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PHARMACOLOGY > DRUGS ACTING ON THE RESPIRATORY SYSTEM > Flashcards

DRUGS ACTING ON THE RESPIRATORY SYSTEM Flashcards

1
Q
  • h1 blocker or h1 antagonist
  • competes with histamine receptors
  • chemical mediator of inflammation that increases secretions and constrict air passageway
A

antihistamine

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2
Q

where is histamine synthesized and stored?

A

mast cells and basophils

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3
Q

histamine release may be triggered by ___ and ___ mechanisms

A

allergic and non allergic

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4
Q

2 major classes of histamine receptors

A

h1 and h2

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5
Q

activation of ___ receptors causes vasodilation, increased capillary permeability, pain, itching, bronchoconstriction, and CNS effects

A

h1

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6
Q

activation of ___ receptors causes release of gastric acid from parietal cells of the stomach

A

h2

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7
Q

true or false: histamine is a major contributor to anaphylactic reactions

A

false

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8
Q

h1 receptor antagonists what generation?

cause sedation and anticholinergic effects

A

first-generation

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9
Q

h1 receptor antagonists what generation?

  • non sedating antihistamine
  • little or no effect of sedation
  • fewer anticholinergic symptoms
A

second generation

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10
Q

CNS depression from 1st gen h1 receptor antagonist can be intensified by ___

A

alcohol

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11
Q

1st generation antihistamine that causes severe respiratory depression, especially in young patients. not used in children below 2

A

promethazine (phenadoz)

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12
Q

antihistamines should be avoided during the ___ trimester of pregnancy and in nursing mothers and ____

A

3rd, newborns

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13
Q
  • used for nasal congestion
  • dilates nasal vessels that may be caused by infection, inflammation, or allergy
A

nasal and systemic decongestant

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14
Q

stimulate the alpha adrenergic receptor producing vascular constriction of capillaries within the nasal mucosa

A

nasal decongestant

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15
Q
  • epherine (ephidrine)
  • phenylephrine
  • pseudoephrine

SE: jittery, nervous, increased BP, increased BG

A

systemic decongestant

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16
Q

___ (e.g., phenylephrine, pseudoephedrine) reduce nasal congestion by activating alpha1-adrenergic receptors.

A

sympathomimetics

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17
Q

true or false: In patients with allergic rhinitis, sympathomimetics relieve only stuffiness.

A

true

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18
Q
  • treatment for allergic rhinitis
  • decrease allergic rhinitis symptoms like: rhinorrea, sneezing, congestion
A

intranasal glucocorticoids

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19
Q
  • suppress cough reflex on the medulla oblongata
  • narcotic and non-narcotic cough suppressants
  • used when coughing becomes detrimental to pt’s progress
A

antitussive

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20
Q

2 major groups of antitussives

A

opioid and non-opioid

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21
Q

___ is the most effective cough suppressant available

A

codeine

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22
Q

codeine should be employed with caution in patients with reduced ___

A

respiratory reserve

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23
Q

___ is a structural analog of 2 local anesthetics: tetracaine and procaine
- suppresses cough by decreasing the sensitivity of respiratory tract stretch receptors

A

benzonatate

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24
Q

what happens if you chew or suck benzonatate capsules?

A

laryngospasm, bronchospasm, and circulatory collapse

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25
Q

___ is the most effective ITC nonopioid cough medicine, and the most widely used of all cough medicines

A

dextromorphan

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26
Q

when dextromorphan is taken in high doses, it can cause ___

A

euphoria

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27
Q

do not give ___ to patients after administration of antitussives

A

water

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28
Q

when giving antitussives, always observe for signs of ___

A

dependency

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29
Q

do not give antitussives to patients who have undergone ___ and ___ surgeries

A

thoracic and abdominal

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30
Q
  • add bulk or fluid to sputum or decrease the viscosity of bronchial secretions
  • loosen bronchial secretion so they can eliminate by coughing
  • stimulates the flow of secretions
A

expectorant

31
Q

doses of this expectorant should be higher than normally employed for it to be effective

A

guaifenesin

32
Q
  • cause the breakdown of secretion or reduces the viscosity of mucus in the bronchial tree
  • react directly with mucus to make it less viscous
A

mucolytics

33
Q

two preparations of mucolytics

A

hypertonic saline and acetylcysteine

34
Q

avoid combining mucolytics with ___ to void formation of precipitates

A

drugs in the nebulizer

35
Q

provide symptomatic relief in patients with asthma and COPD but do not alter the underlying inflammation

A

bronchodilators

36
Q

bronchodilator + inhaled ___ for long term suppression of inflammation

A

glucocorticoid

37
Q

bronchodilator that increase cAMP causing dilation of bronchioles

A

sympathomimetics: alpha and beta 2 adrenergic agonist

38
Q
  • the most effective drugs available for relieving acute bronchospasm and preventing EIB
  • minimally absorbed from the GI tract
A

beta2 agonists

39
Q
  • taken PRN to abort an ongoing attack
  • In patients with EIB, they are taken before exercise to prevent an attack from occurring
A

SABA - short-acting beta2 agonists

40
Q

overdose of SABAs cause?

