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AIM - Pulm > HY pharm > Flashcards

HY pharm Flashcards

1
Q

SABA

examples

A

albuterol

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2
Q

LABA

examples

A

salmeterol and formoterol

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3
Q

long-acting anti-muscarinics

examples

A

tiotropium

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4
Q

short-acting anti-muscarinics

examples

A

ipratropium

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5
Q

inhaled corticosteroids

examples

A

fluticasone, budesonide, dexamethasone

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6
Q

albuterol MOA

A

stim adenylate cyclase → incr cAMP (→ incr Ca2+ efflux → relax airway smc →) BRONCHODILATION.

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7
Q

black box warning of LABAs

A

use of LABAs (without concomitant inhaled steroids) may be associated with increased asthma and cardiac mortality when used without an anti-inflammatory in asthma

→ LABAs not to be used as monotherapy in asthma.

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8
Q

anticholinergics MOA

A

Atropine-like activity - block muscarinic (parasympathetic) receptors

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9
Q

anticholinergics are more effective in ______ due to _____

A

anticholinergics are more effective in COPD due to INCREASED MUSCARINIC TONE IN COPD

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10
Q

What feature of anticholinergics reduces systemic absorption?

A

Quaternary structure

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11
Q

anticholinergics AE

A

dry mouth, urinary retention (older men with prostatic hypertrophy)

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12
Q

Which drug both increases bronchodilation and decreases bronchoconstriction?

A

Theophylline

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13
Q

Theophylline MOA

A
  1. Phosphodiesterase inhibitor leading to incr cAMP due to decr cAMP hydrolysis (→ incr bronchodilation).
  2. Adenosine inhibitor (→ decr bronchoconstriction)
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14
Q

Theophylline AE

A

cardiotoxicity, neurotoxicity (seizures, tachyarrhythmia, nausea)

(caffeine AF)

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15
Q

Leukotriene antagonists MOA

A
  1. inhibit 5-lipooxygenase

2. block LT receptors

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16
Q

Zileuteon MOA

A

inhibit 5-lipooxygenase

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17
Q

Montelukast MOA

A

block LT receptors

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18
Q

Zafirlukast MOA

A

block LT receptors

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19
Q

_____ are effective in aspirin and exercise-induced bronchospasm

A

Leukotriene antagonists

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20
Q

Which leukotriene antagonist is characterized by hepatotoxicity?

A

Zileuton

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21
Q

Which ICS has high GC activity (inc potency, smaller dose req)?

A

dexmathasone

22
Q

Inhaled corticosteroids MOA (general)

A

Principally anti-inflammatory agents (decr the numbers of lymphocytes, mast cells and eosinophils and their associated cytokines)

23
Q

Inhaled corticosteroids MOA (specific)

A

Inactivate NF-κB, the tfac that induces production of TNF-α and other inflammatory agents.

24
Q

Inhaled corticosteroids AE

A

oral –> thrush, dysphonia

systemic –> weight gain, hyperglycemia, cataracts, osteoporosis, less frequently adrenal suppression

25
Q

1st line tx asthma

A

inhaled corticosteroids (fluticasone)

26
Q

Roflumilast

A

PDE-4 inhibitor (increases cAMP)

Weak bronchodilator, effective for reducing COPD exacerbation

27
Q

Mast cell stabilizers

Use

A

prophylactic for bronchospasm, NOT for acute bronchodilation

28
Q

Mast cell stabilizers

examples

A

Cromolyn

Nedocromil

29
Q

cromolyn

MOA and use

A

blocks histamine and leukotriene release from mast cells

Use in PEDS and EXERCISE-INDUCED

30
Q

nedocromil

MOA

A

blocks release of inflammatory mediators from mast cells AND blocks release from other cells (eos, macrophages, platelets)

31
Q

inhaled mucolytics

examples

A

N-acetylcysteine

32
Q

N-acetylcysteine

MOA

A

liquifies mucus in chronic bronchopulmonary diseases (COPD, CF) by disrupting disulfide bonds

33
Q

______ is also an antidote for acetaminophen OD

A

N-acetylcysteine

34
Q

Antihistamines

MOA

A

reversible inhibitors of H-1 receptors

35
Q

1st generation anti-histamines

examples

A

Diphenhydramine, dimenhydrinate, cholorpheniramine

“-en/ine”, “-en/-ate.”

36
Q

1st generation anti-histamines

uses/AE

A

allergy, motion sickness, sleep aid

AE: MORE anticholinergic effects

37
Q

2nd generation anti-histamines

examples

A

Loratadine, fexofenadine, desloratadine, cetirizine

“-adine.”

38
Q

2nd generation anti-histamines

uses/AE

A

allergy

AE: LESS anticholinergic effect and LESS sedating

39
Q

Antitussives

examples

A

Dextromethorphan

Benzonatate

40
Q

Expectorant

examples

A

Guaifenesin

41
Q

codeine MOA

A

opiate, mu receptor

antitussive

42
Q

Dextromethorphan

MOA

A

non-opiate but binds mu

Antagonizes NMDA glutamate receptors

antitussive

43
Q

which drug may cause serotonin syndrome if combined w/ other serotonergic agents?

A

Dextromethorphan (antitussive)

44
Q

Anti-IgE monoclonal therapy

example

A

omalizumab

45
Q

omalizumab

MOA/use

A

Anti-IgE monoclonal Ab

binds unbound serum IgE & blocks binding to FcεRI on mast cells

use: allergic asthma with incr IgE levels resistant to inhaled steroids/long-acting B-2 agonists

46
Q

Which ILD does not improve with corticosteroids?

A

ASBESTOSIS

47
Q

which drug is cryptogenic organizing pneumonia EXQUISITELY sensitive to?`

A

CORTICOSTEROIDS

48
Q

tx for pulmonary arterial hypertension (PAH)

group 1 pulmonary HTN

A

-anticoagulants
-vasodilators (Ca chan blockers, prostacyclins)
-endothelin antagonists
-PDE-5 inhibitors (cGMP)
guanylate cyclase stimulant (cGMP)

49
Q

PDE-5 inhibitors MOA in PAH

A

(inc cGMP to promote vasodilation; sildenafil [Viagra]

50
Q

heparin MOA

A

anticoagulant

indirect thrombin inhibitor, binds anti-thrombin-3 and inactivates thrombin

51
Q

avoid using ____ in CF

A

anticholinergics

AIM - Pulm (4 decks)

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