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Semester 5 PMCP Exam 3 > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

Common col is caused by

A

a number of difference viral agents

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2
Q

Rhinitis

A

inflammation of mucus membranes inside the nose

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3
Q

Inflammatory mechanism with rhinitis

A

mast cell degranulation that releases histamine which causes VD
the VD leads to nasal congestion - an inc in mucus production and triggers sneeze or cough reflex

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4
Q

Drugs for cold are used to address

A

the symptoms

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5
Q

Drugs for a cold include

A

Mucokinetics
Antitussives
Decongestants
Antihistamines

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6
Q

Mucokinetics for a cold - mechanism

A

They move mucus
Dec viscosity of mucus which inc cough productivity
Prevents mucus plugs and microbial colonization

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7
Q

Types of mucokinetics for a cold

A

Diluents
Mucolytics
Expectorants

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8
Q

Antitussives for a cold are what

A

cough suppressants

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9
Q

Decongestants for a cold are what (2 types)

A

Sympathomimetics

Corticosteroids

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10
Q

Antihistamines for a cold are what

A

H1 receptor antagonists

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11
Q

Drugs that address cold symptoms target what

A

The respiratory epithelium (ciliated pseudostratified columnar epithelium)

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12
Q

Respiratory epithelium is made of what two layers

A

Gel layer - high viscosity from goblet cells (mucus)

Sol layer - Low viscosity from submucosal glands (water)

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13
Q

What is the normal ratio for gel to sol layer

A

Normally we have more sol than gel but with a cold we end up with more gel than sol - so the goal is to increase sol so that we can move the mucus better

