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PHARMACOLOGY - Pulmonary > Cough Suppressants, Decongestants, Mucolytics - Drugs listed > Flashcards

Cough Suppressants, Decongestants, Mucolytics - Drugs listed Flashcards

1
Q

Dextromethorphan
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class:
Antitussive

MOA:
Suppresses cough reflex by direct action on the cough center in the medulla

Metabolism:
Must be activated to active metabolite by CYP2D6

Adverse Effects:
Excitability Tachycardia, Insomnia (N/V/D as well)

Contraindications:
MAOI (monoamine oxidase inhibitors) - Can cause SEROTONIN SYNDROME (siezures, jerky movements, cardiac arrest)

Other:
Large Margin of safety at 12 to 75 therapeutic doses, acts on NMDA (N-methyl D-aspartyl) receptor for glutamate to produce hallucinogenic effects

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2
Q

Diphenhydramine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class:
Anti-histamine/Antitussive

MOA:
Anticholinergic effects

Adverse Effects:
Drowsiness, Respiratory depressure, Dry mouth, Urinary Retention, constipation, SEROTONIN SYNDROME

Contraindications:
Prostate hypertrophy, Urinary obstruction, Asthma, COPD

Other:
Can be used in Parkinsonism (due to anti-muscarinic effects), and insomnia

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3
Q

Codeine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Antitussive and opoid analgesic

MOA
Direct action on cough center in the CNS

Metabolism
10% metabolized to morphine and other products

Adverse Effects
Constipation, Histamine Release, vasodilation, orthostatic hypotension, dizziness

Contraindications
Hypersensitivity, Labor of premature birth, pregnancy category C, prostatic hypertrophy, respiratory depression (COPD etc)

Other
May lead to adverse effects in children after tonsillectomy or adenoidectomy

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4
Q

Benzonatate
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Nonnarcotic antitussive agent

MOA
Decreases sensitivity of stretch (TRPV-1) receptors in the airways by its local anesthetic effect (used for patients with emphysema)

Metabolism
nothing mentioned

Adverse Effects
Hypersensitivity reactions, Skin rash, confusion, hallucinations

Contraindications
Do not take with antihistamines, sleep or anxiety meds, muscle relaxors, or anxiety med.
DO NOT GIVE TO INDIVIDUALS allergic to tetracain or procaine

Other
***NOT contraindicated with diseases like emphysema b/c it doesn’t act centrally in breathing like other antitussives)

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5
Q

Camphor
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Topical Antitussives

MOA
Activates then desensitizes TRPM8, TRPV1 and TRPA1 on sensory nerve endings

Metabolism - none
Adverse Effects - none listed
Contraindications - none listed
Other
Note that Camphor is only used via inhalation, NOT LOZENGES

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6
Q

Menthol
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Topical Antitussives

MOA
Activates then desensitizes TRPM8, TRPV1 and TRPA1 on sensory nerve endings

Metabolism - none
Adverse Effects - none listed
Contraindications - none listed
Other
Can be used in lozenge, unlike camphor

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7
Q

Guanfenesin
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Exectorant

MOA
Increased the volume of secretions and reduces viscosity (only FDA approved expectorant)

Metabolism
Nothing mentioned

Adverse Effects
Uric acid nephrolithiasis (kidney stones), Dry mouth, N/V/D.

Contraindications
Hypersensitvity

Other

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8
Q

Phenylephrine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Sympathomimetics

MOA
DIRECT Stimulation of alpha 1-adrenergic receptors leading to blood vessel constriction. (decreases nasal edema)

Metabolism
Rapidly metabolized by MOA (monoamine oxidase) and COMT (catecholamine methy-transferase) in GI mucosa, liver and other tissues

Adverse Effects
None if used topically

Contraindications

Other

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9
Q

Oxymetazoline
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Sympathomimetics

MOA
DIRECT Stimulation of alpha 1-adrenergic receptors leading to blood vessel constriction. (decreases nasal edema) It also is a partial alpha2 agonist

Metabolism
Unlike phenylephrine it is NOT Rapidly metabolized by MOA (monoamine oxidase) and COMT (catecholamine methy-transferase)

Adverse Effects
None if used topically

Contraindications
None stated

Other
Preferred topical agent during pregnancy

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10
Q

Pseudoephedrine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Sympathomimetic

MOA
INDIRECT alpha adrenergic Receptors by causing Norepinephrine release from adrenergic nervse

Metabolism
Pseudoephedrine is metabolized to only a minor extent by N-demethylation to nor-pseudoephedrine

Adverse Effects
CV stimulation (tachycardia and arrythmia), CNS stimulation (insomnia, hallucinations); may cause Rebound congestion

Contraindications
Hyperthyroidism, Heart defects, Uncontrolled HTN

Other

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11
Q

Levamfetamine (Levoamphetamine, Vicks Vapor)
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Sympathomimetic

MOA
Stimulation of alpha adrenergic receptors

Metabolism
Adverse Effects
Contraindications
Other

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12
Q

Propylhexedrine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Sympathomimetic

MOA
Stimulation of alpha adrenergic receptors

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13
Q

Iodides-Iodinated Glycerol
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Expectorant

MOA
Unclear

Metabolism
Adverse Effects
Contraindications
Other

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14
Q

Saline
​Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

​Drug Class
Bland areosol

MOA
Saline acts as an irritant to induce coughing. Hypertonic saline can increase the volume of mucus.

Metabolism
Adverse Effects
Contraindications
Other

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15
Q

Guiafenesin
​Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

​Drug Class
Expectorant

MOA
At high doses stimulates bronchial gland secretion

Metabolism
Adverse Effects
Contraindications
Other

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16
Q

Bromohexine (Bisolvon)
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other

A

Drug Class
Expectorant

MOA
Increases the production of serous mucous in the respiratory tract and decreases the viscosity of phlegm

Metabolism
Adverse Effects
Contraindications
Other

17
Q

N-Acetyl Cysteine
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS

Administration
Aerosol or direct instillation into ET tube

Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.

Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator

Other
May be given in acute liver injury due to Tylenol overdose

18
Q

Acetadote
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS

Administration
Aerosol or direct instillation into ET tube

​
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.

Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator

Other
May be given in acute liver injury due to Tylenol overdose

19
Q

Erdosteine
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS

Administration
Aerosol or direct instillation into ET tube

​
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.

Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator

Other
May be given in acute liver injury due to Tylenol overdose

20
Q

Carbocysteine
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS

Administration
Aerosol or direct instillation into ET tube

​
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.

Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator

Other
May be given in acute liver injury due to Tylenol overdose

21
Q

Dornase Alfa (pulmozyme)
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
Clone of the natural human pancreatic DNAase enzyme that digests extracellular DNA.

Adverse Effects
Voice alteration, Pharyngitis/laryngitis, Conjuctivitis, CHINESE OVARY CELL PRODUCTS (used in other recombinant proteins like EPO)

Contraindications
Only works on infected sputum since it contains great amounts of DNA

22
Q

Sodium Bicarbonate
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
2% NaHCO3 solutions are used to increase the pH of mucus by weakening carbohydrate side chains

Administration
Injection directly into the trachea or aerosolized

Adverse Effects
Can be irritating, especially if higher concentrations are used

23
Q

Amiloride (as respiratory agent)
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other

A

Drug Class
Mucolytic

MOA
Diuretic: Inhibitor of ENaC on respiratory epithelium. More Na+ is left in the bronchioles and secretions become less viscous

Administration
Amiloride is nebulized in a 0.3% solution of NaCl

Adverse Effects
Contraindications
Other

PHARMACOLOGY - Pulmonary (30 decks)

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