Lung Pharm

Question 1

1st generation vs 2nd generation H1 blockers? (and names)

Answer 1

1st: Diphenhydramine, dimenhydrinate, chlorpheniramine (-en—ine or -en—ate)
2nd: lortadine, fexofenadine, desloratadine, cetirizine (-adine)

2nd gen less sedating because of decreased entry into CNS

Question 2

1st gen H1 blockers - uses? (vs 2nd generation)

Answer 2

allergy, motion sickness, sleep aid (vs allergy)

Question 3

Toxicities of 1st generation h1-blockers vs 2nd

Answer 3

sedation, antimuscarininc, anti-a-adrenergic vs less sedating

Question 4

Bronchoconstriction caused by 2 general mechanisms?

Answer 4

inflam or increased PSNS

Question 5

Acute exacerbation of asthma. Use (drug and mech?)

Answer 5

albuterol (b2-agonist)

Question 6

Pt taking a drug for prophylaxis for asthma. Gets a tremor and arrhythmia. Drug?

Answer 6

Salmeterol/formoterol (B2-ags)

Question 7

Asthma drug (and class) that has narrow therapeutic index? toxicities?

Answer 7

Theophylline (methxanthines). Can cause cardiotoxicity (arrhythmias) and neurotoxicites (nervousness/seizures)

Question 8

Drug that blocks vasoconstriction increases vasodilation of airway? Mech?

Answer 8

Theophylline.

1) Inhibits PDE and increases cAMP (increase bronchialdilation)
2) blocks adenosine (decreases bronchoconstriction)

Question 9

Antimuscarinic used in asthma?

Answer 9

Ipratropium (I pray to breath soon) and tiotropium

Question 10

1st line for chronic asthma?

Answer 10

Beclomethasone, fluticasone (steroids)

Question 11

Good for asprin induced asthma? Mech?

Answer 11

Anti-leukotrienes.
1st line: Montelukast and zafirlukast (block LT receptors)
2nd line: zileuton (block lipooxygenase)

Question 12

Specifically blocks conversion of arachidonic acid to leukotrienes? Mech?

Answer 12

Zileuton. 5-lipoxygenase.

Question 13

Used in allergic asthma resistant to inhaled steroids.

Answer 13

Omalizumab. anti-IgE antibody

Question 14

N-acetylcystine - functions?

Answer 14

1) antidote for aspirin OD

2) expectorant - losens mucous plugs in Cystic Fibrosis pts

Question 15

Thins respiratory secretion but does not suppress cough?

Answer 15

Guaifenesin

Question 16

Used to treat pulmonary arterial HTN. Mech?

Answer 16

Bosetan. Antag for endothelin-1 receptors, decreasing pulmonary vascular resistance

Question 17

Opioid for cough?

Answer 17

Dextreomethorphan

Question 18

non-prescription nasal decongestants? Mech? toxicities?

Answer 18

pseudoephedrine, phenylephrine. a-agonistic HTN and CNS stumulant

Question 19

Used in asthma challenge testing?

Answer 19

Methacholine

Question 20

Asthma drugs?

Answer 20

ASSTHMAA
albuterol
Salmeterol/fomoterol
Steroids
Theophylline 
Histamine release blockers
Muscarinic antags
Anti-LTs
Anti-IgE antibodies

Question 21

Asthma drugs?

Answer 21

ASSTHMAA
albuterol
Salmeterol/fomoterol
Steroids
Theophylline 
Histamine release blockers
Muscarinic antags
Anti-LTs
Anti-IgE antibodies

Question 22

Pt comes in with hypokalemia and U-waves. Took too much of?

Answer 22

B-ag like albuterol. (B-ags drive K into cells and can destabilize cardiac membranes, resulting in U-waves)

Question 23

OD on theophylline. Tx?

Answer 23

B-blocker