Respiratory Flashcards
Diphenhydramine: Family
H1 blocker: first generation
Dimenhydrinate: Family
H1 blocker: first generation
Chlorpheniramine: Family
H1 blocker: first generation
Clemastine: Family
H1 blocker: first generation
Brompheniramine: Family
H1 blocker: first generation
Meclizine: Family
H1 blocker: first generation
H1 blockers - 1st gen: Mechanism
Reversible inhibition of H1 histamine receptors
H1 blockers - 1st gen: Use (3)
Allergy
Motion sickness
Sleep aid
H1 blockers - 1st gen: Side effects (4)
Sedation
Anti-muscarinic
Anti-alpha-adrenergic
Anti-serotonergic
Loratadine: Family
H1 blocker: second generation
Fexofenadaine: Family
H1 blocker: second generation
Desloratadine: Family
H1 blocker: second generation
Cetirizine: Family
H1 blocker: second generation
Levocarbastine: Family
H1 blocker: second generation
H1 blocker - 2nd gen: Use
Allergy
How are side effects different for 2nd gen vs 1st gen H1 blockers?
Less sedating than 1st gen because of decreased entry into CNS
Ketotifen: Mechanism
Non competitive H1 antagonist and mast cell stabilizer
Decreases chemotaxis and activation of eosinophils
Ketotifen: Use
Opthalmic antihistamine
Albuterol: Family
Beta-2 agonist (short acting)
Salmeterol: Family
Beta-2 agonist (long acting)
Formoterol: Family
Beta-2 agonist (long acting)
Beta 2-agonists: Mechanism (Resp)
Increase cAMP, relaxes bronchial smooth muscle
Beta 2-agonists: Side effects (2) (Resp)
Long acting beta-agonists: tremor and arrhythmia
Theophylline: Family
Methylxanthine
Theophylline: Mechanism (2)
Inhibits phosphodiesterase, decreases cAMP hydrolysis
Causes bronchodilation
Blocks actions of adenosine (adenosine increases bronchoconstriction)
Theophylline: Side effects (2)
Narrow therapeutic index
- Cardiotoxicity
- neurotoxicity (seizures)
How is theophylline metabolized?
P-450
Ipratropium: Mechanism
Muscarinic receptor antagonist, decreases bronchoconstriction
Ipratropium: Use (2)
Asthma
COPD
Tiotropium: Mechanism
Long acting muscarinic receptor antagonist (for asthma)
Beclomethasone: Family
Corticosteroids
Fluticasone: Family
Corticosteroids
Corticosteroids: Mechanism (Resp)
Inactivate NK-kB (TF that induces TNF alpha)
What is the first line for chronic asthma?
Corticosteroids
Montelukast, Zafirlukast: Mechanism
Leukotriene receptor inhibitors
Montelukast, Zafirlukast: Use
aspirin-induced asthma
Zileuton: Mechanism
5-lipoxygenase pathway inhibitor
Blocks conversion of arachidonic acid to leukotrienes
Zileuton: use
asthma
Omalizumab: Mechanism
Monoclonal anti-IgE antibody
Binds mostly to unbound serum IgE
Omalizumab: Use
Allergic asthma resistant to inhaled steroids and long-acting beta 2 agonist
Guaifenesin: Use
Expectorant
Thins respiratory secretions; does not suppress cough reflex
N-acetylcysteine: Use (2)
Mucolytic - loosen mucous plugs in CF patients
Antidote for acetaminophen
N-acetylcysteine: Mechanism
Cleaves disulfide bridges within mucus glycoprotein
Bosetan: Use
Pulmonary arterial hypertension
Bosentan: Mechanism
Competitively antagonizes endothelin-1 receptors, decreasing PVR
Dextromethorphan: Mechanism
Antagonizes NMDA glutamate receptor; synthetic codeine analog
Dextromethorphan: Use
Antitussive
Dextromethorphan: Side effect
Mild opioid effect when used in excess (naloxone for overdose)
Pseudoephedrine: Family
Sympathomimetic alpha-agonist nasal decongestant
Phenylephrine: Family
Sympathomimetic alpha-agonist nasal decongestant
Xylometazoline, Oxymetazoline: Family
Sympathomimetic alpha-agonist nasal decongestant
Phenylephrine, Pseudoephedrine: Use (4)
Reduce hyperemia
Edema
Nasal congestion
Open obstructed eustachian tubes
Pseudoephrine can also be used as a stimulant
Phenylephrine, Pseudoephedrine: Side effects (2)
Hypertension
CNS stimulant/anxiety (pseudoephedrine)
Methacholine: Mechanism
Muscarinic receptor antagonist
Methacholine: Use
Asthma challenge test