibits Factor II activation (prothrombin)
Rivaroxaban
MOA
MOA: direct Xa inhibitor
⇒ prevents II activation (prothrombin)