Pharma for Pulmo Flashcards
List three first generation antihistamine.
Diphenhydramine, Dimenhydrinate, Chlorpheniramine
What is the mechanism of first generation antihistamine?
reversibly inhibit H1 histamine receptors
what is the clinical use of first generation antihistamine?
Allergy, motion sickness, sleep aid
Adverse effects of first generation antihistamines?
Sedation, antimuscarinic, anti-alpha-adrenergic
second generation antihistamine
cetririzine…
why are second generation better than first
less sedating effect due to decrease CNS penetration
Guaifenesin
expectorant: this respiratory excretions (breaks down mucus)
What is N-acetylcysteine used for? (2 things)
breaks down mucus in COPD patients by disrupting disulfide bonds; acetominophen overdose antidote
Use and mechanism of dextromorphan
Antitussive (antagonizes NMDA glutamate receptors to suppress cough); mid opioid effect in excess
What is the mechanism for pseudoephedrine and phenylephrine?
alpha-adrenergic agonists
What is the clinical use for pseudophedrine and phenylephrine?
Reduce hyperemia, edema and nasal congestion
Adverse effects of pseudophedrine and phenylephrine
Hypertension, anxiety
How does Bosentan treat pulmonary hypertension ?
Competitively antagonizes endothelin 1 receptor to decrease pulmonary resistance
What are the adverse effects of Bosetan?
Hepatotoxicity (monitor LFTs)
How does Sildenafil treat Pulm hypertension?
Inhibit cGMP PDE-5 and prolong vasodilatory effect of NO (
How do Epoprostenol and Iloprost treat pulmonary hypertension
PGI2; direct vasodilatory effects on pulmonary and systemic arterial beds; inhibit platelet aggregation
Side effects of epoprostenol and iloprost
flushing, jaw pain
Which medication is used in acute exacerbation/shortness of breath due to asthma?
Albuterol (beta2-agonist)
How do beta 2 agonists relax bronchial smooth muscles?
Gs–> adenylate cyclase–> cAMP
What are Salmeterol and Formoterol used for?
long-acting agents for prophylaxis
Adverse effects of salmeterol and formoterol
Tremor and arrhythmia
Name two inhaled corticosteroids
Fluticasone and budesonide
What is the mechanism of inhaled corticosteroids
Inhibit synthesis of cytokines by inactivating NF-kappaB
What is the clinical use of fluticasone and budesonide?
First-line tx for chronic asthma
What is the mechanism and clinical use of Ipratropium?
Competitive muscarinic antagonist that prevents bronchoconstriction; COPD
What is the long-acting muscarinic antagonist used to treat COPD?
Tiotropium
Name the best treatment for aspirin-induced asthma
Montelukast, Zafirlukast (block CysLT1 recetpors)
What is the mechanism of Zileuton
5-lipooxygenase inhibitor to block conversion of arachidonic acid to leukotrienes
Adverse effect of Zileuton
Hepatotoxic (monitor LFTs)
What is Omalizumab used for
Steroid and b2-restistant allergic asthma
Mechanism of Omalizumab
binds serum IgE and blocks binding to FceRI
Name a methylxanthine
Theophylline
Mechanism of Theophylline
Inhibits phosphodiesterase to increase cAMP; causes bronchodilation
Adverse effects of Theophylline
Cardiotoxic (arrhythmias), Neurotoxic (seizures, irritation, confusion, tremor), metabolized by P450, blocks actions of adenosine
What is the use of Methacholine?
M3 agonist, used in bronchial challenge test to diagnose asthma
What is used for smoking cessation
Verenicline
What is Varenicline’s mechanism
Partial agonist for alpha4beta2 nicotinic acetylcholine receptors in CNS
How does Varenecline help with smoking cessation
Reduces withdrawal cravings and rewarding effects of nicotine
What are the cancer markers for small cell carcinoma?
NCAM (CD56), enolase, chromogranin, and synaptophysi
Expression of mucin and mutations in EGF and KRAS genes are characteristic of
non-small cell carcinomas
What are the therapeutic effects of Bosentan?
Reduce pulmonary arterial pressure and lessen progression of vascular and RVH
Sleep apnea with loud snoring and gasping respirations indicative of oropharyngeal dysfunction can improve with stimulation of which nerve
Hypoglossal
Have the strongest and most predictable effects on inflammatory component of asthma. Best for long-term management and can reduce number and severity of acute asthma exacerbations
Corticosteroids
What two types of β-agonists are used to treat asthma?
Nonspecific β-agonists and β2-agonists
Is albuterol used as a controller medication or for relief of symptoms during exacerbations?
It is used for relief in acute asthma exacerbations
Salmeterol is a _____ (short/intermediate/long) -acting agent.
long
List two adverse effects of salmeterol.
Tremor and arrhythmia
