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Pharmacology II Exam III Pulmonary Medications > Chronic Rhinitis, Cough, and Cold Medications > Flashcards

Chronic Rhinitis, Cough, and Cold Medications Flashcards

1
Q

Where are cough receptors located?

A
  • Larynx and supralarngeal area
  • Trachea and bronchi
  • Ear canals
  • Pleura, pericardium and diaphragm
  • Esophagus and stomach
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2
Q

What antitussives are centrally acting?

A

Dextromethorphan
Opiates

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3
Q

What antitussives are locally acting?

A

Benzonatate

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4
Q

What is the MOA of dextromethorphan?

A

Crosses the BBB and activates sigma opioid receptors on the cough center in the central nervous system (medulla), thereby suppressing the cough reflex

Does not affect ciliary activity (in the bronchial tree)

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5
Q

What are the indications for dextromethorphan?

A

Short-term relief of cough

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6
Q

What are possible interactions with dextromethorphan?

A

MAIOs and SSRI/SNRI’s, can cause serotonin syndrome

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7
Q

What are the contraindications for dextromethorphan?

A

Avoid in chronic cough, hepatic disease, and operating machinery

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8
Q

What is the MOA of Codeine?

A

Suppresses cough reflex centrally, dries bronchial secretions

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9
Q

What are the indications for codeine?

A

Short term relief of cough

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10
Q

Why should Guaifenesin contraindicated in children?

A

Can cause seizures

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11
Q

What is the indication for guaifenesin?

A

Acute cough, common ingredient in cough medicine

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12
Q

Histamine is released by what cells?

A

Mast cells and basophils

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13
Q

There are four receptors of histamine, but only two are pharmacologically important. What are those receptors?

A

H1: smooth muscle cells, endothelium, and brain
H2: gastric mucosa mast cells, immune cells, and brain

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14
Q

What are the general effects of histamine?

A
  • Local vasodilation
  • Transudation of fluid through endothelial cells
  • Stimulates nerve endings, producing pain and itching
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15
Q

What are the organ-specific effects of histamine?

A
  • Lung- bronchoconstriction
  • GI tract contraction and secretion of gastric acid, pepsin, and intrinsic factor
  • brain-neurotransmitter
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16
Q

What are the first generation antihistamines?

A

Diphenhydramine (Benadryl) and Hydroxyzine (Vistaril or Atarax)

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17
Q

What generation of antihistamines should be avoided in the elderly because it may cause delirium, dizziness, or urinary retention?

A

First generation antihistamines - Diphenhydramine and Hydroxyzine

18
Q

What are the second generation antihistamines?

A

Cetirizine
Loratadine
Fexofenadine

19
Q

What is the MOA of pseudoephedrine?

A

Sympathomimetric, a and B2-adrenergic receptor agonist

Direct stimulation of alpha-adrenergic receptors of respiratory mucosa causes vasoconstriction and of beta-adrenergic receptors causes bronchial relaxation

20
Q

What are the indications of pseudoephedrine?

A

Acute nasal congestion, sinusitis, and otitis media

21
Q

What is the MOA of phenylephrine?

A

Binds primarily to alpha-1 receptors, causing vasoconstriction

22
Q

These two drug classes can increase clearance of phenylephrine making them less effective?

A

ACE inhibitors and CCBs

23
Q

Interaction with these drugs can increase the concentration of phenylephrine?

A

MAOI’s and tricyclic antidepressants

24
Q

To prevent rebound congestion what is the maximum recommended duration of use for Oxymetazoline (Afrin)?

A

3 days

25
Q

What are the indications of inhaled nasal fluticasone?

A

Treatment and prevention of allergic rhinitis
Chronic nasal polyps

26
Q

What are the side effects of inhaled nasal fluticasone?

A

Epitaxis, pharyngitis, systemic absorption of steroid is possible

27
Q

What are the available inhaled antihistamines?

A

Azelastine and Olopatadine

28
Q

Diphenhydramine (Benadryl) and Hydroxyzine are what generation anti-histamines?

A

1st generation

29
Q

What are the indications for diphenhydramine (Benadryl)?

A

Allergic reactions

30
Q

What is included in the PK for diphenhydramine (Benadryl)?

A

Oral, acts quickly
Dosed every 6 hours

31
Q

What are the adverse reactions associated with diphenhydramine (Benadryl)?

A

Sedation
Avoid in elderly- may cause delerium, dizziness, and urinary retention

32
Q

What are the indications for Hydroxyzine?

A

Allergic reactions and can be used as an anxiolytic

33
Q

What are the adverse reactions associated with hydroxyzine?

A

Sedation and avoid in elderly (same as diphenhydramine)

34
Q

What drugs are 2nd generation anti-histamines?

A
  • Cetirizine (Zyrtec)
  • Loratadine (Claritin)
  • Fexofenadine (Allegra)
35
Q

What are the adverse reactions of the 2nd generation anti-histamines?

A

Occasionally sedating

36
Q

What are the indications of the 2nd generation anti-histamines?

A

Relieve sneezing, rhinnorhea and nasal itching. Does not reduce congestion.

37
Q

What is the brand name for Cetirizine?

A

Zyrtec

38
Q

What is the brand name for Loratadine?

A

Claritin

39
Q

What is the brand name for Fexofenadine?

A

Allegra

40
Q

The most commonly associated side effect of nasal decongestants are?

A

Rebound congestion

Pharmacology II Exam III Pulmonary Medications (3 decks)

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