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Pharm > pharm > Flashcards

pharm Flashcards

1
Q

antihistamine smechanism of action

A

reversible inhibitors of H1 histamine recepotrs

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2
Q

Diphenyhydramine, dimenhydrinate, chlorpheniramine are

A

first generation anti histamines

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3
Q

clinical uses of first gen hitstamine

A

allergy, motion sickness, sleep aid, increase depth of sleep

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4
Q

SE of first generation histamine

A

significant sedation, antimuscarininc, anti adrenergic (postural dizziness, falls); anti serotonergic: appetite stimulation, wt gain

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5
Q

avoid these in elderly pt’s

A

first generation anti histamines

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6
Q

second generation histamines

A

loratadine, fexofenadine, desloratadine, cetirizine

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7
Q

use of second gen histamine

A

allergy

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8
Q

Second gen antihistamines SE

A

have far less sedating than 1st generation because of decrease entry into CNS

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9
Q

Guaifenesin use

A

expectorant - thins respiratory secretions, does not suppress cough reflex

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10
Q

N-acetylcysteine

A

Mucolytic; liquifies mucus in chronic bronchopulmonary diseases (COPD, CF) by disrupting disulfide bonds. a

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11
Q

used as an antidote for acetaminophen overdose

A

n-acetylcysteine

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12
Q

Dextromethorphan use

A

antitussive; has mild opiod effect when used in excess

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13
Q

an antitussive that antagonizes NMDA glutaamte receptors

A

dextromethorphan

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14
Q

pseudoephrine, phenylephrine mechanism

A

a-adrenergic agonists, used as nasal decongestants

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15
Q

Use of psuedoephrine, phenylephrine

A

reduce hyperemia, edema, nasal congestion; open obstructed eustachian tubes.

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16
Q

this is illicilty used to make methamephetamine

A

pseudoephedrine

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17
Q

SE of psuedoephrine, phenylephrine

A

hypertension. reboudn congestion if used more than 4-6 days. can also cause CNS stimulation/anxiety (pseudoephrine)

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18
Q

Pulm htn drugs:

A

bosentan, sidenafil, esoprostenol, iloprost

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19
Q

Bosentan mechanism

A

competitively antagonizes ENdothelin-1 receptors: decreases pulm vasc resistance

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20
Q

bosENtan SE

A

hepatotoxic

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21
Q

sildenafil mechainsm

A

inhibits pde5 : increase cGMP: prolonged vasodilatory effect of NO

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22
Q

epoprostenol, iloprost mechanism

A

PGI2 (prostacylin) w direct vasodilatory effects on pulmonary and systemic arterial vascular beds. inhibits platelet aggregation

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23
Q

SE of esoprostenol, iloprost

A

jaw pain, flushing

24
Q

cromolyn and nedocromil mechanism of action

A

inhibit mast cell degranulation and prevents release of preformed chemical mediators.

25
Q

use for cromolyn and nedocromil

A

2nd line treamtent for asthma, allergic rhinitis, prevent acute attacks

26
Q

brocnchoconstriction in astham mediated by

A

inflammatory processes, and parasympatehtic tone

27
Q

B2 agonists:

A

albuterol, salmeterol, formoterol

28
Q

Albuterol use

A

relaxes bronchial smooth muscle (short acting B2 agonist). Used during acute exacerbation

29
Q

Salmeterol, formoterol

A

long acting agents for prophylaxis;

30
Q

SE of salmeterol, formoterol

A

tremor, arrhytmia

31
Q

Inhaled corticosteroids

A

fluticasone, budesonide

32
Q

fluticasone, budesonide

A

inhibit synthesis of virtually all cytokines. inactivaes nfkb, transcription factor that induces prodcution of tnfa and other inflammatory agents.

33
Q

1st line therapy for chronic asthma

A

fluticasone, budesonide

34
Q

muscarininc antagonists:

A

tiotropium, ipratroprium

35
Q

tiotropium, ipratropium mechanism

A

compettively block muscarinic receptors, preventing bronchoconstriction

36
Q

which of muscarininc antagonists is long acting

A

tiotropium

37
Q

Tiotropium and ipratropium also used for

A

COPD ( remember these are asthma drugs)

38
Q

which asthma drug causes oral thrus

A

inhaled corticosteroids

39
Q

asthma drug that blocks leukotriene receptors (CysLT1)

A

montelukast, zafirlukas

40
Q

antileukotrienes

A

montelukast, zafirlukast, zileuton

41
Q

aspirin induced and exercised induced asthma can be treated w

A

montelukast, zafirlukast

42
Q

5 lipoxygenase pathway inhibiotr. blocks conversion of arachidonic acid to leukotrienes

A

zileuton

43
Q

zileuton SE

A

hepatotoxic

44
Q

Anti IgE monocolonal therapy

A

omalizumab

45
Q

omalizumab mechanism

A

binds mostly unbound serum IgE and blocks binding to FceRI.

46
Q

used in allergic astham w Increased IgE levels resistant to inahled steroids and long acting B2 agnosits

A

omalizumab

47
Q

uncontrolled symptoms of asthma

A

omalizumab

48
Q

inhibits proinflammatory substance release (histamine and leukotriense) decreasing airway inflammation

A

omalizumab

49
Q

theophylline mechainsm

A

likely causes bronchodilation by inhibiting phosphodiesterase, increase camp levels due to decrease camp hydrolysis

50
Q

theophyline usage is limited becuase

A

narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by cytochrome p450

51
Q

SE of theophyllinee

A

CNS: tremors, insomnia, seizure
CV: hypotension, tachycardia, cardiac arrhytmias

52
Q

metacholine

A

nonselective muscarinic receptor (M3) agonist. used in bronchial challenge test to help diagnose asthma

53
Q

magnesium sulfate mechainsm

A

inhibits Ca influx into airway smooth muscle and promotes bronchodilation when giving IV during acute asthma flare up. also decreases inflammation by stabilziign T cells and inhibitng mast cell degranulation

54
Q

SE of inahled corticosteroids;

A

thrush, dysphonia: myopathy of laryngeal muscles and mucosal irritation

55
Q

CFTR modulating medications

A

lumacaftor and ivacaftor

56
Q

lumacaftor and ivacaftor mechanism

A

restoring CFTR proteins to membrane and by enhacnign protein function

Pharm (13 decks)

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