Resp Drugs Flashcards
Diphenhydramine, Chlorpheniramine
1st generation H1 blockers - reversible
Use: Allergy, motion sickness, sleep aid
Tox: Sedation, anti-muscarinic, anti-alpha-adrenergic
Loratadine, fexofenadine, deloratidine, cetirizine
-adines
2nd generation H1 blockers - reversible
Use: Allergy
Tox: less sedating than 1st generation due to decreased entry into CNS
Guaifenesin
Expectorant - thins resp secretions; does not suppress cough reflex
N-acetylcysteine
Mucolytic - loosen mucous plugs in CF patients; disrupts disulfide bonds
Also antidote for acetaminophen overdose
Dextromethorphan
Antitussive (relieve cough) Antagonizes NMDA glutamate receptors Codeine analog Opiod effect if excess; Naloxone for opioid overdose Can cause Serotonin syndrome
Pseudophedrine, phenylephrine
Alpha adrenergic agonists - nasal decongestant
Use: reduce hyperemia, edema, nasal congestion;
open obstructed eustachian tubes
(psuedo used to make meth)
Tox: HTN, CNS stimulation/anxiety
Bosentan
Pulmonary hypertension drug
Endothelin receptor antagonists -> decrease pulmonary vascular resistance
Sildenafil
Pulmonary HTN drug
PDE5 inhibitor
cGMP PDE5 inhibitor; Prolong Vasodilator effect of NO
Also used to treat Erectile Dysfunction
Epoprostenol, Iloprost
Prostacyclin analog (PGI2) - vasodilators
direct pulmonary vasodilator and on systemic arteries
Inhibits platelet aggregation
Tox: Flushing, jaw pain
Asthma drug targets
Bronchoconstriction mediated by
1) inflammatory process
2) parasympathetic tone (Ach) -> bronchoconstriction
Albuterol
short acting B2 agonist; relaxes bronchial smooth muscle
Use: Acute exacerbation
Salmeterol, formoterol
Long acting B2 agonist
Use: prophylaxis
Tox: tremors, arrhythmia
Fluticasone, budenoside
Corticosteroids
Inhibit Cytokine synthesis: inactivate NF-kB (Trxn factor) that induce TNF-alpha and other inflammatory agents
Use: 1st line for chronic asthma
Ipratropium
Muscarinic antagonist (blocks Ach receptors) -> prevents bronchoconstriction
Use: Asthma. also for COPD
Montelukast, Zafirlukast
Antileukotriene
Leukotrience receptor blocker
Use: esp for Aspirin induced asthma
Zileuton
Antileukotriene
Moa: 5-lipoxygenase pathway inhibitor; Blocks conversion of Arachidonic acid to leukotrienes
Use: Asthma
Tox: Hepatotoxicity
Omalizumab
Monoclonal anti-IgE antibody
BInds IgE on mast cells and unbound IgE
Use: Allergic asthma RESISTANT to inhaled steroids and long acting Beta agonists
Theophylline
Methylxanthines
Bronchodilation by Inhibiting PDE -> increase cAMP
(PDE hydrolyzes cAMP)
Also blocks Adenosine (induces bronchoconstriction)
Use: limited due to narrow therapeutic index - causes cardio and neurotoxicity
Metabolized by CytP450
Methacholine
M3 agonist
Bronchial challenge test - diagnose asthma
