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1st Year Med School (Random) > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

Physiological Bronchial Tone Regulation

A

Acetylcholine - Muscarinic R (para)’ Stimulation causes CONSTRICTION

Epinephrine - B2 R (symp); Stimulation causes DILATION

Histamine/Leukotrienes - H-1 & LTD4/LTE4 R; Stimulation causes CONSTRICTION

Prostaglandins - PGE2 cuases DILATION; PGF2a causes CONSTRICTION

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2
Q

Short-acting Beta-2-selective agonist (SABAs)

A

-Albuterol (ok pregnancy)
-Levalbuterol/Pirbuterol
Given by inhalation for acute bronchospasm
Minimal cardiac effects
Bronchodilator

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3
Q

Long-acting beta-2-selective agonist (LABA)

A

-Salmeterol (ok pregnancy)
-Nocturnal asthma, exercise-induced bronchospasm if many hours of activity
-Inhibits late-phase allergen bronchoconstri
-Not suitable for monotherapy
Bronchodilator

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4
Q

Cholinergic Antagonists

A

-Ipratropium/ Tiotropium: Muscarinic antagonist
-Best for COPD
Synergistic with B2 blockers (Duoneb)
Adverse: Nasal/mouth dryness, Urine retention especially Males w/ BOH or Prostate CA
Bronchodilator

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5
Q

Theophylline

A

-Methylxanthine class (caffeine)
-Phosphodiesterase inhibitor - Increase cAMP, a dilator
-2ndary actions: Inhibits mucus secretion, Decreases histamine release
Adverse: CNS&Cardiac stimulation; GI irritation; No antidote for OD
Bronchodilator

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6
Q

Glucocorticoids

A

Multiple Mechanisms: Decr Inflammation

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7
Q

Outpatient: CAP

No abx in past 3 months

A

Macrolide
(azithromycin, -thromycin)
- Inhibit bacterial protein synthesis (50s)

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8
Q

Outpatient: CAP

Co-morbidity or abx used in prev 3 mnths

A

Fluoroquinolone
(levofloxacin, -floxacin)
- Inhibit DNA gyrase and Type IV topoismerase

OR
B-lactam (amoxicillin or ceftriaxone) + macrolide

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9
Q

Inpatient, non-ICU: CAP

A

Fluoroquinolone (-floxacin)
Ceftriaxone (or amp-sulbactam) + macrolide

Ceph 3; inhibits cell wall synth, extended spectrum pen + B-lactamase inhib, Protein synth inhib

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10
Q

Inpatient, ICU: CAP

A

Ceftriaxone (or AMP-sublactam)
+
Azithromycin (or fluoroquinolone)

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11
Q

Streptococcus pneumonia

A

-Levofloxacin
fluoroquinolone
Inhibits DNA gyrase and Type IV topoisomerase

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12
Q

Mycoplasma pneumoniae

A

-Azithromycin
Macrolide
Inhibits bacterial protein synthesis (50s)

-Doxycycline
Tetracycline
(30s)

-Levofloxacin (+)
Fluoroquinolone
Inhibits DNA gyrase/IV topoisomerase

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13
Q

Haemophilus influenzae

A

Cefotaxime or Ceftriaxone

3rd gen Cephalosporins
Inhibits cell wall synthesis

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14
Q

Moraxella catarrhalis

A

Amoxicillin + Calvulanate (Augmentin)
AMOX: extended spectrum pen; inhibits cell wall synthesis
CL: B-Lactamase inhib

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15
Q

Klebsiella pneumoniae

A

Imipenem
carbapenem, which is a pen-like abx
Broad spectrum and resistant to many B-lactamases
Cilastatin included to prevent renal dehydropeptidase inactivation

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16
Q

Yersinia pestis

A

Gentamicin
aminoglycoside
inhibits protein synthesis

17
Q

Bacillus anthracis

A

Ciprofloxacin
fluoroquinolone
inhibits DNA gyrase and IV topoisomerase

18
Q

Bordetella pertussis

A

Azithromycin
Macrolide
inhibits bacerial protein syn
(50s)

19
Q

Corynebacterium diphtheriae

A

Erythromycin
macrolide
(50s)

