Pharm Respiratory Flashcards
What class of drugs are diphenhydramine, demenhydrinate, and chlorpheniramine? Clinical uses? Mechanism? Toxicity?
1st generation H1 blockers (en/ine) or (en/ate)
Reversible inhibitors of H1 histamine receptors
Allergy, motion sickness, sleep aid
Sedation, antimuscarinic, anti alpha adrenergic
What class of drugs are loratadine, fexofenadine, desloratadine, cetirizine? Clinical uses? Toxicity? Mechanism?
2nd generation H1 blockers (-adine)
Reversible inhibitors of H1 histamine receptors
Allergy
Far less sedating than 1st generation b/c of decr. entry into CNS
What type of drug is guaifenesin? Actions?
expectorant: thins resp. secretions. Does not suppress cough reflex
What type of drug is N-acetylcysteine? Mechanism/action? Clinical uses?
Mucolytic-Can loosen mucous plugs in CF patients by disrupting Disulfide bonds
Antidote for Acetaminophen overdose
What type of drug is dextromethorphan? Mechanism? What drug is it like? What happens when used in excess? Antidote? Toxicity?
Antitussive (antagonizes NMDA glutamate receptors)
Synthetic codeine analog
Mild opioid effect in excess
Naloxone for overdose
Mild abuse potential
Serotonin syndrome when given with other serotonergic agents
What is the mechanism of pseudoephedrine (1) and phenylephrine? Clinical uses? Other uses of 1? Toxicity? of just 1?
Alpha adrenergic agonists, used as nasal decongestants
Reduce hyperemia, edema, nasal congestion
Open obstructed eustachian tubes
1 is used to make meth
Hypertension
1 can cause CNS stim/anxiety
What type of drug is bosentan? Mechanism? Clincal use? Toxicity?
Endothelin receptor antagonists
Competitively antagonize endothelin 1 receptors leading to decr. pulm. vasc. resistance
Pulm. hypertension
Hepatotoxic (monitor LFTs)
What type of drug is sildenafil? Clinical uses?
PDE-5 inhibitor
Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide.
Pulmonary hypertension
Erectile dysfunction
What type of drugs are epoprostenol and iloprost? Mechanisms? Side effects?
Prostacyclin analogs
PGI2 with direct vasodilatory effects on pulmonary and systemic arterial vasc. beds
Inhibit platelet aggregation
Flushing
Jaw pain
What are the targets of asthma drugs?
Bronchoconstriction is mediated by inflammatory process and parasympathetic tone. Therapy is directed here.
What kind of drugs are albuterol (1), salmeterol (2), and formoterol (3)? Mechanism (1)? 2/3? Clinical use 1? 2/3? Adverse effects 2/3?
Beta 2 agonists
1=relaxes bronchial smooth muscle. Acute exacerbation
2=same, but long acting agent. Prophylaxis.
Tremor and arrhythmia
What type of drugs are fluticasone and budesonide? Mechanism? Clinical use?
Corticosteroids
Inhibit synth of virtually all cytokines
Inactivate NF-kappa beta, the transcription factor that induces production of TNF-alpha and other inflamm agents.
1st line therapy for chronic asthma
Waht type of drug is ipratropium (1) and tiotropium (2)? Mechanism? Clinical uses? How does tiotropium differ (2)?
Muscarinic antagonist
Competetively block musc. receptors
Prevent bronchoconstriction
Asthma
COPD
2 is long acting
What type of drugs are montelukast, zafirlukast? Mechanism? Clinical use?
Antileukotrienes
Block LT receptor
Asthma, especially asthma induced
What type of drug is zileuton? Mechanism? Toxicity?
antileukotriene
5-lipoxygenase pathway inhibitor.
Blocks conversion of AA to LT
Hepatotoxic
