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USMLE > Pulm pharmacology > Flashcards

Pulm pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

List three first generation antihistamines

A

Diphenhydramine, Dimenhydrinate, Chlorpheniramine

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2
Q

What is the mechanism of first generation antihistamines?

A

reversibly inhibit H1 histamine receptors

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3
Q

What is the clinical us of first generation antihistamines?

A

Allergy, motion sickness, sleep aid

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4
Q

Adverse effects of first generation antihistamines

A

Sedation, antimuscarinic, anti-alpha-adrenergic

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5
Q

Name 4 second generation antihistamines

A

Loratadine, fexofenadine, desloratadine, ceterizine

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6
Q

What are second generation antihistamines used for?

A

Allergies

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7
Q

How are second generation antihistamines better than first generation?

A

Less sedating due to decreased entry into CNS

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8
Q

What is Guaifenesin used for?

A

Expectorant: thins respiratory secretions (breaks down mucus)

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9
Q

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

A

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

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10
Q

Use and mechanism of dextromorphan

A

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

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11
Q

What is the mechanism for pseudoephedrine and phenylephrine?

A

alpha-adrenergic agonists

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12
Q

What is the clinical use for pseudophedrine and phenylephrine?

A

Reduce hyperemia, edema and nasal congestion

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13
Q

Adverse effects of pseudophedrine and phenylephrine

A

Hypertension, anxiety

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14
Q

How does Bosentan treat pulmonary hypertension ?

A

Competitively antagonizes endothelin 1 receptor to decrease pulmonary resistance

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15
Q

Adverse effect of Bosentan

A

Hepatotoxicity (monitor LFTs)

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16
Q

How does Sildenafil treat Pulm hypertension?

A

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

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17
Q

What other condition is Sildenafil used for?

A

Erectile dysfunction

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18
Q

How do Epoprostenol and Iloprost treat pulmonary hypertension

A

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

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19
Q

Side effects of epoprostenol and iloprost

A

flushing, jaw pain

20
Q

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

A

Albuterol (beta2-agonist)

21
Q

How do beta 2 agonists relax bronchial smooth muscles?

A

Gs–> adenylate cyclase–> cAMP

22
Q

What are Salmeterol and Formoterol used for?

A

long-acting agents for prophylaxis

23
Q

Adverse effects of salmeterol and formoterol

A

Tremor and arrhythmia

24
Q

Name two inhaled corticosteroids

A

Fluticasone and budesonide

25
Q

What is the mechanism of inhaled corticosteroids

A

Inhibit synthesis of cytokines by inactivating NF-kappaB

26
Q

What is the clinical use of fluticasone and budesonide?

A

First-line tx for chronic asthma

27
Q

What is the mechanism and clinical use of Ipratropium?

A

Competitive muscarinic antagonist that prevents bronchoconstriction; COPD

28
Q

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

A

Tiotropium

29
Q

Name the best treatment for aspirin-induced asthma

A

Montelukast, Zafirlukast (block CysLT1 recetpors)

30
Q

What is the mechanism of Zileuton

A

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

31
Q

Adverse effect of Zileuton

A

Hepatotoxic (monitor LFTs)

32
Q

What is Omalizumab used for

A

Steroid and b2-restistant allergic asthma

33
Q

Mechanism of Omalizumab

A

binds serum IgE and blocks binding to FceRI

34
Q

Name a methylxanthine

A

Theophylline

35
Q

Mechanism of Theophylline

A

Inhibits phosphodiesterase to increase cAMP; causes bronchodilation

36
Q

Adverse effects of Theophylline

A

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

37
Q

What is the use of Methacholine

A

M3 agonist, used in bronchial challenge test to diagnose asthma

38
Q

Which drug is used to assist with smoking cessation

A

Verenicline

39
Q

What is Varenicline’s mechanism

A

Partial agonist for alpha4beta2 nicotinic acetylcholine receptors in CNS

40
Q

How does Varenecline help with smoking cessation

A

Reduces withdrawal cravings and rewarding effects of nicotine

41
Q

What are the cancer markers for small cell carcinoma?

A

NCAM (CD56), enolase, chromogranin, and synaptophysi

42
Q

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

A

non-small cell carcinomas

43
Q

What are the therapeutic effects of Bosentan?

A

Reduce pulmonary arterial pressure and lessen progression of vascular and RVH

44
Q

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

A

Hypoglossal

45
Q

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

A

Corticosteroids

USMLE (36 decks)

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