Resp drugs Flashcards
Opioid Antitussive examples
Codeine
Opioid Antitussive uses
most effective antitussive for dry cough
Opioid Antitussive moa
Act in CNS to suppress cough
Opioid Antitussive roa
Oral
Opioid Antitussive ae
- CNS - sedation, confusion
- Respiratory depression - risk on overdose
- Abuse potential at high dose
Non-opioid Antitussive examples
Dextromethorphan
Diphenhydramine
Non-opioid Antitussive uses
Dextromethorphan:
most effective non-opioid antitussive for dry cough
Diphenhydramine:
dry cough
Non-opioid Antitussive moa
Dextromethorphan:
acts on CNS to suppress cough
Diphenhydramine:
anti-histamine with unknown moa
Non-opioid Antitussive roa
Oral
Non-opioid Antitussive ae
Dextromethorphan:
1. CNS - drowsiness, confusion, dizziness, insomnia, excitement, nervousness
2. GIT - nausea, vomiting, stomachache
3. Abuse potential at high dose but less risk of addiction than codeine
Diphenhydramine:
1. Sedative
2. Anticholinergic
Mucolytics examples
Acetylcysteine
Carbocisteine
Mucolytics uses
productive cough
Mucolytics moa
Free sulfhydryl group opens disulphide bonds in mucoproteins -> Lowers mucous viscosity
Mucolytics roa
Oral
Inhalation
Mucolytics ae
- Bronchospasm - Caution for asthma
- Anaphylactoid reactions - rash, hypotension, dyspnea, wheezing
- GI disturbance
Mucokinetic examples
Bromhexine
Mucokinetic uses
productive cough
Mucokinetic moa
- Promote mucous clearance
- Stimulate surfactant production
Mucokinetic ae
- Allergic reactions
- Cutaneous adverse effects
Mucoregulator examples
Ipratropium
Mucoregulator uses
severe cold
Mucoregulator moa
- Short-acting Muscarinic Receptor antagonist (SAMA)
- Block inflammation-induced parasympathetic cholinergic M3 receptor activation of submucosal glands/goblet cells
Mucoregulator roa
Intranasal
Mucoregulator ae
- Few ADR as little enters systemic circulation intranasally
- Unpleasant taste
- Dry mouth
Mast Cell Stabilizer examples
Cromoglicic Acid
Mast Cell Stabilizer uses
For severe cold symptoms
Mast Cell Stabilizer roa
- Intranasal
- Inhaled
Mast Cell Stabilizer moa
- Reduce Mast cell degranulation
- Secrete Annexin A1
Mast Cell Stabilizer ae
- Throat and nasal irritation, mouth dryness, cough
- Unpleasant/bitter taste
Beta2-Adrenoceptor Agonist examples
Non selective:
Epinephrine
Beta-2 selective:
Salbutamol (SABA)
Formoterol (LABA)
Salmeterol (LABA)
Beta2-Adrenoceptor Agonist uses
1st line bronchodilator for asthma
Beta2-Adrenoceptor Agonist moa
Airway smooth muscle relaxation -> bronchodilation
Beta2-Adrenoceptor Agonist roa
Epinephrine (IV/SC in emergency)
Salbutamol (Fast acting SABA: 2-3 hours) (Inhalation or IV in emergency)
Formoterol (Fast acting LABA: 12 hours) (Inhalation)
Salmeterol (Long acting LABA: 12 hours) (Inhalation)
Beta2-Adrenoceptor Agonist ae
- Tremor and muscle cramps
- Palpitations, tachycardia
- Beta-2 adrenoceptor tolerance - relievers may not work during attacks
Muscarinic Receptor Antagonist examples
Ipratropium Bromide
Tiotropium Bromide
Muscarinic Receptor Antagonist uses
1st line bronchodilator for COPD
Muscarinic Receptor Antagonist moa
Inhibit M3 receptor-mediated bronchoconstrictions
Muscarinic Receptor Antagonist roa
Inhalation
Ipratropium Bromide (SAMA)
Tiotropium Bromide (LAMA)
Muscarinic Receptor Antagonist ae
- Typical parasympatholytic effects - dry mouth, urinary retention
Methylxanthines uses
acute severe asthma or COPD
Methylxanthines examples
Theophylline
Methylxanthines moa
- Inhibits phosphodiesterases (PDEs)
- prevent breakdown of cAMP
- potentiates bronchodilation
Methylxanthines roa
- Oral-ER
- IV
Methylxanthines ae
- GI: Nausea, vomiting, anorexia, discomfort
- CNS: Nervousness, tremor, seizures, insomnia, anxiety
- Narrow therapeutic window
- Many DDIs: Caution for potential drug interactions
Leukotrine Receptor Antagonist examples
Montelukast
Leukotrine Receptor Antagonist uses
Adjunct therapy for mild to moderate asthma
Leukotrine Receptor Antagonist moa
Relax airways in mild asthma
Leukotrine Receptor Antagonist roa
Tablet
Leukotrine Receptor Antagonist ae
Not used alone as reliever to rescue asthma attack
Inhaled Corticosteroids (ICS) examples
Budesonide
Fluticasone
Ciclesonide
Inhaled Corticosteroids (ICS) uses
First line prophylactic for asthma and COPD treatment - anti-inflammatory!!!!
