Respiratory Drugs Flashcards
When a drug is inhaled ____ goes to the lungs and ____ is swallowed or absorbed into systemic circulation.
- 10-30%
- 70-90%
albuterol mechanism
- B2 agonist - raises cAMP production from adenylyl cyclase
- limits airway edema
- short acting (SABA)
salmeterol, formoterol mechanism
- B2 agonist - raises cAMP production from adenylyl cyclase
- limits airway edema
- long acting (LABA)
use of albuterol
prn for acute asthma exacerbation
use of salmeterol, formoterol
- prophylaxis for asthma with ICS
- alone for COPD
- before exercise to prevent EIA
fluticasone, budesonide
inhaled corticosteroids
mechanism of fluticasone, budesonide
inactivation of NF-kB which is the transcription factor that induces cytokine production, so inhibits synthesis of cytokines
use of fluticasone, budesonide
- 1st line for chronic asthma to decrease airway hyper-responsiveness
SEs of fluticasone, budesonide
- topical - oral candidiasis, horseness
mechanism of ipatropium
M3 antagonist - prevents ACh binding and bronchoconstriction
uses of ipatropium
- asthma
- COPD
SEs of iptropium
- dry mouth
- urinary retention
- increased IOP
mechanism of montelukast, zafirlukast
leukotriene receptor antagonists
mechanism of zileuton
inhibits 5-lipoxygenase, blocks leukotriene synthesis
mechanism of omalizumab
monoclonal IgE ab - binds unbound IgE and IgE on mast cells and basophils (prevents mast cell degranulation)
use of omalizumab
allergic asthma
mechanism of theophylline
- causes bronchodilation by inhibiting phosphodiesterase degradation of cAMP
- adenosine antagonist which causes bronchoconstriction
SEs of theophylline
low therapeutic window - GI irritation, seizures, tachycarida
mechanism of methacholine
M3 agonist used in bronchial challenge to diagnose asthma
______ are preferred in peds instead of ICS.
leukotriene mediators
The leukotrienes involved in asthma are:
C4, D4, E4
mechanism of (-prost-) drugs: beraprost, epoprostenol, iloprost
prostacyclin analogues that induce vasodilation (pulmonary and systemic arterial vascular beds and prevent platelet aggregation
SEs of (-prost-) drugs: beraprost, epoprostenol, iloprost
flushing, jaw pain
clinical use of (-prost-) drugs: beraprost, epoprostenol, iloprost
pulmonary HTN
mechanism of -sentan drugs: bosentan
competitive endothelin-1 receptor antagonist - prevents vasoconstriction and lowers pulmonary vascular resistance
SEs of -sentan drugs: bosentan
hepatotoxicity
clinical use of -sentan drugs: bosentan
pulmonary HTN
mechanism of sildenafil
PDE5 inhibitor - prevents breakdown of cGMP and so prolongs vasodilation via NO
clinical use of sildenafil
ED (oral), pulm HTN (inhaled)
mechanism of riociguat
guanalyl cyclase stimulator –> more cGMP –> more vasodilation
clinical use of riociguat
pulmonary HTN
