Respiratory

Question 1

First generation antihistamines

Answer 1

Diphenhydramine, dimenhydrinate, chlorpheniramine.

Used for allergy, motion sickness, as a sleep aid.

Question 2

First generation antihistamine toxicity

Answer 2

Sedating – crosses BBB
Antimuscarinic and anti alpha adrenergic effects

Causes urinary retention, dry mouth, delirium)

Question 3

Second generation antihistamines

Answer 3

Fexofenidine, cetirizine, desloratidine, loratidine

Used for allergy

Less CNS penetration

Question 4

Guaifenesin

Answer 4

Expectorant that thins secretions but does not suppress gag reflex

Question 5

N-acetyl cysteine

Answer 5

Mucolytic – breaks SH bonds to break up mucous

Question 6

Dextromethorphan

Answer 6

Antitussive (NMDA receptor antagonist) codeine analog. Treat with naloxone

Question 7

Pseudoephedrine

Answer 7

Alpha agonist nasal decongestant

Question 8

Pseudoephedrine side effects

Answer 8

CNS stimulation/anxiety and hypertension

Question 9

Albuterol

Answer 9

B agonist that activates b2 which relaxes smooth muscle in airway

Question 10

Salmeterol/formoterol

Answer 10

Long acting B agonists that are used for asthma prophylaxis.

Question 11

Salmeterol/formoterol side effects

Answer 11

Tremor and arrhythmia

Question 12

Theophylline

Answer 12

Phosphodiesterase inhibitor that increases cAMP in bronchial smooth muscle.

Question 13

Theophylline toxicity

Answer 13

Narrow therapeutic range, metabolized by cyp450, can cause seizures. Blocks actions of adenosine

Question 14

Ipratropium

Answer 14

M3 blocker (competitive) that prevents bronchoconstriction. Also used for COPD as tiotropium

Question 15

Beclomethasone/fluticasone

Answer 15

Inhibit synthesis of cytokines by inactivating NFKB (the transcription factor that induces TNF alpha). First line therapy for chronic asthma.

Question 16

Antileukotriene drugs side effect

Answer 16

Montelukast/zafirlucast. Can increase liver enzymes.

Question 17

Omalizumab

Answer 17

Monoclonal anti-ige antibody that binds unbound IgE and prevents binding to receptors on mast cells. used for asthma resistant to inhaled steroids and long acting beta two agonists

Question 18

Methacholine

Answer 18

used to challenge, drop in fev 1 more than 20 percent means asthma

Question 19

Bosentan

Answer 19

Endothelin receptor antagonist to decrease pulmonary hypertension

Question 20

Cromolyn

Answer 20

stabilizes mast cells and prevents degranulation