Resp drugs

Question 1

Palivizumab (mechanism and use)

Answer 1

Monoclonal Ab against F protein

Prevents pneumonia caused by RSV infection in premies

Question 2

Gemcitabine (mechanism and use)

Answer 2

EGFR inhibitor

For NSCLC harboring EGFR mutation (adenocarcinoma)

Question 3

Nitrites (mechanism and use)

Answer 3

Oxidizes Hb to methemoglobin, which binds cyanide

For cyanide poisoning

Question 4

Thiosulfate (mechanism and use)

Answer 4

Binds cyanide

For cyanide poisoning

Question 5

Methylene blue (use)

Answer 5

Treat methemoglobinemia

Question 6

1st generation H1 blockers (mechanism)

Answer 6

Names w/ “-en/-ine” or “-en/-ate” -> diphenhydramine, dimenhydrinate, chlorpheniramine, brompheniramine,
Others: hydroxyzine, promethazine
1st generation H1 blocker (reversible) -> considered REVERSE blockade b/c it works by increasing the proportion of inactive H1 receptors
Crosses BBB

Question 7

1st generation H1 blockers (3 uses)

Answer 7

Allergy
Motion sickness
Sleep aid

Question 8

1st generation H1 blockers (4 side effects)

Answer 8

Sedation (crosses BBB)
Antimuscarinic
Anti alpha adrenergic
Paradoxical rxn (increased HR, palpitations, hyperactivity)

Question 9

“-adine” + cetirizine (mechanism)

Answer 9

Loratadine, fexofenadine, desloratadine, cetirizine
2nd generation H1 blocker (reversible) -> considered REVERSE blockade b/c it works by increasing the proportion of inactive H1 receptors
Doesn’t cross BBB as well so less sedating than 1st gen

Question 10

“-adine” + cetirizine (use)

Answer 10

Allergy

Question 11

Guaifenesin (use)

Answer 11

Expectorant (thins resp secretions)

Doesn’t suppress cough reflex

Question 12

N-acetylcysteine (3 uses)

Answer 12

Expectorant (mucolytic; can help loosen mucous plugs in CF by cleaving disulfide bonds w/in glycoproteins)
Antidote for acetaminophen overdose
Prevent radiocontrast-induced nephropathy

Question 13

Dextromethorphan (mechanism)

Answer 13

Antagonizes NMDA receptors

Synthetic codein analog

Question 14

Dextromethorphan (use)

Answer 14

Antitussive

Question 15

Dextromethorphan (side effect)

Answer 15

Mild opioid effect when used in excess, mild abuse potential

Question 16

Dextromethorphan (antidote)

Answer 16

Naloxone

Question 17

Theophylline (mechanism)

Answer 17

A methylxanthine

Inhibits cAMP-specific phosphodiesterase (PDE) -> increased cAMP -> bronchodilation

Question 18

Theophylline (use and side effects)

Answer 18

Asthma drug
But usage limited b/c narrow therapeutic index (SEIZURES AND TACHYARRHYTHMIAS!) -> treat tachyarrhythmias w/ beta blockers, seizures w/ benzodiazepines and barbiturates
Blocks actions of adenosine (caffeine does the same thing)

Question 19

Theophylline (metabolism)

Answer 19

P-450

Question 20

“-asone” (mechanism)

Answer 20

Beclomethasone, fluticasone

Corticosteroids - inactivates NF-KB transcription factor -> inhibits synthesis of virtuall all cytokines

Question 21

“-asone” (use)

Answer 21

1st line for chronic asthma

Question 22

“-lukast” (mechanism)

Answer 22

Montelukast, zafirlukast -> “Lukas blocks receptors”

Blocks leukotriene receptors CysLT1

Question 23

“-lukast” (use)

Answer 23

Asthma (esp good for aspirin-induced asthma)

Question 24

Zileuton (mechanism)

Answer 24

Inhibits 5-lipoxygenase pathway -> can’t convert arachidonic acid to leukotrienes

Question 25

Zileuton (use)

Answer 25

Asthma

Question 26

Omalizumab (mechanism)

Answer 26

Monoclonal IgE Ab

Question 27

Omalizumab (use)

Answer 27

Allergic asthma resistant to inhaled steroids and long-acting B2 agonists

Question 28

Bosentan and other "-sentan" (mechanism)

Answer 28

Competitively inhibits endothelin-1 receptors -> decreased pulm vascular resistance

Question 29

Bosentan and other "-sentan" (use)

Answer 29

Pulm arterial HTN

Question 30

Cromolyn (mechanism and use)

Answer 30

``` Mast cell stabilizer Asthma controller (prophylaxis only, not for acute attacks) ```

Question 31

Nedocromil (mechanism and use)

Answer 31

``` Mast cell stabilizer Asthma controller (prophylaxis only, not for acute attacks) ```

Question 32

Flunisolide (mechanism and use)

Answer 32

Inhaled glucocorticoids | For asthma

Question 33

Flunisolide (side effects)

Answer 33

``` Oral candidiasis (so encourage good oral care) Dysphonia (myopathy of laryngeal muscles) Systemic side effects at higher dose: same as other glucocorticoids ```