RESPIRATORY Flashcards
What is the MOA of theophylline? What cardiac drug does it block the effect of?
bronchodilation by inhibiting phosphodiesterase and increasing cAMP by decreasing its breakdown; adenosine
What is the MOA for omalizumab?
monoclonal anti-IgE antibody
What kind of drug is chlorpheneramine?
First Generation antihistamine
Salmeterol and formeterol are long acting beta 2 agonists with these 2 AE’s:
tremor and arrhythmia
Why are montelukast and zafirlukast the best drugs for aspirin induced asthma?
Because in ASA-induced asthma, all of the arachidonic metabolites have been shunted into leukotriene synthesis since COX is blocked, since these drugs inhibit leukotrine receptors they will alleviate the effects
Why are second generation antihistamines less sedating than first generation?
Don?t cross the BBB
Which drug is used as muscarinic AGONIST in the asthma challenge test?
methacholine
Which respiratory drug is a person most likely to attempt to get high off of?
dextromethorphan
What is the MOA of methacholine?
Muscarinic agonist used in asthma challenge test
What drugs can be used to open obstructed eustachian tubes
pseudoephedrine and phenylephrine
What is the MOA of montelukast and zafirlukast?
block leukotriene receptors
Which drug is a methylxanthine and produces bronchodilation?
theophylline
Name 2 alpha agonist alpha-agonists used for colds
pseudoephedrine and phenylephrine
Name 3 second generation antihistamines
loratidine, fexofenadine, cetirizine
Which drugs block leukotriene receptors?
zafirlukast and montelukast
What drug is a monoclonal anti-IgE antibody?
omalizumab–binds mostly to the UNBOUND serum IgE
When is omalizumab indicated?
In chronic asthma that is REFRACTORY to inhaled steroids (beclamethasone, fluticasone) and long-acting B2 agonists (salmeterol, formoterol)
What 2 pathways are anti-asthmatic drugs targeting?
inflammation and parasympathetics as these both lead to bronchoconstriction
What is the MOA of gaunifenesin?
Thins respiratory secretions so functions as an expectorant but has NO effect on cough reflex
What is the MOA of dextromethorphan?
antagonizes NMDA glutamate receptors (but it is also a mild codiene analog)
Which drug inhibits the synthesis of leukotrienes?
zileuton
What drugs are first line therapy for chronic asthma?
corticosteroids – beclomethasone and fluticasone
Which drug competitively antagonizes endothelin-1 receptors for pulmonary hypertension?
Bosentan
Name the acute B2 agonist
albuterol
What are the AE of pseudoephedrine and phenylephrine?
hypertension and CNS stimulation and anxiety
Name 2 long acting beta2 agonists
salmeterol and formoterol
What is the toxicity of the first generation antihistamines?
sedation, antimuscarinic, anti-alpha-adrenergic
Which drug is also called Mucinex?
Guanifenesin
Beclomethasone and Fluticasone are useful in asthma by inhibiting production of this important transcription factor _________
NF- kappa B (NF-kB)
What is the MOA of N-acetylcysteine?
mucolytic used to loosen mucous plugs in cystic fibrosis patients and also used to treat overdose of acetaminophen by replenishing glutathione
Name 2 muscarinic antagonists used for asthma and COPD
ipratropium and tiotropium
What is the antidote for dextromethorphan overdose? Why?
Naloxone, because DXM is a mild opiate–synthetic codeine analog
What is the MOA of pseudoephedrine and phenylephrine?
alpha agonists so they decrease hyperemia by constricting blood vessels
What is the MOA of zileuton?
5-lipoxygenase inhibitor –i.e. prevents the SYNTHESIS of leukotrienes
What limits the use of theophylline?
a narrow therapeutic index, it causes cardiotoxicity and neurotoxicity and is metabolized by P-450
Which drug is a long-acting muscarinic antagonist for asthma and COPD?
tiotropium
Which 2 classes of drugs ultimately increase cAMP in bronchial smooth muscle?
B2 agonists (activate cAMP synthesis) and methylxanthines (decrease cAMP degradation)
What is the MOA of bosentan?
competitive antagonist of endothelin-1 receptor in pulmonary vasculature, thus it is used for Tx of pulmonary hypertension
What is the MOA of cromolyn sodium?
Blocks a chloride channel to prevent mast cell degranulation
Which drug blocks a chloride channel to prevent mast cell degranulation?
Cromolyn sodium
