Respi

Question 1

Albuterol

[MOA, clinical use]

Answer 1

B2-agonist, for Asthma.
Relaxes bronchial smooth muscles (B2).
For acute exacerbation (fast onset, short duration).

Question 2

Salmeterol, Formoterol

[MOA, clinical use]

Answer 2

B2-agonist, for Asthma.
Bronchodilation.
Long-acting, for prophylaxis (slow onset, long duration).

Question 3

Fluticasone, Budesonide

[MOA, clinical use]

Answer 3

Corticosteroids.
1st line: chronic asthma.
Inhibit cytokine synthesis; inactivates NF-KB (transcription factor for TNF-a).
Anti-inflammation, bronchodilator.

Question 4

Ipratropium

[MOA, clinical use]

Answer 4

Muscarinic antagonist (bronchodilator).
Prevents bronchoconstriction.
For Asthma, COPD.

Question 5

Montelukast, Zafirlukast

[MOA, clinical use]

Answer 5

Antileukotrienes, block leukotriene receptors.
Esp. good for aspirin-induced asthma.
Monitor liver enzymes (inc.).

Question 6

Zileuton

[MOA, clinical use, toxicity]

Answer 6

> 5-lipoxygenase path inhibitor (rate-limiting enzyme) – Blocks conversion of arachidonic acid to leukotrienes.
For anti-inflammation in Asthma.
Hepatotoxic.

Question 7

Theophylline

[MOA, clinical use, Toxicity]

Answer 7

Methylxanthine.
>Inhibits phosphodiesterase – dec. cAMP hydrolysis – inc. cAMP.
>For bronchodilation in asthma, COPD.
>Limited use: Cardiotoxic, neurotoxic (permeable to all tissues).

Question 8

1st gen H1 blockers

Drug names

Answer 8

Diphenhydramine
Dimenhydrinate
Chlorpheniramine

Question 9

1st gen H1 blockers

MOA

Answer 9

Reversibly inhibits H1 receptors.

Dec. parasympathetic tone of arterioles.

Question 10

1st gen H1 blockers

Clinical use

Answer 10

Allergy, motion sickness, sleep aid

Question 11

1st gen H1 blockers

Toxicity

Answer 11

Sedation (CNS depressant).

Anticholinergic, antiemetic (antimuscarinic, anti-alpha-adrenergic).

Question 12

2nd gen H1 blocker

Drug names

Answer 12

Loratidine, fexofenadine, desloratidine, cetirizine

Question 13

2nd gen H1 blockers

MOA

Answer 13

Reversibly inhibits H1 receptors.

Dec. parasympathetic tone of arterioles

Question 14

2nd gen H1 blockers

Clinical use

Answer 14

Allergy

Question 15

Guaifenesin

[MOA, clinical use]

Answer 15

Expectorant.
Thins respi secretions; less viscous mucus.
Doesn’t suppress cough reflex.

Question 16

N-acetylcysteine

[MOA, clinical use, antidote for what]

Answer 16

Mucolytic.
>Loosens mucus plugs by breaking disulfide bonds (in CF pts); lessens viscosity.
>Antidote: acetaminophen overdose.

Question 17

Dextromethorphan

[MOA, clinical use, toxicity]

Answer 17

Antitussive.
Codeine analog, mild opioid – Naloxone for overdose.
Antagonizes NMDA glutamate receptors.
May cause serotonin syndrome.

Question 18

Pseudoephedrine, Phenylephrine

MOA

Answer 18

alpha-adrenergic agonists.

Dec. airway resistance – vasoconstriction in nasal passages.

Question 19

Pseudoephedrine, Phenylephrine

Clinical use

Answer 19

Nasal decongestant.

Reduce hyperemia, edema, nasal congestion.

Question 20

Pseudoephedrine, Phenylephrine

Toxicity

Answer 20

HTN

CNS stimulation/anxiety (pseudoephedrine)

Question 21

Omalizumab

[MOA, clinical use]

Answer 21

Monoclonal anti-IgE antibody.
Binds to unbound IgE; blocks IgE binding to mast cells and basophils – lowers free serum IgE.
For allergic asthma resistant to inhaled steroids and B2-agonists.

Question 22

Bosentan

[MOA, clinical use, SE]

Answer 22

> Antagonizes endothelin-1 receptors to dec. pulmo vasculature resistance.
For Pulmonary HTN.
Hepatotoxic (monitor LFTs)

Question 23

Sildenafil

[MOA, clinical use]

Answer 23

> PDE-5 inhibitor – inc. cGMP, prolongs vasodilatory effect of NO.
For pulmonary HTN, erectile dysfunction.