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316 Pharmacology > Exam 3: Upper Respiratory Tract Disorders > Flashcards

Exam 3: Upper Respiratory Tract Disorders Flashcards

1
Q

Inflammatory process

A

Protective response of the body to harmful stimuli with the goal of removing the irritant and/or limiting its spread

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2
Q

Most common conditions that affect the upper respiratory tract involve the

A

Inflammatory response and it’s effects on the mucosal layer of the conducting airway

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3
Q

Common cold

A

Caused by a number of viruses

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4
Q

Seasonal (allergic) Rhinitis

A

Inflammation of the nasal cavity

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5
Q

Sinusitis

A

Inflammation of the epithelial cells lining the sinus cavities

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6
Q

Pharyngitis and Laryngitis

A

Infections of the pharynx and the larynx; caused by common bacteria or viruses

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7
Q

Infection

A

A contagion of the body tissues with disease causing agents that multiple and lead to a response by the immune system to their presence and the toxins they produce

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8
Q

Causes of common cold

A

Invasion of body by a cold virus such as rhinovirus or influenza

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9
Q

Symptoms of the common cold

A

Excess mucus production
Swelling or nasal and sinus mucous membranes
Redness of eyes, nose, and throat
Nasal congestion, coughing, and sneezing

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10
Q

Allergy is a reaction

A

to something from outside the body

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11
Q

The most common type of allergies

A

Type 1 hypersensitivity reactions

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12
Q

Type 1 hypersensitivity reactions occur after an

A

individual is sensitized by initial expose to an antigen (allergen)

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13
Q

Examples of antigen

A 
Pollen 
Mold 
Dust mites 
Cockroaches 
Animal dander 
Foods
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14
Q

Immune system involvement for type 1 hypersensitivity

A 
Antigen 
Mast cells that line upper airways 
Immunoglobin E (ig E) antibosy 
Eosinophils
Cytokines 
Chemical mediators act locally
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15
Q

What do IgE’s ?

A

IgE coats the surface of the mast cells in tissues, cause the mast cell to degranulate and release chemical mediators

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16
Q

What chemical mediators are released from a degranulated mast cell

A

Histamine

Serotonin

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17
Q

Examples of cytokines

A

Histamine
Serotonin
Leukotrienes
Prostaglandins and thomboxanes

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18
Q

Histamine effects

A 
Vasodilation 
Increases capillary permeability 
Smooth muscle contraction ---> broncho constriction 
Urticaria 
Angioedema
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19
Q

Serotonin effects

A

Vasodilation
Increase capillary permeability
Smooth muscle contraction —> bronchoconstriction

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20
Q

Leukotrienes is produced during hypersensitivity rxn from

A

Arachidonic acid via LOX pathway

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21
Q

Leukotrienes effect

A

Increases capillary permeability
Smooth muscle contraction –> bronchoconstriction
Stimulates the influx of eosinophils and neutrophils into airway tissues

