M 3.1

Question 1

Isoniazid (INH)

Answer 1

antitubercular agent

• inhibits call-wall biosynthesis by interfering with lipid and DNA synthesis
• hepatic problems

Question 2

Rifampin (RIF)

Answer 2

antitubercular agent

• inhibits DNA-dependent RNA polymerase by binding to beta subunit, which in turn blocks RNA transcription; potent enzyme inducer
• hepatic problems

Question 3

Pyrazinamide (PZA)

Answer 3

antitubercular agent

• Unknow action; bacteriostaic or -cidal for mycobacterium
• hepatic damage can occur

Question 4

Ethambutol (Myambutol)

Answer 4

antitubercular agents

• Interferes with metabolite produciton in mycobacterium
• optic neuritis / hypersensitivity

Question 5

Pyridoxine (Vitamin B6)

Answer 5

vitamin

-used to help alleviate symptoms of neuritis caused by isoniazid (INH) therapy for tuberculosis

Question 6

Adrenalin (epinephrine)

Answer 6

bronchodilator/andrenergics- Beta Agonist

• Strong beta1- and moderate beta2-adrenergic effects, resulting in bronchial smooth muscle relaxation
• watch for angina or arrhythmias, respiratory difficulties

Question 7

Albuterol (Proventil, Ventolin)

Answer 7

bronchodilator/andrenergic-beta agonist
-beta-2 receptor agonist with some beta-1 activity
used for acute bronchospasm, severe bronchospasm, and exercise induced bronchospasm
- watch for tachycardia

Question 8

Levalbuterol (Xopenex)

Answer 8

bronchodilator/ andrenergic- beta agonist
-Beta-2 receptor agonist with some beta-1 activity relaxes bronchial smooth muscle
may increase BS levels, cardiovascualr disorders used in caution

Question 9

Metaproterenol Sulfate (Alupent)

Answer 9

bronchodilator/andrenergic- beta agonist
-beta-2 receptor agonist with some beta-1 activity; stimulation of beta2 receptors may result in bronchial smooth muscle relaxation
watch for hypokalemia, patients with heart conditions, reports of cramps may increase serum glucose

Question 10

Tiotropium (Spiriva)

Answer 10

anticholinergics,

• long acting, antimuscarinic agent, often referred to as an anticholinergic
• inhibits M3-receptors at the smooth muscle leading to bronchodilation
• lactose allergy!!

Question 11

Salmeterol (serevent)

Answer 11

beta-2 agonist
-long acting beta-2 agonist; action on beta-2 receptors relaxes bronchial smooth muscle with little effect on heart rate
-50 times more selective than albuterol
RISK of Asthma related DEATH, cardiovascular disorders

Question 12

Ipratropium bromide (Atrovent)

Answer 12

bronchodilator/anticholinergic

• anticholinergic agent; inhibits vagally mediated reflexes by antagonizing acetylcholine action; prevents increase intracellular calcium concentration which is caused by interaction of acetylcholine with muscarinic receptors on the bronchial smooth muscle
• used for maitenance therapy not rescue

Question 13

Theopylline

Answer 13

bronchodilator/methylxanthines

• methylxanthine, directly relaxes smooth muscles of respiratory tract
• watch for hypersensitivity, active peptic ulcer disease, underlying uncontrolled seizure disorder

Question 14

Zafirlukast (Accolate)

Answer 14

bronchodilator/leukotriene receptor antagonist

• inhibits bronchoconstriction as competitive receptor antagonist of leukotrienes D4 and E4; receptor occupation and cysteinyl leukotriene production has been associated with the pathophysiology of asthma
• watch for hepatic impairment, status asthmaticus

Question 15

Montelukast (Singulair)

Answer 15

bronchodilator/ leukotriene receptor antagonist
-blocks binding of leukotrine D4 to its receptor; alters pathophysiology associated with the inflammatory process that contributes to the signs and symptoms of asthma
watch for not for asthma attacks hypersensitivity

Question 16

Robitussin (guaifenesin)

Answer 16

expectorants

• reduces viscosity of secretions by increasing amount of respiratory tract fluid
• do not use as self medication in chronic or persistent coughs

Question 17

Mucomyst (acetylcysteine)

Answer 17

mucolytics/pulmonary

• mucolytic activity through its sulfhydryl group, which opens up disulfide bonds in the mucoproteins and lowers mucous viscosity of pulmonary secretions.
• increased volume of bronchial secretions after adminitration, monitor asthma patients closely

Question 18

Cromolyn sodium (intal)

Answer 18

miscellaneous steroids/ mast cell stabalizer

• inhibits release of histamine, leukotrienes, and slow-reacting substance of anaphylaxis from mast cell by inhibiting degranulation following exposure to reactive antigens
• watch for hypersensitivity/ acute asthma attack

Question 19

Methylprednisone (Solu-Medrol)

Answer 19

steroid; corticosteroid; anti-inflammatory agent

• glucocorticoid; controls or prevents inflammation by controlling rate of protien synthesis, suppressing migration of polymorphonuclear leukocytes (PMNs) and fibroblasts, reversing capillary permeability, and stabilizing lysosomes at cellular level
• watch for cirrhosis, ocular herpes, hypertension, diverticulitis, hypothyroidism, myasthenia gravis, peptic ulcer disease, osteoporosis, renal insufficiency, diabetes

Question 20

Fluticasone (flovent)

Answer 20

corticosteroid, inhalent
-antiinflammatory corticosteroid; exact mechanism of action unknown but shown to exhibit anti-inflammatory effect on neutrophils, eosinophils, machrophages, mast cells, lymphcytes, and mediators (histamine, leukotrienes, cytokines and eicosanoids)
hypersensitivity, may result in anaphylaxis from milk, angioedema,

Question 21

Triamcinolone (Azmacort)

Answer 21

corticosteroids, inhalent
-glucocorticoid; anti-inflammatory, precise mechanism of action unknown
-effective local steroid activity with minimal systemic effects
must be used regularly not PRN
chicken pox or measles serious or FAtal course

Question 22

Benadryl (diphenhydramine)

Answer 22

antihistamine
-histamine H1-receptor antagonist of effector cells in respiratory tract, blood vessels, and GI smooth muscle
-moderate to high anticholinergic and antimetic properties
sleepiness, lowers respiratory tract diseases, such as acute asthma

Question 23

Allegra (fexofenadine)

Answer 23

antihistamines 2nd generation
-H1 histamine receptor antagonist; major metabolite of terfenadine
watch for severe renal impairment

Question 24

Claritin (loratadine)

Answer 24

antihistamine 2nd gen
-long acting tricyclic antihistamine with selective peripheral histamine H1-receptor antagonist activity
use with caution in hepatic impairment and renal impairment

Question 25

Zyrtec (cetirizine)

Answer 25

antihistamine 2nd gen
-histamine H1-receptor antagonist
avoid alcohol and tranquilizers due to drowsiness
hepatic and renal impairment