Respiratory

Question 1

H1 blockers =
1st gen ex’s?
2nd gen ex’s?

Answer 1

Reversible inhib’s of H1 Hist Rs

• diphenhydramine, dimenhydrinate, chlorpheniramine
• loratadine, fexofenadine, desloratadine

Question 2

Diphenhydramine, dimenhydrinate, chlorpheniramine

MoA, clin uses, tox

Answer 2

• H1 blockers, 1st gen
• allergy, motion sickness, sleep aid
• sedation, antiM, anti-a-adrenergic

Question 3

Loratadine, fexofenadine, desloratadine

MoA, clin uses, tox

Answer 3

• H1 blockers, 2nd gen
• allergy
• less sedating than 1st gen bc of decr’d entry into CNS

Question 4

Albuterol

MoA, use for?

Answer 4

• B2 agonist, relaxes bronchial SmM

- use during acute asthma exacerbation

Question 5

Salmeterol, formoterol

MoA, use for?, AEs

Answer 5

• B2 agonist, relaxes bronchial SmM
• asthma, long-acting agents for prophylaxis
• tremor, arrhythmia

Question 6

Theophylline
MoA, use for? AEs
Metab’d by? Blocks action of?

Answer 6

• methylxanthine, bronchodilation by inhibiting PDE -> decr’d cAMP hydrolysis
• asthma
• narrow therapeutic use, causes cardiotox and neurotox
• P450
• adenosine

Question 7

Ipratropium
MoA, use for?
Long acting version?

Answer 7

• M antag, prevents bronchoconstriction
• asthma, COPD
• tioprotium

Question 8

Beclomethasone, fluticasone

MoA, use for?

Answer 8

• corticosteroids, inhibit syn of cytokines, inact NF-kB (no TNF-a made, nor other inflamm agents)
• 1st line tx for chronic asthma

Question 9

Montelukast, zafirlukast

MoA, use for?

Answer 9

• antileukotrienes (block R)

- asthma, esp asthma induced

Question 10

Zileuton

MoA, use for?

Answer 10

• antileukotriene (5-lipoxygenase pthwy inhib), blocks conversion of arachidonic acid to leukotrienes)
• asthma

Question 11

Omalizumab

MoA, use for?

Answer 11

• mAb to IgE, binds mostly unbd serum IgE

- allergic asthma resistant to inhaled steroids and LABAs

Question 12

Guaifenesin

- use for?

Answer 12

expectorant; thins resp secretions; doesn’t suppress cough reflex

Question 13

N-acetylcysteine

- use for?

Answer 13

mucolytic; can loosen mucous plugs in CF pt’s, also used as antidote for acetaminophen overdose

Question 14

Bosentan

- use for?

Answer 14

• pulm art HTN; competitively antag’s endothelin-1-Rs -> decr’d pulm vasc resistance

Question 15

Dextromethorphan

• use for?
• if used in excess?
• if overdose, give?

Answer 15

• antitussive (antag’s NMDA glutamate Rs), is synthetic codeine analog
• has mild opioid effect, mild abuse potential
• Naloxone

Question 16

Pseudoephedrine, phenylephrine

Mech, clin use, tox

Answer 16

• sympathomimetic a-agonist, non-Rx nasal decongestant
• reduce hyperemia, edema and nasal congestion; open obstructed eustachian tubes; pseudoephedrine also used as stimulant
• HTN, can also cause CNS stim’n/anxiety (pseudoephedrine)

Question 17

Methacholine

MoA, use for?

Answer 17

• M R agonist

- asthma challenge testing