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Respiratory Pharmacology > Cough and Cold > Flashcards

Cough and Cold Flashcards

1
Q

Name 2 type of medications that are used for severe rhinorrhoea/nasal congestion/post-nasal drip?

A

Mucoregulators
Mast Cell Stabilisers

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2
Q

____ is used to control severe cold symptoms by decreasing mucus hypersecretion from goblet cells and submucosal glands

A

Ipratropium

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3
Q

Name a SAMA that is used for severe cold symptoms

A

Ipratropium

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4
Q

Route of administration of Ipratropium?

A

Intranasal

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5
Q

(MOA) Ipratropium ____ inflammation-induced ____ cholinergic receptor _____ which blocks the activation of ______. This leads to a ____ in stimulated mucus output and _____ volume.

A

Ipratropium blocks inflammation-induced parasympathetic cholinergic receptor M3 which blocks the activation of submucosal glands/ goblet cells. This leads to a decrease in stimulated mucus output and sputum volume.

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6
Q

Name 3 side effects of Ipratropium

A

Unpleasant taste
Dry Mouth
Urinary retention in elderly

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7
Q

Name a mast cell stabiliser

A

Cromoglicic acid

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8
Q

Name a medication for severe cold symptom that can be inhaled

A

Cromoglicic acid

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9
Q

(MOA) Cromoglicic acid controls _____ channels to inhibit cellular activation
____ mast cell degranulation induced by ____ mediated FC epsilon receptor crosslinking
Decrease secretion of inflammatory mediators from _____, neutrophils and _____
____ secretion of Annexin A1

A

Cromoglicic acid controls chloride channels to inhibit cellular activation
Decrease mast cell degranulation induced by IgE mediated FC epsilon receptor crosslinking
Decrease secretion of inflammatory mediators from eosinophils, neutrophils and macrophages
Increase secretion of Annexin A1

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10
Q

What are 3 side effects of Cromoglicic acid

A

Dry mouth
Unpleasant taste
Throat and nasal irritation
Cough

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11
Q

What is the duration of action for 1st gen antihistamines?

A

4 to 6 hours

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12
Q

What is the duration of action for 2nd gen antihistamines?

A

12 to 24 hours

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13
Q

Name 3 antihistamines which are frequently used in oral cough and cold formulations

A

Chlorpheniramine
Triprolidine
Promethazine

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14
Q

What is one 2nd gen antihistamine that still has a little sedation effect?

A

Cetirizine

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15
Q

What are some examples of sympathomimetic decongestants

A

“PON PE”P: PhenylephrineO: OxymetazolineN: NaphazolineP: PseudoepedrineE: Epedrine

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16
Q

(MOA) Sympathomimetic decongestants are direct _____ adrenoceptor ____ thus having the effect of ____ of nasal blood vessels. It also reduces _____ and secretion of ____.

A

Sympathomimetic decongestants are direct alpha-adrenoceptor agonist, thus having the effect of vasoconstriction of nasal blood vessels. It also reduces inflammation and secretion of mucus.

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17
Q

Route of administration of nasal glucocorticoid?

A

Intranasal

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18
Q

Name 2 sympathomimetic decongestant that can be taken orally

A

Phenylephrine
Pseudoephedrine (think of the Ps)

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19
Q

Fluticasone and mometasone are examples of nasal _____

A

Glucocorticoid

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20
Q

Which sympathomimetic decongestant is alpha 1 selective?

A

Phenylephrine

21
Q

List 2 examples of non-selective sympathomimetic decongestant

A

Oxymetazoline
Naphazoline

22
Q

Pseudoepedrine and ephedrine are examples of _____ sympathomimetic decongestants

A

Indirect

23
Q

Name a side effect which occurs with prolonged use of topical intranasal decongestants

A

Rebound congestion

24
Q

In a patient with hypertension or other CVS history, ___ sympathomimetic agent should be avoided as it can cause the side effects of palpitations and hypertension.

A

Indirect

due to B1 effects(Alpha adrenoceptor agonist would be preferred)

25
Q

Antitussives are used for dry or wet cough?

A

Dry Cough

26
Q

What is the most effective non-opioid antitusive?

A

Dextromethorphan

27
Q

What is the most potent antitusive but has the potential for abuse

A

Codeine

28
Q

(MOA) Codeine acts in ___ to suppress cough

A

CNS

29
Q

List 3 adverse effects of Codeine

A

Sedation
Respiratory depression
Potential for abuse at high dose

30
Q

Codeine needs to be used with caution as it is a CYP___ ultra-rapid metabolizer which means that codeine will be more rapidly converted to the more potent opioid morphine, hence increasing the risk of opioid adverse effect.

A

CYP2D6

31
Q

Can a 10 year old patient be prescribed codeine?

A

Not recommended for <18 years old

32
Q

What is the typical adult dose for dextromethorphan?

A

10 to 30mg every 4 to 8 hours

33
Q

List any 3 adverse effects of Dextromethorphan

A

Drowsiness
Dizziness
Confusion
Nausea
Vomitting

34
Q

Dextromethorphan is an opioid. True or False?

A

False. Opiate but not opioid

35
Q

Which receptor does Dextromethorphan at high dose block?

A

NMDA receptor blocker

36
Q

Expectorants are used for dry or wet cough?

A

Wet cough

37
Q

Name one example of an expectorant

A

Guaifenesin

38
Q

(MOA) Guaifenesin increase/decrease production of respiratory tract fluids to help liquefy and increase/decrease viscosity of tenacious secretions

A

Guaifenesin increase production of respiratory tract fluids to help liquefy and decrease viscosity of tenacious secretions

39
Q

Can guaifenesin be used for a 1 year old patient?

A

Not indicated < 2 years oldCaution < 6 years old

40
Q

List 2 adverse effect of guaifenesin

A

GI disturbances
Nausea

41
Q

Name 2 examples of mucolytics

A

Acetylcysteine
Carbocisteine

42
Q

Name a medication that smells and taste strongly of sulfur (rotten egg smell)

A

Acetylcysteine

43
Q

Can asthmatics be prescribed Acetylcysteine?

A

Avoided or use with caution as Acetylcysteine has the side effect of bronchospasm

44
Q

Carbocisteine is contraindicated in patients with _____

A

Active peptic ulcer

45
Q

What medication is safe for use for patients under 6 months old

A

Usually not to mediate and observe closely while infection recovers within 3 to 7 days

46
Q

Name a cough and cold medication that is safe for geriatric use

A

Expectorant (Guaifenesin)
Mucolytic (Acetylcysteine)
Decongestants (Pseudoephedrine, phenylephrine)

47
Q

Can a elderly patient be prescribed dextromethorphan?

A

Not recommended as elderly are more susceptible to sedation and confusion

48
Q

60 year old Mr Lim presents to your clinic with cough and cold, has a history of hypertension and narrow angled glaucoma. P1. What medications are contraindicated for him? P2. What medication would you prescribe?

A

P1. Antihistamines, Diphenhydramine, Pseudoepedrine, PhenylephrineP2. Guaifenesin / Acetylcysteine

Respiratory Pharmacology (3 decks)

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