Inhaled Corticosteroids (ICS) moa
Reduce pro-inflammatory mediators in airways
Inhaled Corticosteroids (ICS) roa
- Inhalation
- IV in acute asthma attack
Inhaled Corticosteroids (ICS) ae
- Oropharyngeal Candidiasis
- Dysphonia
Expectorant examples
Guaifenesin
Expectorant uses
productive cough
Expectorant roa
oral
Expectorant moa
Produce more respiratory tract fluids to reduce viscosity of mucus secretions
Expectorant ae
GI disturbance, Nausea
Sympathomimetic Agents examples
Phenylephrine: Direct A-adrenoceptor Agonist:
Alpha-1 selective
Oxymetazoline: Direct A-adrenoceptor Agonist: Non-Selective
Naphazoline:Direct A-adrenoceptor Agonist: Non-Selective
Pseudoephedrine: Indirect rise in adrenaline release
Ephedrine:Indirect rise in adrenaline release
Sympathomimetic Agents uses
For cold:
Reduce inflammation and secretion of mucus
Sympathomimetic Agents moa
Vasoconstriction of nasal blood vessels
Sympathomimetic Agents roa
Phenylephrine: oral or intranasal
Oxymetazoline: Intranasal
Naphazoline: Intranasal
Pseudoephedrine: oral or intranasal
Ephedrine: Intranasal
Sympathomimetic Agents ae
- Rebound congestion
- CNS stimulation - Restlessness, tremors, irritability, anxiety, insomnia
- Dry mouth
Nasal Glucocorticoid examples
Fluticasone
Mometasone
Nasal Glucocorticoid uses
For cold: decrease mucus and congestion
Nasal Glucocorticoid moa
Anti-inflammation
Nasal Glucocorticoid roa
Intranasal
Nasal Glucocorticoid ae
Local mucosal dryness and irritation
what class of drug is Codeine
opioid antitussive
what class of drug is Salmeterol
Beta2-Adrenoceptor Agonist (LABA)
what class of drug is Fluticasone
Inhaled Corticosteroids (ICS)
Nasal Glucocorticoid
what class of drug is Guaifenesin
expectorant
what class of drug is Pseudoephedrine
Sympathomimetic Agents
what class of drug is Carbocisteine
mucolytic
what class of drug is Tiotropium Bromide
Muscarinic Receptor Antagonist (LAMA)
what class of drug is Cromoglicic Acid
mast cell stabiliser
what class of drug is Naphazoline
Sympathomimetic Agents
what class of drug is Dextromethorphan
non opioid antitussive
what class of drug is Epinephrine
Beta2-Adrenoceptor Agonist
what class of drug is Salbutamol
Beta2-Adrenoceptor Agonist (SABA)
what class of drug is Ciclesonide
Inhaled Corticosteroids (ICS)
what class of drug is Mometasone
Nasal Glucocorticoid
what class of drug is Ephedrine
Sympathomimetic Agents
what class of drug is Ipratropium
Mucoregulator
what class of drug is Acetylcysteine
Mucolytic
what class of drug is Montelukast
Leukotrine Receptor Antagonist
what class of drug is Phenylephrine
Sympathomimetic Agents
what class of drug is Bromhexine
Mucokinetic
what class of drug is Ipratropium Bromide
Muscarinic Receptor Antagonist (SAMA)
what class of drug is Budesonide
Inhaled Corticosteroids (ICS)
what class of drug is Oxymetazoline
Sympathomimetic Agents
what class of drug is Diphenhydramine
non opioid antitussive
what class of drug is Formoterol
Beta2-Adrenoceptor Agonist (LABA)
what class of drug is Theophylline
Methylxanthines