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22
Q

Prostaglandins and thromboxanes are synthesized at

A

the site, derived from arachidonic acid via COX pathway

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23
Q

Prostaglandins and thromboxane effects

A

Vascular dilation
Increase capillary permeability
bronchoconstriction

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24
Q

Eosinophil is a type of

A

White blood cell

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25
Eosinophil sound increase with
Hypersensitivity reactions/diseases | Parasitic diseases
26
Are eosinophils phagocytic?
No! they are not phagocytic or mildly phagocytic
27
Killing mechanism of eosinophil
Binds to and empties its contents onto a parasite, damaging its surface and killing it
28
Eosinophils contain
Histaminase (degrades histamine) | Leukotrienes
29
Histaminase
Enzyme the degrades histamine
30
Symptoms of allergic reactions / inflammatory response
``` Local vasodilation Increase capillary permeability Leakage of fluid into extravascular space Smooth muscle CONTRACTION --> bronchospasm Itchy watery eyes Uticaria (hives) Increase secretions (mucus); rhinorrhea Stuffy nose Cough Sneezing ```
31
Goal of agents to treat upper respiratory tract disorders
Prevent expose to triggers that cause symptoms and to effectively manage the symptoms when they occur
32
First generation antihistamines
Sedating
33
Second generation antihistamines
Non-sedating
34
Histamine-1 receptor antagonists
Block EFFECTS of histamine at H1 receptor sites (does not block the RELEASE of histamine)
35
Histamine-1 receptor antagonists are most helpful when
Taken prophylactically
36
Histamine-1 receptor antagonists relieves what symptoms
Sneezing, rhinorrhea, nasal itching; does not affect nasal congestion
37
Histamine-1 receptor antagonists may also be used to treat
Reactions to blood/blood products (NOT hemolytic) Urticaria Angioedema Adjunct to anaphylactic therapy
38
1st generation antihistamines examples
Diphenhydramine (Benadryl) | Chlorpheniramine (Chlor-Trimeton)
39
1st generation antihistamines moA
Binds to H1 receptor sites to block the actions of histamine, also has anticholinergic properties
40
1st generation antihistamines indications
Management of mild reactions Seasonal allergic rhinitis mild transfusion reaction Urticaria Management of severe anaphylactic responses: Hypotension, actor laryngeal edema, bronchospasm Treatment of motion sickness and insomnia
41
1st generation antihistamines administration
Oral (OTC) | IM, IV (w/ prescription)
42
1st generation antihistamines side effects
``` Drowsiness Dizziness Dry mouth Tachycardia Constipation Urinary hesitancy ```
43
1st generation antihistamines toxicity
Adults: Flushed face, high fever, tachycardia, dry mouth, urinary retention, pupil dilation Children: excitation, hallucinations, seizures
44
1st generation antihistamines precaution
Children & older adults -Ppl with history of asthma, urinary retention, open-angle glaucoma, hypertension, impaired kidney or liver function
45
1st generation antihistamines contraindications
Glaucoma Prostatic hypertrophy acute asthma exacerbation (can thicken secretion) Increased CNS depressant effect with CNS depressants
46
2nd generation antihistamines examples
Cetrizine Loratadine Dexofenadine Deloratadine
47
2nd generation antihistamines MoA
Bind to H2 peripherally
48
2nd generation antihistamines side effects
``` Usually minor - headache - nausea - fatigue fewer than sedating antihistamines Mild anticholinergic effects ```
49
2nd generation antihistamines precaution
ppl impaired kidney function
50
2nd generation antihistamines contrindication
Infants under 6 months; breastfeeding women
51
2nd generation antihistamines interactions
Theophylline can reduce clearance and lead to toxicity | Atropine may cause increased anticholinergic effects
52
Drugs therapy for nasal congestion and cough
Nasal decongestants (sympathomimetics) Antitussives Expectorants Mucolytics
53
Examples of nasal decongestants
Phenylephrine Pseudoephedrine Ephedrine
54
nasal decongestants moa
Active alpha 1 in the nose, produce vasoconstriction thus striking nasal mucosal membrane
55
nasal decongestants side effects
``` CNS stimulation with oral agents Systemic vasoconstriction Tachycardia Heart palpitations with oral agents REBOUND nasal congestions with abrupt stoppage/prolonged use ```
56
nasal decongestants precautions
older adults | patients w/ CAD or HTN
57
nasal decongestants contraindications
Chronic rhinitis | Narrow - angle glaucoma; hypertension; dysrhythmia
58
nasal decongestants interactions
MAOI antidepressants potentiate effects | Beta 2 adrenergic agonists and other stimulants increase hypertensive effects
59
Antitussives-opioid example
Codeine
60
Antitussives-opioid moA
Suppress cough reflex in the brain (medulla)
61
nasal decongestants-opioid side effects
``` CNS depression Dizziness Light headedness GI discomfort Constipation Respiratory depression ```
62
nasal decongestants-opioid precaution
Children and older adults Patients with reduces respiratory reserve History of substance abuse Prostatic hypertrophy
63
Antitussives-opioid contraindications
``` Acute asthma Liver disease Renal disease Acute alcoholism Head trauma ```
64
Antitussives-non opioid examples
Dexthromethorphan (Delsym) | Benzonatate (Tessalon)
65
Antitussives-non opioid moA
Suppress cough reflex in the brain
66
Antitussives-non opioid side effects
CNS depression with large doses GI discomfort Potential for abuse
67
Antitussives-non opioid precautions
Patients with reduced respiratory reserve History of substance abuse Prostatic hypertrophy
68
Expectorants examples
Guaifenesin
69
Expectorants MoA
Reduce surface tension of secretions, thins thick mucus
70
Expectorants side effects
dizziness drowsiness GI distress allergic rxn (rash)
71
Expectorants contraindication
cough due to heart failure; ACE inhibitor therapy
72
Expectorants precautions
Chronic cough, asthma
73
Expectorants interactions
Increase risk of hemorrhage with heparin (b/c guaifenesin inhibits platelet function)
74
Mucolytic example
Acetylcysteine
75
Mucolytic MoA
Breaks the disulfide linkages of proteins in mucus
76
Mucolytic side effects
Bronchospasm Aspiration of excessive secretions GI distress
77
Mucolytic precautions
``` ppl with weak or ineffective cough peptic ulcer disease esophageal varices severe liver dysfunction asthma anaphylactic reaction (w/ IV administration) ```
78
Mucolytic contraindications
Risk for or actual GI bleeding
79
1st generation antihistamines cross
The blood brain barrier! Which is why it is sedating!
80
Chemical mediators act
Locally!!

316 Pharmacology (19 decks)

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