Pharmacology Flashcards
What Histamine receptor is associated with positive cardiac chronotropism ?
H2
What Histamine receptor is associated with positive cardiac inotropism ?
H1 & H2
What histamine receptor is associated with secreting gastric acid and from which cell is the histamine released?
H2; enterochromaffun-like cells
Name 2 histamine release inhibitors
Cromolyn & Nedocromil
Which first generation H1 blocker particularly increases apetite and how?
Cyproheptaine; blocks serotonin
Which 1st gen H1 blocker has the highest chance of blocking a-adrenergic receptors?
Promethazine
Which 1st gen H1 blockers have the highest chance of blocking cholinergic receptors?
Promethazine & Diphenhydramine
Which 1st gen H1 blocker has the highest chance of causing tachycardia?
Promethazine (sinus + reflex)
Diphenhydramine (sinus)
What’s the most common cause of coughs?
URT viral infection
How is a cough by ACE inhibitors treated?
Lower dose or replace with ARBs
What’s the optimal particle size for an inhaler?
2-5 um
Why do LABAs last that long?
High lipid solubility = dissolves in smooth muscle in high conc.
What is the methylxanthine used as bronchodilator called?
Theophylline
How is ipratropium bromide derived?
Atropine + NH4+
What time of the day are ICS given? And why?
Late afternoon; worse symptoms (even though it’s against natural ACTH release)
When is full response achieved in SABA?
After 3 uses
When is full response achieved in ICS?
After 2-4 weeks
What do we treat COPD with?
LABA + LAMA
When is a nebulizer used?
When coordination for inhaler is hard
What B2 agonists are available as an oral regimen?
Albuterol & Terbutaline
How often should SABA inhaler be taken?
Every 20 minutes
When do mast cell stabilizers start working?
2 weeks; maximum effect at 4-6 weeks
What is the DOC LABA; why?
Formoterol; instant onset of action
How long do LABAs last?
12h ; 24h for ultra long
What is the onset of action of salmeterol?
30 minutes
What are the suffixes used in ICS?
Asone ate & onide
What is the minimum age for omalizumab?
6 years
What is the route of omalizumab?
Subcutaneous
What are the side effects of mast cell stabilizers?
Wheeze & cough
What does ECL cells stand for?
Enterochromaffin-like
When are leukotriene inhibitors used in asthma patients?
Cortisol alternative for worried parents & as prophylaxis
Why should diphenhydramine be avoided in children?
Paradoxical hyperactivity
When is ICS used for a cough?
Asthma & Eosinophilic bronchitis
How many is gastroesophageal reflux cough treated?
H2 blockers / Proton pump inhibitor
What drugs do we use for intractable chronic cough?
Morphine & Methadone
What is Azelastine used for and what generation is it?
Conjunctivitis: 2nd gen
What is olopatadine used for and what generation is it?
Conjunctivitis; 2nd gen
What is ketotifen used for and what generation is it?
Conjunctivitis; 2nd gen
What is diphenhydramine used for and what generation is it?
Eczema (topical) + insomnia (2nd choice); 1st gen
What is doxylamine used for and what generation is it?
2nd choice for insomnia; 1st gen
What is Meclizine used for and what generation is it?
In combination with scopolamine for motion sickness vertigo prophylaxis; 1st gen
What are the side effects of Diphenhydramine?
Cholinergic activation (low BP & reflex tachycardia)
Paradoxical hyperactivity (&Hypersensitivity)
What is the physiological antagonist of antihistamines?
Epinephrine
What histamine receptor facilitates vasodilation & its consequences ?
Both H1 & H2
What is the MOA of isoniazid?
Interferes with mycolic acid synthesis
What is the MOA of ethambutol?
Inhibit arabinosyl transferases
What is the DOC corticosteroid for severe and critical covid-19 ?
Dexamethazone
What is the DOC antiviral for severe and critical covid-19 ?
Remdesivir
