Pulm

Question 1

Histamine blockers

• MOA
• first generation: examples, indication
• second generation: examples, indication

Answer 1

• reversible inhibitors of H1 histamine receptors
• Diphenhydramine, dimenhydrinate, doxylamine; allergy, motion sickness, sleep aid
• loratadine, fexofenadine, certrizine; allergy

Question 2

N- acetyl cysteine

• what is it
• off brand use

Answer 2

• mucolytic: liquifies mucus in chronic broncho pulm dx by disrupting disulfide bonds
• antidote for acetaminophen overdose

Question 3

Dextromethorphan

• what is it
• overdose tx

Answer 3

• anti-tussive -> antagonizes NMDA glutamate receptors

- nalaxone

Question 4

Psuedoepherine

• MOA
• indication

Answer 4

• alpha adrenergic agonist

- reduce hyperemia, edema

Question 5

Pulm HTN drugs

• endothelin receptor antagonists: MOA
• PDE-5 inhibitors: MOA; also used in
• Prostacyclin analogs: MOA

Answer 5

• competitively antagonizes endothelin 1 receptors -> decrease pulmonary vascular resistance
• inhibit PDE-5 -> increase c-GMP -> prolonged vasodilatory effect of NO; also used for ED
• vasodilatory effects on pulmonary and systemic arterial vasculature beds; inihibit platelet aggregation; flushing/ jaw pain

Question 6

Asthma drugs

• Beta 2 agonists
• Inhaled corticosteroid
• Muscarinic antagonist
• Anti-leukotrienes
• Anti- IgE monoclonal therapy
• Methylxanthines
• Chormones
• Methacholine

Answer 6

• relaxes bronchial smooth muscle; can cause tremor or arrythmia; short - albuterol, long- salmeterol
• inhibit synthesis of call cytokines, inactivate NF-kappaB; 1st line for chronic asthma -> use a spaces or rinse mouth after use to prevent oral thrush
• competitively block muscarinic receptors, preventing bronchoconstriction; also used for COPD; tiotropium
• montelukast: block leukotriene receptors, especially good for aspirin and exercise induced asthma; zileuton: 5-lipoxygenase pathway inhibitor, blocks conversion of arachdonic acid to leukotriene

Question 7

Asthma drugs

• Beta 2 agonists: MOA; short vs long
• Inhaled corticosteroid: MOA; used for; also need
• Muscarinic antagonist: MOA; indications
• Anti-leukotrienes: montelukast - MOA, used for; zileuton - MOA
• Anti- IgE monoclonal therapy: MOA, used for
• Methylxanthines: MOA
• Chormones: MOA, indication
• Methacholine: MOA; used for

Answer 7

• beta 2: relaxes bronchial smooth muscle; can cause tremor or arrythmia; short - albuterol, long- salmeterol
• inhaled cortico: inhibit synthesis of all cytokines, inactivate NF-kappaB; 1st line for chronic asthma -> use a spaces or rinse mouth after use to prevent oral thrush
• muscarinic: competitively block muscarinic receptors, preventing bronchoconstriction; also used for COPD; tiotropium
• anti-leuko: montelukast: block leukotriene receptors, especially good for aspirin and exercise induced asthma; zileuton: 5-lipoxygenase pathway inhibitor, blocks conversion of arachdonic acid to leukotriene
• anti- IgE: binds unbound serum IgE and blocks binding to FceRI, used in allergic asthma w/ increased IgE levels resistant to inhaled steroids and long acting beta agonists; omalizumab
• methyl: inhibits phophodiesterase -> increases cAMP levels -> bronchodilation
• chor: prevents mast cell degranulation; prevents acute asthma symptoms; rarely used
• metha: nonselective muscarinic receptor agonist, used in bronchial challenge test to diagnose asthma