Respiratory

Question 1

Guaifenesin

Answer 1

Expectorant used to thin respiratory secretions

Question 2

N-acetylcysteine

Answer 2

Mucolytic used to loose mucous plugs in CF patients

Also used as an antidote for acetaminophen overdose

Question 3

Dextromethorphan

Answer 3

Antitussive (antagonizes NMDA glutamate receptor); synthetic codeine analog.

Treat overdose with naloxone

Question 4

Pseudophredrine, phenylephrine

Answer 4

Sympathomimetic alpha-agonistic nasal decongestants

Toxicity: HTN. Anxiety (pseudophedrine)

Question 5

Salmeterol, formoterol

Answer 5

Long-acting B2-agonists used for asthma prophylaxis.

Toxicity: Tremor, Arrhythmia

Question 6

Theophylline

Answer 6

Methylxanthine that causes bronchodilation via inhibition of PDE, leading to increased cAMP. Prevents early response (bronchoconstriction)

Narrow therapeutic index - cardiotoxicity, neurotoxicity

Metabolized by P450

Blocks actions of adenosine

Question 7

Ipratropium, Tiotropium

Answer 7

Muscarinic antagonist that prevents bronchoconstriction

Tiotropium is a long-acting muscarinic antagonist

Question 8

Beclomethasone, fluticasone

Answer 8

Corticosteroids that inhibit the synthesis of all cytokines.

Inactivate NF-kB (the transcription factor that induces production of TNF-a and other inflammatory agents)

First-line therapy for chronic asthma

Question 9

Montelukast, zafirlukast

Answer 9

Block leukotriene receptors to inhibit late response (inflammation)

Treat aspirin-induced asthma

Question 10

Zileuton

Answer 10

5-lipoxygenase pathway inhibitor that blocks conversion of arachidonic acid to leukotrienes. Inhibits late response (inflammation)

Question 11

Omalizumab

Answer 11

Monoclonal anti-IgE antibody that mostly binds unbound serum IgE and blocks binding to FceRI

Treats allergic asthma resistant to inhaled steroids and long-acting B2-agonists

Question 12

Methacholine

Answer 12

Muscarinic receptor agonist

Used in bronchial provocation challenge to help diagnose asthma

Question 13

Bosentin

Answer 13

Competitive antagonist of endothelin-1 receptors. Decreases pulmonary vascular resistance.

Treats pulmonary arterial hypertension

Question 14

Cromyolyn, Nedocromil

Answer 14

Mast cell stabilizing agents that inhibit mast cell degranulation independent of stimuli present.

Second-line for the treatment of allergic rhinitis and bronchial asthma