Respiratory Drugs

Question 1

How do decongestants work?

Answer 1

Act as alpha 1 agonists; causing vasoconstriction resulting in decongestion; Does not relieve sneezing, itching, or discharge

Question 2

What drug is good only for reducing discharge

Answer 2

Ipratropium (note also used for COPD pt.)

Question 3

Mechanism of Action of Cromolyn sodium

Answer 3

Mast cell stabilizer which results in the prevention of early and late allergic response

Question 4

How do inhaled/oral corticosteroids work?

Answer 4

They act by influencing the immunological response via increasing or decreasing genetic activity

Question 5

Adverse Effects of corticosteroids

Answer 5

Epitaxis (most common)

Oral Thrush

Question 6

Two common decongestants

Answer 6

Phenylephrine (topical) and Pseudophedrine (intranasal)

Question 7

Adverse Effects of Decongestants

Answer 7

Rhinitis medicarnentosa - due to chronic use it can result in dependency and relapse
Urinary retention
Insomnia

Question 8

How do H1 receptors work?

Answer 8

They work by using the Gq protein pathway which results in an increase in Ca creating the contractile effects on smooth muscle, bronchoconstriction, exocrine excretion

Question 9

2nd generation H1 receptor antagonist

Answer 9

Fexofendadine

Question 10

Adverse effects of 1st generation H1 receptor antagonists

Answer 10

CNS problems
Sedation
Anti-muscarinic effects (blurred vision)

Question 11

What is the function of Varenicline?

Answer 11

1) partial agonist of nicotinic acetylcholine receptor

2) Results in reducing withdrawal cravings

Question 12

Loratadine
Fexofenadine
Desloratadine

Answer 12

Second generation anti-histamine

Question 13

Diphenhydramine
Dimenhydrinate
Chlorpheniramine

Answer 13

First Generation Anti-Histamine

Question 14

Beclomethasone

Fluticasone

Answer 14

Corticosteroids

Question 15

MOA of Beclomethasone/fluticasone

Answer 15

1) Inhibit synthesis of all cytokinse

2) Inactivates NF-kappaB transcription factor

Question 16

MOA of Theophylline

Answer 16

Causes bronchodilation by inhibiting phosphodiesterase, thereby decreasing cAMP hydrolysis which leads to bronchodilation

Question 17

MOA of omalizumab

Answer 17

Monoclonal anti-IgE antibody

Question 18

MOA of Zileuton

Answer 18

5-Lipoxygenase pathway inhibitor; blocks arachadonic acid conversion to leukotrienes

Question 19

MOA for Montelukast and Zafirlukast

Answer 19

Block leukotriene receptors

Question 20

MOA of N acetylcysteine

Answer 20

Mucolytic, loosens mucous plugs in CF pt.

Note: also used in acetaminophen overdose

Question 21

MOA of Bosentan

Answer 21

Used to treat pulmonary hypertension

Competitive antagonist of endothelin 1 receptor