Pulmonary

Question 1

H1-blockers (first generation)

Answer 1

1) Diphenhydramine, dimenhydrinate, chlorpheniramine
2) Used for allergy, motion sickness, sleep aid
3) Causes sedation, anti-muscarinic effects, anti-alpha effects

Question 2

H1-blockers (second generation)

Answer 2

1) Loratadine, fexofenadine, desloratadine, cetirizine
2) Used for allergy
3) Far less sedating than first generation because of decreased CNS entry

Question 3

Long acting beta-2 agonists

Answer 3

1) Salmeterol, formoterol
2) Asthma prophylaxis
3) Cases tremors and arrhythmias

Question 4

Theophylline

Answer 4

1) PDE-I -> increases cAMP
2) Cardiotoxic and neurotoxic
3) Metabolized by p450
4) Blocks action of adenosine

Question 5

Ipratropium

Answer 5

1) Competitive block of muscarinic receptors -> prevents bronchoconstriction
2) Tiotropium can be used for COPD; ipratropium used for asthma

Question 6

Beclomethasone; fluticasone

Answer 6

1) Corticosteroids that are used first line for chronic asthma
2) Inactivate NF-kB which blocks TNF-alpha production

Question 7

Montelukast; zafirlukast

Answer 7

1) Block leukotriene receptors

2) Good for aspirin-induced asthma

Question 8

Zileuton

Answer 8

Asthma medication which inhibits 5-lipooxygenase -> blocks conversation of arachidonic acid to leukotrienes

Question 9

Omalizumab

Answer 9

Monoclonal anti-IgE antibody which is used in allergic asthma resistant to inhaled steroids and long-acting beta-2 agonists.

Question 10

Guaifenesin

Answer 10

Expectorant which thins respiratory secretions and does not suppress cough reflex

Question 11

Dextromethorphan

Answer 11

1) Antitussive which antagonizes NMDA glutamate receptors

2) Synthetic codeine analog which can have opioid effects -> abuse/ overdose potential

Question 12

Pseudoephedrine; phenylephedrine

Answer 12

1) Sympathomimetic alpha-agonist
2) Reduces edema and nasal congestion; can open obstructed eustation tubes
3) Causes HTN and anxiety