Respiratory

Question 1

Diphenhydramine, dimenhydrinate, chlorpheniramine

Answer 1

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

Question 2

Loratadine, fexofenadine, desloratadine, cetirizine

Answer 2

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

Question 3

Albuterol

Answer 3

1) Use: Asthma, acute exacerbation
2) Class/MOA: Beta 2 agonist, relaxes broncial smooth muscle
3) Side effects/ADEs:
4) Fun Facts

Question 4

Salmeterol, formoterol

Answer 4

1) Use: Asthma, prophylaxis
2) Class/MOA: Beta 2 agonist, relaxes bronchial smooth muscle, long acting
3) Side effects/ADEs: Tremor, arrhythmia
4) Fun Facts

Question 5

Ipratropium

Answer 5

1) Use: asthma, COPD (tiotropium)
2) Class/MOA: Long Acting muscarinic antagonist/ competeitve block of muscarinic receptors, prevents bronchoconstriction
3) Side effects/ADEs:
4) Fun Facts

Question 6

Beclomethasone, fluticasone

Answer 6

1) Use: 1st line for chronic asthma
2) Class/MOA: Corticosteroid/ inhibits the synthesis of virtually all cytokines. Inactivates NFkB transcription factor for production of TNF alpha, among other inflammatory agents
3) Side effects/ADEs:
4) Fun Facts

Question 7

Montelukast, zafirlukast

Answer 7

1) Use: Block Asthma, especially aspirin induced
2) Class/MOA: Antileukotrienes/block leukotriene receptor
3) Side effects/ADEs:
4) Fun Facts

Question 8

Zileuton

Answer 8

1) Use: Asthma
2) Class/MOA: Antileukotrienes/5 lipoxygenase pathway inhibitor, blocks conversion of arachidonic acid to leukotrienes
3) Side effects/ADEs:
4) Fun Facts

Question 9

Omalizumab

Answer 9

1) Use: Allergic asthma resistant to inhaled steroid and long acting beta agonists
2) Class/MOA: Monoclonal anti IgE antibody, binds mosly unbound serum IgE
3) Side effects/ADEs:
4) Fun Facts

Question 10

Theophylline

Answer 10

1) Use: Asthma
2) Class/MOA: Methylxanthines/ causes bronchodilation by inhibiting phosphodiesterase, thereby decreasing cAMP hydrolysis, blocks adenosine
3) Side effects/ADEs: cardiotoxicity, neurotoxicity, metabolized by P450 these limit use
4) Fun Facts

Question 11

Guaifenesin

Answer 11

1) Use: Expectorant
2) Class/MOA: Thins respiratory secreitons, doesn’t suppress cough reflex
3) Side effects/ADEs:
4) Fun Facts

Question 12

N-acetylcysteine

Answer 12

1) Use: Expectorant, CF patients, antidote for acetaminophen overdose
2) Class/MOA: Mucolytic, loosen mucous plugs (CF patients)
3) Side effects/ADEs:
4) Fun Facts

Question 13

Bosentan

Answer 13

1) Use: Pulmonary arterial hypertension
2) Class/MOA: Compeitively antagonizes endothelin 1 receptors, decreasing pulmonary vascular resistance
3) Side effects/ADEs:
4) Fun Facts

Question 14

Dextromethorphan

Answer 14

1) Use: antitussive=cough suppressant
2) Class/MOA: Antagonizes glutamate recptors, synthetic codeine analog
3) Side effects/ADEs: Mild opioid effect when used in excess, mild abuse potential
4) Fun Facts: Naloxone can be given for overdose

Question 15

Pseudoephedrine, phenylephrine

Answer 15

1) Use: Nonprescription nasal decongestants: Reduce hyperemia, edema and nasal congestion, obstructed eustachian tubes
2) Class/MOA: Sympathomimetic alpha antagonistic
3) Side effects/ADEs: Hypertension, CNS stimulaiton/anxiety (pseudoephedrine)
4) Fun Facts: also used as a stimulant and to make meth

Question 16

Methacholine

Answer 16

1) Use: Asthma challenge testing
2) Class/MOA: Muscarinic receptor agonist
3) Side effects/ADEs:
4) Fun Facts

Question 17

What is bronchoconstriction mediated by?

Answer 17

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