Resp Pharm

Question 1

Diphenhydramine

Answer 1

1st gen H1 blocker

Uses: Allergy, motion sickness, sleep aid

Toxicity: Sedation, anti-muscarinic, anti-@-adrenergic

Question 2

Dimenhydrinate

Answer 2

1st gen H1 blocker

Uses: Allergy, motion sickness, sleep aid

Toxicity: Sedation, anti-muscarinic, anti-@-adrenergic

Question 3

Chlorpheniramine

Answer 3

1st gen H1 blocker

Uses: Allergy, motion sickness, sleep aid

Toxicity: Sedation, anti-muscarinic, anti-@-adrenergic

Question 4

Loratadine

Answer 4

2nd gen H1 blocker

Uses: Allergy

Toxicity: Far less sedating than 1st gen b/c of dec’d entry into CNS

Question 5

Fexofenadine

Answer 5

2nd gen H1 blocker

Uses: Allergy

Toxicity: Far less sedating than 1st gen b/c of dec’d entry into CNS

Question 6

Desloratadine

Answer 6

2nd gen H1 blocker

Uses: Allergy

Toxicity: Far less sedating than 1st gen b/c of dec’d entry into CNS

Question 7

Cetirizine

Answer 7

2nd gen H1 blocker

Uses: Allergy

Toxicity: Far less sedating than 1st gen b/c of dec’d entry into CNS

Question 8

Drugs for Asthma

Answer 8

Drugs for Asthma

Isoproterenol
Albuterol
Salmeterol
Theophylline
Ipratropium
Cromolyn
Beclomethasone
Prednisone
Zileuton
Zafirlukast
Montelukast

Question 9

Formoterol

Answer 9

Asthma

• beta-2 agonist, relaxes smooth muscle
• long-acting agent for prophylaxis
• adverse effects: tremor, arrhythmia

Question 10

Albuterol

Answer 10

Asthma

• beta-2 agonist
• relaxes bronchial smooth muscle
• use for acute exacerbation

Question 11

Salmeterol

Answer 11

Asthma

• beta-2 agonist, relaxes smooth muscle
• long-acting agent for prophylaxis
• adverse effects: tremor, arrhythmia

Question 12

Theophylline

Answer 12

Asthma
(methylxanthines)

Use: Bronchodilation, likely by inhibiting Phosphodiesterase, decreasing cAMP hydrolysis
- Blocks actions of adenosine

Toxicity: Seizures, Tachyarrhythmias
(Antidote = β-blockers)
*limited use due to narrow TI

Question 13

Ipratroprium

Answer 13

Asthma
(muscarinic antagonist)

• competitive block of muscarinic receptors
• prevents bronchoconstriction
• used for COPD
  (Tiotropium also used for COPD & is longer-acting)

Question 14

Omalizumab

Answer 14

Monoclonal anti-IgE antibody

• Binds mostly unbound serum IgE
• Used in allergic asthma resistant to inhaled steroids & long-acting β2-agonists

Question 15

Beclomethasone / Fluticasone

Answer 15

Asthma
(corticosteroids)

• inhibit synthesis of virtually all cytokines
• inactivate NF-kappaB (transcirption factor that induces TNF-alpha)
• 1st line therapy for chronic asthma

Question 16

Zileuton

Answer 16

Asthma
(antileukotriene)

• 5 lipoxygenase pathway inhibitor
• block conversion of arachidonic acid to leukotrienes

Question 17

Zafirlukast, montelukast

Answer 17

Asthma
(antileukotrienes)

• block leukotriene receptors
• especially good for aspirin induced asthma

Question 18

Gauifenesin

Answer 18

Expectorant

• Thins respiratory secretions
• Does not suppress cough reflex

Question 19

N-acetylcysteine

Answer 19

Mucolytic

Expectorant

• Can loosen mucous plugs in CF pts
• Also used as antidote in acetominophen OD

Question 20

Bosentan

Answer 20

Tx plumonary arterial hypertension

• Competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance

Question 21

Dextromethorphan

Answer 21

Antitussive

• Antagonizes NMDA glutamate receptors
• Synthetic codeine analog
• Mild opioid effect when used in excess
• Naloxone for OD
• Mild abuse potential

Question 22

Pseudoephedrine, phenylephrine

Answer 22

MOA: Sympathomimetic α-agonist non-prescription nasal decongestants

Use:

• reduces hyperemia, edema, & nasal congestion
• opens obstructed eustachian tubes
• pseudoephedrine also as a stimulant

Toxicity:

• Hypertension
• CNS stimulation/anxiety (Pseudoephedrine)

Question 23

Methacholine

Answer 23

Muscarinic receptor agonist

Asthma challenge testing