Obstructive lung disease

Question 1

Albuterol

Answer 1

SABA (short acting beta2-agonist)

Uses: Asthma, COPD

Toxicity: Tremor, tacchycardia

Question 2

Salmeterol

Answer 2

LABA (long acting beta2-agonist)

Uses: Asthma, COPD

Toxicity: cough, runny nose, sneezing, headache

long-acting, recommended for co-use with inhaled corticosteroid

Question 3

Formoterol

Answer 3

LABA (long acting beta2-agonist)

Uses: Asthma, Exercise induced bronchospasm, COPD

Toxicity: cough, runny nose, sneezing, headache

long-acting, not for acute, slow onset

Question 4

Theophylline

Answer 4

Methylxanthine: PDE3 inhibitor, adenosine receptor antagonist

Uses: Acute asthma, Controller med

Toxicity: Insomnia, tremor, anorexia

Narrow TI

Question 5

Ipratropium

Answer 5

M3 muscarinic antagonist

Uses: COPD, asthma, rhinitis

Toxicity: Dry mouth, cough

Controller med for asthma/COPD

Question 6

Fluticasone

Answer 6

ICS (inhaled corticosteroid) Glucocorticoid receptor agonist

Uses: asthma controller med, anti-allergenic

Toxicity: Cough, headache nausea

CYP3A4 substrate

Question 7

Prednisone

Answer 7

Systemic corticosteroid. Glucocorticoid receptor agonist

Uses: asthma controller med, anti-allergenic

Toxicity: Cough, headache nausea

CYP3A4 substrate

Question 8

Cromolyn

Answer 8

Mast cell stabilizer

Uses: asthma controller med

Toxicity: Cough, nausea, throat irritation

Question 9

Roflumilast

Answer 9

Selective PDE type 4 inhibitor

Uses: Reduce acute COPD exacerbation

Toxicity: Diarrhea, weight loss, nausea

used in patients with severe airflow limitation, symptoms of chronic bronchitis and history of exacerbations not controlled by long-acting bronchodilators

Question 10

Montelukast

Answer 10

Leukotriene antagonist - Cys-LTR1 receptor antagonist

Uses: asthma, exercise induced bronchospasm, allergic rhinitis

Toxicity: GI disturbances, hypersensitivity reactions

effective for aspirin-induced asthma, CYP3A4/2C9 substrate

Question 11

Azithromycin

Answer 11

Macrolide Ab’c - binds 50s ribosomal subunit

Uses: Hearing impairment

effects are additive with beta2 agonists and long-acting muscarinic antagonists; patients should be pre-screened for QTc prolongation before use

Question 12

Omalizumab

Answer 12

Binds IgE anti-bodies

Uses: Asthma controller med

Toxicity: Headaches, dizziness, fatigue

effective in asthma resistant to B2-agonists/steroids

Question 13

Diphenhydramine

Answer 13

H1 histamine receptor antagonist

Uses: allergy, insomnia, motion sickness

Toxicity: sedation (+++), anti-cholinergic activity (+++)

1st generation anti-histamine, not for use in children <6

Question 14

Hydroxyzine

Answer 14

H1 histamine receptor antagonist

Uses: allergy, potentiate opioid analgesia, general anxiety

Toxicity: sedation (+++), anti-cholinergic activity (+++)

1st generation anti-histamine abuse potential

Question 15

Brompheniramine

Answer 15

H1 histamine receptor antagonist

Uses: allergy, common cold

Toxicity: sedation (+), anti-cholinergic activity (+)

1st generation anti-histamine effective for daytime use

Question 16

Promethazine

Answer 16

H1 histamine receptor antagonist

Uses: allergy, motion sickness

Toxicity: sedation (+++), anti-cholinergic activity (+++)

1st generation anti-histamine, black box warning for gangrene at injection site

Question 17

Loratadine

Answer 17

H1 histamine receptor antagonist

Uses: allergy

Toxicity: non-sedating minimal AC activity

2nd generation anti-histamine zwitterionic

Fexofenadine and cetirizine in same class