Penicillin also effective

20
Q

Streptoccosus pyogenes

GAS

A

-Pen V
B-lactam abx
Narrow-spectrum pen
Inhibits cell wall synthesis

-Amoxicillin (taste)
-Macrolide if pen allergy
CONFIRM GAS before ABX

21
Q

Pseudomonas aeruginosa

A

-Piperacillin + Tazobactam
PIP: extended, antipseudomonal pen
TZ: B-lactamase inhib

-Imipenem
carbapenem, pen like abx
broad spectrum and resistant to many B-lactamases
cilastatin for inactivation by renal

-Cefepime
4th gen cephalosporin
inhibits cell wall synth

-Tobramycin
Aminoglycoside
inhibits protein synthesis

22
Q

Legionella pneumophila

A

Levofloxacin
fluoroquinolone
inhibits DNA gyrase and IV topoisomerase

23
Q

Adverse effects:
Penicillin G/V
Amoxicillin
Piperacillin + Tazobactam

A

Pen: GI, hypersensitivity

Amoxicillin: GI distress, hypdersensitivity

Pip+ Tzbm: GI, yeast infection

24
Q

Adverse effects:
Cefotaxime/Ceftriaxone
Levofloxacin/Cipro
Doxycycline

A

Cef: hypersensitivity, yeast inf, cross-sensitivity w/ pen
-floxacin: GI, tendonitis, photo, prolonged QT interval, seizures
Doxy: phototoxicity, discoloration of teeth

25
Q

Adverse effects:
Azithromycin/erythro
Gentamicin/Tobramy
Imipenem

A

Azithr: GI distress, Erythro binds receptors for gastric hormone, inducing uncoordinated peristalsis
Gent: nephrotoxic, ototoxic
Imip: hypersensitivity, cross-sensitivity w/ penicillins

26
Q

1st line drugs for TB

A

Isoniazid
Ethambutol
Pyrazinamide
Rifampin

resistance: Fluoroquinolone

27
Q

TB
Newly dx
Latent

A

Newly dx: isoniazid
Exposed neonates: isoniazid 3 mo
Latent in TST with HIV

28
Q

Active TB

A

Isoniazid, rifampin, ethambutol and pyrazinamide

PZA reduces to 6 mo therapy

29
Q

Isoniazed

A

Inhibits synthesis of mycolid acid
Activated by mycobacterial catalase peroxide (katG gene)
Isoniazid complex is formed which INHIBITS enoyl reductase

key metabolizing enzyme is acetyltransferase (rate gene determined)

30
Q

Rifampin

A

Broad spectrum abx
Binds DNA-dependent RNA polymerase
Results in the inhibition of DNA transcription
selective for bacterial RNA polymerase

31
Q

Influenza

A

Oseltamivir
-Neuraminidase inhibitor (give within 48hrs)

Amantadine/Rimantadine
-Blocks M2 proton selective ion channels
prevents acidification of virus and fusion of membranes required for UNCOATING and transfer of viral NA’s

32
Q

RSV

A

Palivizumab
-Ab directed at FUSION PROTEIN ON RSV
virus cannot enter cell

33
Q

Blastomyces dermatidis

A

Liposomal Amphotericin B
-Polyene abx
Selectively binds ergosterol in fungal membranes
increases membrane permeability

34
Q

Cryptococcus neoformans

A

Fluconazole
-inhibits enzyme responsible for converting lanosterol to ergosterol

Amphotericin B
-Polyene abx
Selectively binds ergosterol in fungal membranes
increases membrane permeability

35
Q

Asperfillus fumigatus

A

Voriconazole

inhibits enzyme responsible for converting lanosterol to ergosterol

36
Q

Pneumocystis jirovecii

A

Trimethoprim + Sulfamethoxazole (TMP-SMX)

Antimetabolites that inhibit folate synthesis in bacteria

37
Q 
Adverse effects:
Isoniazid
Rifampin
Oseltamivir
Palivizumab
A

Isoniazid: liver toxicity, peripheral neuritis (need B6 supplementation)
Rifampin: liver toxicity, reddish-orange body fluids, induces P450
Oseltamivir: rare
Palvizumab: fever, rash

38
Q 
Adverse effects:
Fluconazole
Vorconazole
Amphotericin B
TMP-SMX
A

Fluconazole: many drug interactions (P450)
Vorconazole: many drug interactions (P450); Liver toxicity visual disturbances
Amphotericin B: Nephrotoxic
TMP-SMX: GI distress, Stevens-Johnson syndrome, megaloblastic anemia, photoxicity

1st Year Med School (Random) (20 decks)

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