A

tachydysrhythmias, angina, seizures

41
Q
  • patients who experience frequent attacks may be prescribed this for long-term control
  • dosing is done on a fixed schedule, not PRN
  • are preferred over SABAs for patients with stable COPD
A

LABA - long acting inhaled beta2 agonists

42
Q

true or false: LABA can be used alone in asthma

A

false - it must be used with a glucocorticoid to avoid asthma-associated deaths

43
Q

take bronchodilators ___ mins before exercise

44
Q

drug of choice for the treatment of acute bronchospasm, including that which is caused by anaphylaxis

A

epinephrine

45
Q

improve lung function by blocking muscarinic receptors in the bronchi, reducing bronchoconstriction

A

anticholinergics

46
Q

two agents of anticholinergic drugs

A

ipratopium and tiotopium

47
Q
  • inhibits salivary and mucus glands secretions and dilating bronchial smooth muscle
  • relax the air passages to the lungs
A

ipratropium

48
Q

which anticholinergic agent has a longer duration of action and thus can be dosed less often

A

tiotropium

49
Q
  • an atropine derivative administered by inhalation to relieve bronchospasm
  • the drug has FDA approval only for bronchospasm associated with COPD, but is often used off-label for asthma
A

ipratropium

50
Q

therapeutic effects of ipratropium begins within ___ and reach 50% of their maximum in ___

A

30 seconds, 3 mins

51
Q
  • inhibit the phosphodiesterase thus increasing the cAMP
  • relaxing the bronchial smooth muscle
A

methyxanthine derivatives

52
Q
  • has a direct effect on smooth muscles of the respiratory tract
  • stimulates the CNS
  • relieves bronchial asthma and reversal of bronchospasm
  • stimulation of respiration in cheyne-strokes respiration
  • treatment of apnea and bradycardia in premature infants
A

methyxanthine derivatives

53
Q

a theophylline salt that is considerably more soluble than theophylline itself

A

aminophylline

54
Q

therapeutic range of aminophylline

A

10-20 mcg/mL

55
Q

3T’s of aminophylline

A

T - toxic range 20 mcg/mL
T - tonic-clonic seizure
T - tachycardia

56
Q

2 drugs that can cause toxicity along with aminophylline

A

cimetidine, ciprofloxacin

57
Q

what time of day is it ideal to take aminophyllines?

58
Q

you need to stop aminophyllines before doing this procedure

A

cardiac stress test

59
Q

anti-inflammatory agents: what does SLM mean?

A

steroids, leukotriene, mast cells stabilizer cromalyn

60
Q

decrease the inflammatory response in airwary and decrease airway edema

61
Q

___ (e.g., budesonide, fluticasone) are the most effective drugs available for long-term control of airway inflammation.

A

glucocorticoids

62
Q

how does glucocorticoids decrease asthma symptoms?

A
  • decreased synthesis and release of inflammatory mediators
  • decreased infiltration and activity of inflammatory cells
  • decreased edema of airway mucosa
63
Q

true or false: steroids are contraindicated for acute asthma attacks

64
Q

4S of steroids

A

swelling
slow onset
sugar increase
sore in the mouth

65
Q

drug doses of steroids must not be missed and must be tapared off over a ___ days period

66
Q

chemical mediator that causes inflammatory changes in the lungs

A

leukotriene

67
Q
  • suppress the effects of leukotrienes, which are compounds that promote smooth muscle constriction, blood vessel permeability, and inflammatory responses
  • in patients with asthma, these drugs can decrease bronchoconstriction and inflammatory responses such as edema and mucus secretion
A

leukotriene receptor antagonist

68
Q

true or false - all the leukotriene modifiers can cause adverse neuropsychiatric effects, including depression, suicidal thinking, and suicidal behavior

69
Q

luekotrienes are used for long term management of ___

70
Q

therapeutic range of leukotrienes

71
Q
  • an inhalational agent that suppresses bronchial inflammation
  • used for prophylaxis—not quick relief—in patients with mild to moderate asthma
A

mast cell stabilizers

72
Q

you should take mast cell stabilizers ___ mins before exertion

73
Q
  • suppresses inflammation; it does not cause bronchodilation
  • stabilizes the cytoplasmic membrane of mast cells, preventing release of histamine and other mediators

PHARMACOLOGY (9 decks)

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