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PMCOL 200 > OTC Cough and Cold > Flashcards

OTC Cough and Cold Flashcards

1
Q

what do common OTC contain singly or a combination of? (4)

A

decongestant, cough suppressant (antitussive), expectorant and antipyretic

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2
Q

what do OTC cough and cold medications usually treat?

A

upper respiratory infections (runny nose, congestion, cough, fever)

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3
Q

what is the cough reflex?

A

reflex to clear breathing passage of irritants, microbes, fluids and mucus

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4
Q

what is the cough reflex a common symptom of? (4)

A

upper respiratory tract viral or bacterial infections, asthma, bronchial irritation, etc.

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5
Q

what is the cough reflex initiated by?

A

stimulation of sensory nerves in throat and lungs (eg. P2X3, TRPV1)

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6
Q

where do sensory neurons send “cough info” to?

A

medulla oblongata (cough center in brain stem)

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7
Q

what do efferent nerves (parasymp. and motor) stimulate in the cough reflex?

A

diaphragm, intercostal muscles and lungs to initiate “noisy expiration”

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8
Q

what are drugs that inhibit cough reflex called?

A

antitussives

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9
Q

how do most OTC antitussives work?

A

inhibit neurons in medulla oblongata

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10
Q

how effective are antitussives at reducing cough in clinical trials?

A

only moderately effective (not much better than placebo)

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11
Q

what is codeine?

A

mu opioid receptor agonist

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12
Q

where are mu opioid receptors found?

A

medulla oblongata (cough center) and peripheral nerves in respiratory tract

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13
Q

what are mu opioid receptors?

A

inhibitory GPCRs

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14
Q

how does activation of opioid receptors affect neuronal activity? (3)

A

inhibit of Ca channels, activate of K channels, and inhibit of adenylyl cyclase ie. neuronal inactivation and decr NT release

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15
Q

what are the effects of codeine?

A

arrests cough response (efferent) and decr respiration

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16
Q

what are 2 serious side effect of codeine?

A

addiction, overdose (death)

17
Q

what was low dose codeine mixed with?

A

Tylenol 3s

18
Q

what is dextromethorphan?

A

centrally active NMDA receptor antagonist

19
Q

how are dextromethorphan and codeine similar and different?

A

sim: inhibit neurons in medulla oblongata
diff: dex-antagonist, cod-agonist

20
Q

what is diphenhydramine?

A

antihistamine (H1 inverse agonist~antagonist)

21
Q

what H1 receptors?

A

Gq coupled receptors

22
Q

where are H1 receptors?

A

respiratory smooth muscles

23
Q

what do H1 receptors stimulate?

A

sensory nerves producing cough

24
Q

what does diphenhydramine binding to H1 receptors cause?

A

inhibits histamine action and receptor action

25
Q

what does histamine binding to H1 receptors cause?

A

in resp. tract - coughing

26
Q

what allows diphenhydramine to inhibit cough reflex in medulla oblongata?

A

can cross BBB (blood brain barrier)

27
Q

what do decongestants do?

A

decr nasal congestion, edema (swelling) of nasal passage, decr tissue hyperemia, etc.

28
Q

what is pseudoephedrine?

A

agonist for a and B adrenergic receptors (sympathomimetic drug-mimics noradrenaline)

29
Q

what does activation of a adrenergic receptors by pseudoephedrine cause?

A

vasoconstriction of blood vessels in mucosa of resp. tract

30
Q

what does activation of B adrenergic receptors by pseudoephedrine cause?

A

smooth muscle relaxation and vasodilation (bronchi)

31
Q

what is pseudoephedrine structurally similar to?

A

amphetamine (stimulant)

32
Q

what is phenylephrine?

A

specific a adrenergic receptor agonist

33
Q

what does phenylephrine binding to a adrenergic receptors cause?

A

vasoconstriction in nasal mucosa (no bronchial relaxation or HR incr) - less effective

34
Q

what are expectorants?

A

oral drugs that incr mucus clearance

35
Q

what expectorant was not removed from the market in the 90s by the FDA/Health Canada?

A

Guaifenesin (Mucinex)

36
Q

where was guaifenesin discovered by indigenous communities?

A

bark of Guaiac tree

37
Q

how does guaifenesin work?

A

incr expulsion of bronchial secretion by dec adhesiveness and surface tension of mucus

38
Q

what is theorized to be the mechanism of action of guaifenesin? (not actually known)

A

irritate gastric vagal receptors that recruit efferent parasymp. reflexes causing glandular exocytosis of less viscous mixture

39
Q

Why is codeine not recommended for individuals under 18 y/o?

A

Children are at higher risk for on-target effects leading to respiratory depression

PMCOL 200 (27 decks)

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