Respiratory

Question 1

Diphenhydramine

Answer 1

1) Use: Allergy, motion sickness, sleep aid2) Class/MOA: H1 blockers 1st generation/ Reverisble inhibitors of H1 histamine receptors3) Side effects/ADEs: sedation, antimuscarinic, anti alpha andrenergic4) Fun Facts: Names contain “-en/-ine” or “-en/-ate”

Question 2

Loratadine

Answer 2

1) Use: Allergy2) Class/MOA: H1 blockers 2nd generation/reversible inhibitors of H1 histamine receptors3) Side effects/ADEs: Less sedating than 1st generation because of decreased entry into CNS4) Fun Facts: Name usually ends in “-adine”

Question 3

Albuterol

Answer 3

1) Use: Asthma, acute exacerbation2) Class/MOA: Beta 2 agonist, relaxes broncial smooth muscle

Question 4

Salmeterol, formoterol

Answer 4

1) Use: Asthma, prophylaxis2) Class/MOA: Beta 2 agonist, relaxes bronchial smooth muscle, long acting3) Tremor, arrhythmia

Question 5

Ipratropium, Tiotropium

Answer 5

1) Use: asthma, COPD2) Class/MOA: Long Acting muscarinic antagonist/ competeitve block of muscarinic receptors, prevents bronchoconstriction

Question 6

Beclomethasone, fluticasone

Answer 6

1) Use: 1st line for chronic asthma2) Class/MOA: Corticosteroid/ inhibits the synthesis of virtually all cytokines. Inactivates NFkB (transcription factor that induces production of TNF alpha and other inflammatory agents)4) Take a few hrs-days to kick in, used for “late relief” of an asthma attackRemember to rinse out mouth!! don’t want thrush - eww!

Question 7

Montelukast, zafirlukast

Answer 7

1) Use: Block Asthma, especially aspirin induced2) Antileukotrienes/block leukotriene receptor

Question 8

Zileuton

Answer 8

1) Use: Asthma2) Class/MOA: Antileukotrienes/5 lipoxygenase pathway inhibitor, blocks conversion of arachidonic acid to leukotrienes

Question 9

Omalizumab

Answer 9

1) Use: Allergic asthma resistant to inhaled steroid and long acting beta agonists2) Class/MOA: Monoclonal anti IgE antibody, binds mosly unbound serum IgE4) Shown to be effective in reducing dependency on oral/inhaled steroids

Question 10

Guaifenesin

Answer 10

1) Use: Expectorant2) Class/MOA: Thins respiratory secretions, doesn’t suppress cough reflex

Question 11

N-acetylcysteine

Answer 11

1) Use: Expectorant, CF patients, antidote for acetaminophen overdose2) Class/MOA: Mucolytic, loosen mucous plugs (CF patients)4) also antidote for acetaminophen OD

Question 12

Bosentan

Answer 12

1) Use: Pulmonary arterial hypertension2) Compeitively antagonizes endothelin 1 receptors, decreasing pulmonary vascular resistance4) Endothelin = vasoconstrictor, stimulant of endothelial proliferation

Question 13

Dextromethorphan

Answer 13

1) Use: antitussive=cough suppressant2) Class/MOA: Antagonizes NMDA glutamate recptors.3) Side effects/ADEs: Mild opioid effect when used in excess, mild abuse potential4) Fun Facts: Is a synthetic codeine analog. Naloxone can be given for overdose.

Question 14

Pseudoephedrine, phenylephrine

Answer 14

1) Use: Nonprescription nasal decongestants: Reduce hyperemia, edema and nasal congestion, obstructed eustachian tubes2) Class/MOA: Sympathomimetic alpha agonist3) Side effects/ADEs: Hypertension, CNS stimulation/anxiety (pseudoephedrine)

Question 15

Methacholine

Answer 15

1) Use: Asthma challenge testing2) Class/MOA: Muscarinic receptor agonist

Question 16

What is bronchoconstriction mediated by?

Answer 16

1 ) Inflammatory processes 2) prasympathetic tone so therapy is direct at these 2 pathways

Question 17

Dimenhydrinate

Answer 17

1) Use: Allergy, motion sickness, sleep aid2) Class/MOA: H1 blockers 1st generation/ Reverisble inhibitors of H1 histamine receptors3) Side effects/ADEs: sedation, antimuscarinic, anti alpha andrenergic4) Fun Facts: Names contain “-en/-ine” or “-en/-ate”

Question 18

Chlorpheniramine

Answer 18

1) Use: Allergy, motion sickness, sleep aid2) Class/MOA: H1 blockers 1st generation/ Reverisble inhibitors of H1 histamine receptors3) Side effects/ADEs: sedation, antimuscarinic, anti alpha andrenergic4) Fun Facts: Names contain “-en/-ine” or “-en/-ate”

Question 19

Fexofenadine

Answer 19

1) Use: Allergy2) Class/MOA: H1 blockers 2nd generation/reversible inhibitors of H1 histamine receptors3) Side effects/ADEs: Less sedating than 1st generation because of decreased entry into CNS4) Fun Facts: Name usually ends in “-adine”

Question 20

Desloratadine

Answer 20

1) Use: Allergy2) Class/MOA: H1 blockers 2nd generation/reversible inhibitors of H1 histamine receptors3) Side effects/ADEs: Less sedating than 1st generation because of decreased entry into CNS4) Fun Facts: Name usually ends in “-adine”

Question 21

Cetirizine

Answer 21

1) Use: Allergy2) Class/MOA: H1 blockers 2nd generation/reversible inhibitors of H1 histamine receptors3) Side effects/ADEs: Less sedating than 1st generation because of decreased entry into CNS4) Fun Facts: Name usually ends in “-adine”

Question 22

Theophylline

Answer 22

1) asthma2) Methylxanthine; inhibits phosphodiesterase –> incr cAMP –> bronchodilation3) Narrow therapeutic index: Cardiotox/arrhythmias, neurotox/seizures, abdml pain/vomiting4) metabolized by P450. Blocks actions of adenosine