Pulm pharmacology

Question 1

List three first generation antihistamines

Answer 1

Diphenhydramine, Dimenhydrinate, Chlorpheniramine

Question 2

What is the mechanism of first generation antihistamines?

Answer 2

reversibly inhibit H1 histamine receptors

Question 3

What is the clinical us of first generation antihistamines?

Answer 3

Allergy, motion sickness, sleep aid

Question 4

Adverse effects of first generation antihistamines

Answer 4

Sedation, antimuscarinic, anti-alpha-adrenergic

Question 5

Name 4 second generation antihistamines

Answer 5

Loratadine, fexofenadine, desloratadine, ceterizine

Question 6

What are second generation antihistamines used for?

Answer 6

Allergies

Question 7

How are second generation antihistamines better than first generation?

Answer 7

Less sedating due to decreased entry into CNS

Question 8

What is Guaifenesin used for?

Answer 8

Expectorant: thins respiratory secretions (breaks down mucus)

Question 9

What is N-acetylcysteine used for? (2 things)

Answer 9

breaks down mucus in COPD patients by disrupting disulfide bonds; acetominophen overdose antidote

Question 10

Use and mechanism of dextromorphan

Answer 10

Antitussive (antagonizes NMDA glutamate receptors to suppress cough); mid opioid effect in excess

Question 11

What is the mechanism for pseudoephedrine and phenylephrine?

Answer 11

alpha-adrenergic agonists

Question 12

What is the clinical use for pseudophedrine and phenylephrine?

Answer 12

Reduce hyperemia, edema and nasal congestion

Question 13

Adverse effects of pseudophedrine and phenylephrine

Answer 13

Hypertension, anxiety

Question 14

How does Bosentan treat pulmonary hypertension ?

Answer 14

Competitively antagonizes endothelin 1 receptor to decrease pulmonary resistance

Question 15

Adverse effect of Bosentan

Answer 15

Hepatotoxicity (monitor LFTs)

Question 16

How does Sildenafil treat Pulm hypertension?

Answer 16

Inhibit cGMP PDE-5 and prolong vasodilatory effect of NO (

Question 17

What other condition is Sildenafil used for?

Answer 17

Erectile dysfunction

Question 18

How do Epoprostenol and Iloprost treat pulmonary hypertension

Answer 18

PGI2; direct vasodilatory effects on pulmonary and systemic arterial beds; inhibit platelet aggregation

Question 19

Side effects of epoprostenol and iloprost

Answer 19

flushing, jaw pain

Question 20

Which medication is used in acute exacerbation/shortness of breath due to asthma?

Answer 20

Albuterol (beta2-agonist)

Question 21

How do beta 2 agonists relax bronchial smooth muscles?

Answer 21

Gs–> adenylate cyclase–> cAMP

Question 22

What are Salmeterol and Formoterol used for?

Answer 22

long-acting agents for prophylaxis

Question 23

Adverse effects of salmeterol and formoterol

Answer 23

Tremor and arrhythmia

Question 24

Name two inhaled corticosteroids

Answer 24

Fluticasone and budesonide

Question 25

What is the mechanism of inhaled corticosteroids

Answer 25

Inhibit synthesis of cytokines by inactivating NF-kappaB

Question 26

What is the clinical use of fluticasone and budesonide?

Answer 26

First-line tx for chronic asthma

Question 27

What is the mechanism and clinical use of Ipratropium?

Answer 27

Competitive muscarinic antagonist that prevents bronchoconstriction; COPD

Question 28

What is the long-acting muscarinic antagonist used to treat COPD?

Answer 28

Tiotropium

Question 29

Name the best treatment for aspirin-induced asthma

Answer 29

Montelukast, Zafirlukast (block CysLT1 recetpors)

Question 30

What is the mechanism of Zileuton

Answer 30

5-lipooxygenase inhibitor to block conversion of arachidonic acid to leukotrienes

Question 31

Adverse effect of Zileuton

Answer 31

Hepatotoxic (monitor LFTs)

Question 32

What is Omalizumab used for

Answer 32

Steroid and b2-restistant allergic asthma

Question 33

Mechanism of Omalizumab

Answer 33

binds serum IgE and blocks binding to FceRI

Question 34

Name a methylxanthine

Answer 34

Theophylline

Question 35

Mechanism of Theophylline

Answer 35

Inhibits phosphodiesterase to increase cAMP; causes bronchodilation

Question 36

Adverse effects of Theophylline

Answer 36

Cardiotoxic (arrhythmias), Neurotoxic (seizures, irritation, confusion, tremor), metabolized by P450, blocks actions of adenosine

Question 37

What is the use of Methacholine

Answer 37

M3 agonist, used in bronchial challenge test to diagnose asthma

Question 38

Which drug is used to assist with smoking cessation

Answer 38

Verenicline

Question 39

What is Varenicline's mechanism

Answer 39

Partial agonist for alpha4beta2 nicotinic acetylcholine receptors in CNS

Question 40

How does Varenecline help with smoking cessation

Answer 40

Reduces withdrawal cravings and rewarding effects of nicotine

Question 41

What are the cancer markers for small cell carcinoma?

Answer 41

NCAM (CD56), enolase, chromogranin, and synaptophysi

Question 42

Expression of mucin and mutations in EGF and KRAS genes are characteristic of

Answer 42

non-small cell carcinomas

Question 43

What are the therapeutic effects of Bosentan?

Answer 43

Reduce pulmonary arterial pressure and lessen progression of vascular and RVH

Question 44

Sleep apnea with loud snoring and gasping respirations indicative of oropharyngeal dysfunction can improve with stimulation of which nerve

Answer 44

Hypoglossal

Question 45

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

Answer 45

Corticosteroids