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Respiratory - Pharmacology > Resp Pharm > Flashcards

Resp Pharm Flashcards

1
Q

What is the mechanism of diphenhydramine, dimenhydrinate, chlorphiramine?

A

1st gen H1 blockers - reversible inhibitors of H1 histamine receptors (found in nasal/bronchioles).

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2
Q

What are the clinical uses of diphenhydramine, dimenhydrinate, chlorphiramine?

A

Allergy, motion sickness, sleep aid.

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3
Q

What are the toxicities of diphenhydramine, dimenhydrinate, chlorphiramine?

A

Sedation, also anti-muscarinic, anti-alphaadrenergic.

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4
Q

What is the mechanism of Loratadine, fexofenadine, desloratadine, cetirizine?

A

2nd gen H1 blockers - reversible inhibitors of H1 histamine receptors (found in nasal/bronchioles). Decreased entry into CNS.

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5
Q

What are the clinical uses for Loratadine, fexofenadine, desloratadine, cetirizine?

A

Allergy. Far less sedating than 1st generation because of decreased CNS penetration.

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6
Q

What is the mechanism of guaifenesin?

A

Expectorant. Thins respiratory secretions, does not suppress cough reflex.

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7
Q

What is the mechanism of N-acetylcysteine?

A

Mucolytic- can loosen CF plugs in CF patients by disrupting disulfide bonds. Also used as antidote for acetominophen overdose.

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8
Q

What is the mechanism of dextromethorphan?

A

Antitussive - antagonists NMDA glutamate receptors. Synthetic codeine analog.

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9
Q

What is the toxicity of dextromethorphan?

A

Mild opiod effect when used in excess. Mild abuse potential. Nalaxone for overdose. MAy cause serotonin syndrome if combined with other drugs.

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10
Q

What is the mechanism of Pseudoephedrine, phenylephrine?

A

α-adrenergic agonists, used as nasal decongestants.

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11
Q

What is the clinical use of Pseudoephedrine, phenylephrine?

A

Reduce hyperemia, edema, nasal congestion; open obstructed eustachian tubes. Pseudoephedrine
also illicitly used to make methamphetamine.

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12
Q

What is the toxicity of Pseudoephedrine, phenylephrine?

A

Hypertension. Can also cause CNS stimulation/anxiety (pseudoephedrine).

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13
Q

What is the mechanism of drugs such as bosentan?

A

Endothelin-1-receptor antagonists. Competitively antagonize endothelin-1 receptors Ž pulmonary vascular
resistance.

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14
Q

What is the toxicity of bosentan?

A

Hepatotoxic, monitor LFTs.

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15
Q

What is the mechanism of sildenafil?

A

PDE-5 inhibitors. Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide.

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16
Q

What is the clinical use of bosentan?

A

Pulmonary HTN

17
Q

What is the clinical use of sildenafil?

A

Pulmonary HTN, erectile dysfunction.

18
Q

What is the mechanism of epoprostenol, iloprost?

A

Prostacyclin analogs. PGI2 with with direct vasodilatory effects on pulmonary and systemic arterial vascular beds. Inhibit platelet aggregation.

19
Q

What is the clinical use of epoprostenol, iloprost?

A

Pulmonary HTN

20
Q

What is the toxicity of epoprostenol, iloprost?

A

Flushing, jaw pain.

21
Q

What is the mechanism of albuterol?

A

B2-agonist. Relaxes bronchial smooth muscle. Fast-acting.

22
Q

What is the clinical use of albuterol?

A

Used during acute asthma exacerbation.

23
Q

What is the mechanism of salmeterol, formoterol?

A

B2-agonists, long-acting agents for prophylaxis of asthma exacerbations.

24
Q

What is the toxicity of salmeterol, formoterol?

A

Tremor, arrythmia.

25
Q

What is the mechanism of action of fluticasone, budesonide?

A

Corticosteroids. budesonide—inhibit the synthesis of virtually all cytokines. Inactivate NF-κB, the
transcription factor that induces production of TNF-α and other inflammatory agents.

26
Q

What is the clinical use for fluticasone, budesonide?

A

First line therapy for chronic asthma.

27
Q

What is the mechanism of ipratropium/tiotropium?

A

Muscarinic antagonists. Competitively blocks muscarinic receptors, preventing bronchoconstriction. Tiotropium is long-acting.

28
Q

What is the clinical use for ipratropium/tiotropium?

A

Asthma, COPD.

29
Q

What is the mechanism of Montelukast, zafirlukast

A

Antileukotrienes. —block leukotriene
receptors (CysLT1). Especially good for
aspirin-induced asthma.

30
Q

What is the mechanism of Zileuton?

A

Antileukotrienes. 5-lipoxygenase pathway inhibitor.
Blocks conversion of arachidonic acid to
leukotrienes..

31
Q

What is the toxicity of Zileuton?

A

Hepatotoxic

32
Q

What is the mechanism of omalizumab?

A

Monoclonal anti-IgE antibody. Binds mostly
unbound serum IgE and blocks binding to
FcεRI..

33
Q

What is the clinical use of omalizumab?

A

Used in allergic asthma resistant to
inhaled steroids and long-acting β2
-agonists.

34
Q

What is the mechanism of theophylline?

A

Methylxanthine. Theophylline—likely causes bronchodilation by inhibiting phosphodiesterase. Blocks adenosine (which increases bronchoconstriction). Ž Decr cAMP levels due to  cAMP hydrolysis.

35
Q

What is the clinical use and toxicity of theophylline?

A

Usage is limited because of narrow therapeutic index
(cardiotoxicity, neurotoxicity); metabolized
by cytochrome P-450.

36
Q

What is the mechanism of methacholine?

A

Muscarinic receptor (M3) agonist.

37
Q

What is the clinical use of methacholine?

A

Used in bronchial challenge test to help diagnose asthma.

Respiratory - Pharmacology (1 decks)

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