Pulmonary Pharmacology Flashcards by Jacquelyn Haines

Q

Cholinergic Input

A

Stim. muscarinic receptor ^ activity of guanyl cyclase > conversion of GTP to cyclic GMP.
Cyclic GMP > BRONCHOCONSTRICTION.
Cyclic GMP broken down by phosphodiesterase

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Q

SNS Beta2 input

A

Stim. Beta2 receptor ^ activity of adenyl cyclase > conversion of ATP to cyclic AMP.
Cyclic AMP (second messenger) ^ activity of protein kinase > inhibits smooth muscle contraction > BRONCHODILATION.
Cyclic AMP broken down by phosphodiesterase

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Q

SNS Alpha input

A

Stim. Alpha1 receptor > decrease cyclic AMP > BRONCHOCONSTRICTION (in diseased lungs only)

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Q

Histamine
Heparin
Tryplase

A

Allergen induced Mediators of BRONCHOCONSTRICTION

Immediate to 5 min. response

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Q

Arachidonic Acid producing Leukotriente-D4 and Prodstaglandin-D2

A

Allergen induced Mediators of BRONCHOCONSTRICTION

5-30 min. response

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Q

TNF-alpha and IL-4

A

Allergen induced Mediators of BRONCHOCONSTRICTION

Hours to respond

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Q

Albuterol (Salbutamol (INN), Proventil, Ventolin)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Fast acting - “rescue drug”

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Q

Terbutaline (Brethine, Brethine tablet)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Short acting

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Q

Salmeterol (Serevent)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Long acting

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Q

Formoterol (Oxeze, Foradil)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Long acting

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Q

Itolterol (Tornalate)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Long acting

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Q

Metaproterenol (Alupent)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Long acting

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Q

Pirbuterol (Maxair)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
Selective
Long acting

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Q

Ephedrine (alpha-mild activity, beta1-mod. activity, beta2- more activity)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
NON-selective

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Q

Epinephrine or Adrenaline (alpha-mod. activity, beta1-storng activity, beat2-mod. activity)

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
NON-selective

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Q

Isoproterenol (Isuprel) - beta1, beta2

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
NON-selective

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Q

Ethylnorepinephrine - beat1, beta2

A

Bronchodilator
Sympathomimetic (Beta2 agonist)
NON-selective

Q

Side effects of selective drugs

A

Nervousness
Headaches
Tremors

Q

Side effects of NON-selective drugs

A

Nervousness, Headaches, Tremors
Results of beta stim.: tachycardia, angina, cardiac dysrhythmias
Results of alpha stim.: peripheral vasoconstriction

Q

Phentolamine

A

Bronchodilator
Sympatholytic (Alpha agonist)
Bronchconstriction by blocking alpha receptors

Q

Ipratropium (Atrovent)

A

Bronchodilator
Parasympatholytic (anti-cholingergics)
Blocks cholinergic receptor - causes BRONCHODILATION

Q

Aiminophylline

A

Bronchodilator
Methylxanthine
BRONCHODILATION

Q

Theophylline (Theo-dur)

A

Bronchodilator
Methylxanthine
BRONCHODILATION

Q

Side effects of Methylxanthines

A

Can be serious or life threatening
Therapeutic levels: 10-20mg/ml
Toxic level: 15-20mg/ml
Plasma levels are monitored closely

Q

Signs of toxicity

A

Cardiac arrhythmias
Seizures (late signs)
Nausea, restlessness, irritability, confusion (early signs)

Q

Beclomethasone (Beclovent, Vanceril)

A

Anti-inflammatory
Corticosteroid
Inhaled

Q

Dexamethasone (Decadron)

A

Anti-inflammatory
Corticosteroid
Inhaled

Q

Flunisolide (AeroBid)

A

Anti-inflammatory
Corticosteroid
Inhaled

Q

Methylprednisolone (Medrol)

A

Anti-inflammatory
Corticosteroid
IV

Q

Prednisolone

A

Anti-inflammatory
Corticosteroid
IV or IM

Q

Predisone

A

Anti-inflammatory
Corticosteroid
Oral

Q

Triamcinolone (Azmacort)

A

Anti-inflammatory
Corticosteroid
Inhailed

Q

Triamcinolone (Azmacort)

A

Anti-inflammatory
Corticosteroid
Inhaled

Q

Side effects of anti-inflammatory corticosteroids

A

Osteoporosis
Muscle wasting
Skin breakdown
Hyperglycemia
Cataracts

Q

Cromolyn sodium (Intal)

A

Anti-inflammartory
Prevention drug
Inhaled
S.E.: Irritation of nasal and upper respiratory passages

Q

Nedocromil sodium

A

Anti-inflammartory
Prevention drug
S.E.: Irritation of nasal and upper respiratory passages

Q

Montelukast (Singular)

A

Anti-inflammatory
Leukotriene receptor antagonist
No S.E. > often used in children

Q

Zafirlukast (Acculate)

A

Anti-inflammatory
Leukotriene receptor antagonist
No S.E. > often used in childre

Q

Zileuton (Zyflo)

A

Anti-inflammatory
Leukotriene synthesis inhibitor
No S.E. > often used in childre

Q

N-acetylcysteine (Mucomyst)

A

Mucolytic
Thin secretions by breaking disulfide bonds of mucus
Smells like rotten eggs