Resp Pharm Flashcards
Beta 2 agonists used for asthma Tx
albuterol (short-acting), salmeterol, formoterol (long-acting)
What are the adverse effects of albuterol?
jitteriness and tachycardia
What beta 2 agonists are used for Tx of COPD?
Salmeterol and formoterol
What must be given with long-acting beta 2 agonists when used for asthma Tx?
inhaled corticosteroids
What are the adverse effects of salmeterol and formoterol?
tremor and arrhythmia
What inhaled corticosteroids are used for Tx of asthma?
Fluticasone, budesonide, beclomethasone
What muscarinic antagonists are used for the Tx of asthma? Which one is long-acting?
tiotropium, ipratropium
Tiotropium is long-acting
What antileukotrienes are used for the Tx of asthma?
Montelukast, zafirlukast, zileuton
How is the MOA different between montelukast and zileuton?
montelukast/zafirlukast - block leukotriene receptors (especially good for aspirin-induced and exercise-induced asthma)
Zileuton - inhibits 5-lipoxygenase, blocking the conversion of arachidonic acid to leukotries
What anti-IgE monoclonal therapy is used for the Tx of asthma?
omalizumab
What methylxanthine drug is used in the Tx of asthma?
theophylline
What is the MOA of theophylline?
causes bronchodilation by inhibiting phosphodiesterase -> increased cAMP levels due to decreased cAMP hydrolysis
What is the MOA of cromolyn?
prevents release of histamines from mast cells; prevents bronchoconstriction and inflammation
What expectorants are used in the Tx of obstructive lung Dz?
Guaifenesin and N-acetylcysteine
What is the MOA of guaifenesin?
thins respiratory secretions, does not suppress cough reflex
What is the MOA of N-acetylcysteine? What else can it be used for?
mucolytic - liquifies mucus in COPD/CF by disrupting disulfide bonds
Also used as an antidote for acetaminophen overdose
What is the MOA of dextromethorphan?
antitussive (antagonizes NMDA glutamate receptors); mild opioid effect when used in excess. Naloxone can be given for overdose. May cause serotonin syndrome when combined with other serotonergic agents.
Can cause constipation
What drugs are used for pulmonary hypertension?
Bosentan/Ambrisentan, Sildenafil, Epoprotenol/iloprost
What is the MOA of bosentan/ambrisentan? What are the AE?
competitively antagonize Endothelin-1 receptors -> decreased pulmonary vascular resistance. AE = hepatotoxic
What is the MOA of sildenafil? What else can it be used for? What meds are C/I with its use?
PDE5 inhibitor -> increase cGMP -> prolonged vasodilatory effect of NO.
Can also be used to treat erectile dysfunction
Nitroglycerin C/I
What is the MOA of epoprostenol/iloprost? What are the SE?
prostaglandins (PGI2) with direct vasodilatory effects on pulmonary and systemic arterial vascular beds (inhibit platelet aggregation). SE = flushing, jaw pain
Preventative inhaled treatment of choice for mild persistent asthma?
inhaled corticosteroids
Fluti Jason, budesonide, beclomethasone
Inhaled treatment of choice for acute exacerbations of asthma?
albuterol (short-acting beta agonist)
Narrow therapeutic index, drug of last resort for asthma
theophylline
Blocks conversion of arachidonic acid to leukotriene?
Zileuton
Inhibits mast cell release of mediators, used for prophylaxis only?
cromolyn
Inhale Treatment that blocks muscarinic receptors?
Tiotropium, Ipatropium
Inhaled long-acting beta2-agonist?
salmeterol, formoterol
Blocks leukotriene receptors?
Montelukast, Zafirlukast
Which medications if taken long term can resulting rebound nasal congestion?
Pseudoephedrine, phenylephrine
Pseudoephedrine/phenylephrine
alpha-adrenergic agonists, used as nasal decongestants
AE = HTN, rebound nasal congestion if used longer than 4-6 days
