Respiratory Flashcards

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1
Q

H1 antagonists

A

Reversible inhibitors of H1 histamine receptors

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2
Q

H1 antagonists - 1st generation

Examples

A

Diphenhydramine
Dimenhydrinate
Chlorpheniramine
“-en/-ine” or “-en/-ate”

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3
Q

Diphenhydramine, Dimenhydrinate, Chlorpheniramine

Uses and toxicity

A

H1 antagonists - 1st generation
Uses = allergy, MOTION SICKNESS, sleep aid
Toxicity = sedation, antimuscarinic, anti-a-adrenergic

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4
Q

H1 antagonists - 2nd generation

Examples

A
Loratadine
Fexofenadine
Desloratadine
Cetirizine
"-adine"
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5
Q

Loratadine, Fexofenadine, Desloratadine, Cetirizine

Uses and toxicity

A

H1 antagonists - 2nd generation
Uses = allergy
Toxicity = far LESS SEDATING than 1st gen due to decreased CNS entry

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6
Q

Expectorants (3)

A

Guaifenesin
N-acetylcysteine
Dextromethorphan

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7
Q

Guaifenesin

A

Expectorant
Thins respiratory secretions
Does NOT suppress cough reflex

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8
Q

N-acetylcysteine

A

Mucolytic
Can loosen mucous plugs in CF patients
Also used as antidote for acetaminophen overdose

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9
Q

Which drug can be used for acetaminophen overdose?

A

N-acetylcysteine

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10
Q

Dextromethorphan

A
Antitussive
NMDA glutamate receptor antagonist
Synthetic codeine analog (mild opioid effect when used in excess)
Naloxone used in overdose
Mild abuse potential
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11
Q

Which drug can be used for dextromethorphan overdose?

A

Naloxone

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12
Q

Pseudoephedrine, Phenylephrine

MOA

A

Sympathomimetic a-agonistic nonprescription nasal decongestants

Reduce hyperemeia, edema, and nasal congestion
Open obstructed eustachian tubes
Pseudoephedrine used in illicit methamphetamine production

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13
Q

Sympathomimetic a-agonistic nonprescription nasal decongestants
Toxicity

A

Pseudoephedrine, Phenylephrine

Hypertension
Can also cause CNS stimulation/anxiety (pseudoephedrine)

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14
Q

Asthma drug therapy targets (2)

A

Inflammatory processes
Parasympathetic tone

Both lead to bronchoconstriction

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15
Q

B2 agonsts

A

Albuterol

Salmeterol, formoterol

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16
Q

Albuterol

A

B2 agonist
Relaxes bronchial smooth muscle (B2)
Use during acute exacerbation

17
Q

Salmeterol, formoterol

Use? Adverse effects (2)?

A

B2 agonists
Long acting agents for prophylaxis
Adverse effects are tremor and arrhythmia

18
Q

Theophylline

A

Methylxanthines

Likely causes bronchodilation by inhibiting phosphodiesterase = increase cAMP levels due to decreased cAMP hydrolysis

19
Q

What factor limits theophylline usage? How metabolized? Blocks actions of which other drug?

A

Narrow therapeutic index = cardiotoxicity, neurotoxicity
Metabolized by cytochrome P450
Blocks actions of adenosine

20
Q

Ipratropium

A

Muscarinic antagonist
Competitive block of muscarinic receptors, preventing bronchoconstriction
“I pray I can breathe”
Also used for COPD (as is tiotropium, a long acting version)

21
Q

Beclomethasone, fluticasone

A

Corticosteroids
Inhibit synthesis of virtually all cytokines
Inactivate NF-kB (transcription factor that induces production of TNF-a and other inflammatory agents)
First line therapy for chronic asthma

22
Q

Antileukotrienes

A

Montelukast
Zafirlukast
Zileuton

23
Q

Montelukast, zafirlukast

A

Antileukotrienes
Block leukotriene receptors
Especially good for aspirin-induced asthma

24
Q

Zileuton

A

Antileukotriene
5-lipoxygenase pathway inhibitor
Blocks conversion of arachidonic acid to leukotrienes

25
Q

Omalizumab

A

Monoclonal anti-IgE antibody
Binds mostly unbound serum IgE and blocks binding to FcERI
Used in allergic asthma resistant to inhaled steroids and long-acting B2-agonists

26
Q

Methacholine

A

Muscarinic receptor agonist

Used in bronchial provocation challenge to help diagnose asthma

27
Q

Bosentan

A

Used to treat pulmonary arterial hypertension

Competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance