Decongestants (Maize)

Question 1

What is a stuffy nose?

Answer 1

Blood vessels: warm and humidify inspired air and provide nutrients to goblet glands,
Structures: arteriovenous anastomoses, arteroiles and venules and cavernous sinusoids

Question 2

Secretions and Innervations

Answer 2

Secretory cells: epithelial cells, goblet cells & basal cells

• Secrete, enzymes IgA and mucous
• Sensory
• Cholinergic, vasodilation and increase mucous secretion
• Adrenergic, vasoconstriction and decreases muscus secretions

Question 3

Location of adrenergic receptors

Answer 3

alpha-1: mucosal membrane vasculature of the nasopharynx, vascular smooth muscle, heart, CNS, bladder neck and piloerector muscle

Question 4

Location of adrenergic receptors

Answer 4

alpha-2: mucosal membrane vasculature of nasopharnyx, vascular smooth muscle, pancreas, CNS/Peripheral NS

Question 5

Location of adrenergic receptors

Answer 5

beta-1: heart and juxtaglomerular cells of kidney

beta-2: respiratory, uterine, vascular smooth muscle, liver and eye

Question 6

What is a chronotrop?

Answer 6

a drug that increases the rate of something

Question 7

What is an inotrop?

Answer 7

a drug that increases the strength of the contraction

Question 8

Receptor Selectivity

Answer 8

Drug Class:

• phenylethylamine (alpha-1 > beta-1)
• -> phenylephrine, pseudoephedrine and epinephrine
• Imidazoline (alpha-2&raquo_space; beta-1)

Question 9

Mechanism of Action

Answer 9

Direct Agonist: binds to alpha and beta receptors and initiate the transduction pathway
Indirect Agonist: cause the release of NE from the nerve terminal to produce an effect
***Pseudoephedrine and illicit drugs are mixed agonists

Question 10

Pharmacological Effect

Answer 10

Constriction of nasal vasculature
Reduced tissue swelling
Increased nasal drainage (initial, then dries up)
Improved airflow through nasal passages
Reduced mucus secretions by decreasing blood flow to mucus glands

Question 11

Phenylethylamine

Answer 11

• epinephrine (multiple routes): only in surgical procedures to decrease blood flow
• ephedrine (oral): direct and indirect agonist
• phenylpropanolamine (oral): diet aid/appetite suppression, off the market b/c of hemorrhagic stroke and looks like amphetamine
• pseudoephedrine (oral): 1/4 as potent and 1/2 potent as a bronchodilator as compared to ephedrine
• phenylephedrine (oral): less beta activity of all the phenylethylamines does not work as well as pseudoephedrine

Question 12

Imidazoline

Answer 12

Products: Naphazoline (eye), tetrahydrozoline (visine), xylometrazoline, oxymetozoline

• more specific for alpha-2
• poor oral BA
• different structure than phenyethylamines

Question 13

Phenylethylamine Side Effects

Answer 13

CNS: nervousness, irritability, insomnia, athletic performance enhancements
Cardio: increase BP, increase HR, tachycardia, HTN and ischemia
GI: decrease appetite

Question 14

Imidazoline Side Effects

Answer 14

Rhinitis medicamentosa: rebound congestion (use

Question 15

Choosing a drug based on PCOL properties

Answer 15

Decongestants: prevent production of mucus, HR and excitation
Antihistamines: prevent cause of mucus, prevent production of muscus, anticholinergic effects of 1st gen
Anticholinergics: prevent production of mucus and anti-SLUDGE (don’t give these for cough, cold, and allergies)