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14
Q

Secretion from goblet cell with ___ viscosity

A

increase

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15
Q

Secretion from submucosal glands will ___ viscosity

A

decrease

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16
Q

Antimucokinetic drugs - what will they cause

A

nasal congestion

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17
Q

Antimucokinetic drugs - what is their action

A

dec production of bronchial secretions

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18
Q

Antimucokinetic drugs - what is the respiratory effect

A

thick viscous secretions
dry mouth
nasal stuffiness

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19
Q

Two examples of antimucokinetic drugs

A

Parasympatholytic drugs

Opioid drugs

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20
Q

Antimucokinetic drug - parasympatholytic - examples and mechanism

A

muscarinic antagonsists

Atropine, scopolamine

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21
Q

Antimucokinetic drug - parasympatholytic - medicinal uses

A

motion sickness
organophosphate poisoning
antichemical warfare agent

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22
Q

Antimucokinetic drug - opioids - examples

A

morphine
codeine
papaverine

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23
Q

Mucokinetic - Diluents action

A

liquefy bronchial secretions

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24
Q

Mucokinetic - diluents example

A

saline solution - aerosol

Hypoviscosity or wetting agents

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25
Mucokinetic diluents do what to the sol and gel layers
Increase the sol layer and dilute the gel layer
26
Problems with mucokinetic diluents
in order for them to work you need to have a productive cough Bronchospasms can occur Mucosal swelling can occur Need to stay hydrated
27
Mucokinetic - mucolytics - action
break down the chemical structure of mucus
28
Mucokinetic - mucolytics - agents (2)
Acetylcyteine | Deoxyribonuclease
29
Mucokinetic - mucolytics - acetylcysteine - what does it do
Cleaves disulfide bonds Breaks mucoprotein and H bonds Creates more of a watery sputum
30
Mucokinetic - mucolytics - acetylcysteine - problem
18% have anaphylaxis rxn Bronchospasms Short shelf life (96 hr) Inactivates some antibiotics
31
Mucokinetic - mucolytics - deoxyribonuclease - what does it do
Hyprolyzes DNA in mucus Release DNA which adds to stickiness of mucus Used for cystic fibrosis
32
Mucokinetic - mucolytics - deoxyribronuclease - problem
stability (is heat and light sensitive) | short shelf life
33
Mucokinetic - expectorants - action
increase volume of bronchial secrections through gastropulmonary reflex
34
Mucokinetic expectorants - what do they do to the gel and sol layers
Inc sol layer through vagal stimulation | vagal stimulation will stimulation the serous glands to increase sol layer
35
Mucokinetic expectorants - agents (3)
SSKI Ammonium chloride Guaifenesis
36
Mucokinetic expectorants - SSKI
foul taste | extremely bitter
37
Mucokinetic expectorants - Ammonium chloride
found in children cough syrups | can cause metabolic acidosis
38
Mucokinetic expectorants - Guaifenesis
very effective for chronic bronchitis | most common - mucinex, robitussin
39
Mucokinetic expectorants - side effects
excess vagal stimulation GI issues nausea, vomitting Don't make you vomit but stimulate the same pathway - gastropulmonary reflex
40
Cough reflex - beneficial means of
removing respiratory secretions and foreign objects
41
Cough reflex - can be nonproductive which can result in
sleep disturbance and epithelial damage
42
Cough reflex - cough can be due to
``` smoking chronic bronchitis pulm TB asthma ACE inhibitor ```
43
Mucokinetics can dec cough by what
loosening/thinning the mucus (but this is not their main mechanism) They dec cough by moving mucus and irritants along
44
Mucokinetic - antitussives - do what and are used whn
cough suppression | used when cough is not productive
45
Mucokinetic - antitussives - can act __ or __
centrally or perpherally
46
mucokinetic - centrally acting antitussives - mechanism
cross the BB Depress medullary cough centers by binding opioid receptors Inc threshold of cough centers
47
mucokinetic - peripherally acting antitussives - mechanism
interrupt the cough/tussal impulse
48
Example of mucokinetic - centrally acting antitussives
morphine codeine dextromethorphan diphenhydramine
49
Example of mucokinetic - peripherally acting antitussive
lozenges
50
Mucokinetic - antitussive - codeine compared to morphien
codeine is less potent than morphine as an analgesic and resp depressent
51
Mucokinetic - antitussive - codeine - side effects
``` sedation mausea constipation* low but present abuse potential resp depression at high doses CONTRAINDICATED FOR ASTHMATICS Can be antimucokinetic ```
52
Mucokinetic - antitussive - dextromethorphan compared to codeine
as effective as codeine without the side effects of codeine
53
Mucokinetic - antitussive - dextromethorphan - side effects
dizziness drowsiness nausea
54
If cough lasts more than ___ see physician
1 week
55
Mucokinetic - decongestants - mechanism
reduce swelling in nasal passage
56
Mucokinetic - decongestants - 2 types
Sympathomimetics | Corticosteroids
57
Mucokinetic decongestant - sympathomimetic - what do they do
constriction of vessels in mucus membranes which results in improved ventilation, inc drainage, and dec stuffiness
58
Mucokinetic decongestant - sympathomimetic - side effects
adrenergic stimulation - nervousness, insomnia, palpitations | VC, inc HR, inc contractility
59
Mucokinetic decongestant - sympathomimetic - cuation with
CAD, HPTN, glaucoma
60
Mucokinetic decongestant - sympathomimetic - administration
orally or topically
61
Mucokinetic decongestant - sympathomimetic - rebound effect
VC followed by VD | Could lead to worse congestion when you get off of it - associated with prolonged use
62
Mucokinetic decongestant - corticostreoid - what do they do
decrease inflammation/irritation to reduce congestion
63
Mucokinetic decongestant - corticosteroid - side effects
mucosal dryness irritation septal perforation
64
Mucokinetic decongestant - corticosteroid - examples
beclomethasone | asalide
65
Mucokinetic decongestant - oral vs. topical sympathomimetics - ORAL
prolonged effects but delayed onset less potent no rebound congestions
66
Mucokinetic decongestant - oral vs. topical sympathomimetics - ORAL examples
phenylephrine pseudoephedrine sudafed
67
Mucokinetic decongestant - oral vs. topical sympathomimetics - TOPICAL
prompt onset and potent | limit use 3-5 days because of rebound effect
68
Mucokinetic decongestant - oral vs. topical sympathomimetics - TOPICAL examples
vicks | oxymetazolme
69
Decongestants are often combined with
an expectorant like guaifenesin
70
Mucokinetic antihistamines - what are they
H1 antagonists
71
Mucokinetic antihistamines - indication
relieving allergic sx, cold sx, and motion sickness
72
Mucokinetic antihistamines - block
inc capillary permeability inc resp secretions VD bronchial smooth mm contraction
73
Mucokinetic antihistamines - types
1st gen drugs | 2nd gen drugs
74
Mucokinetic antihistamines - 1st gen drugs - examples
diphenyhydramine (Bendadryl)
75
Mucokinetic antihistamines - 1st gen drugs - what do they do
cross BBB - have low to moderate sedative effect and moderate to high anticholinergic effect More effective against cold sx
76
Mucokinetic antihistamines - 2nd gen drugs - example
Cetirizine (Zyrtec) | Loratidine (Claritin)
77
Mucokinetic antihistamines - 2nd gen drugs - what do they do
NOT cross BBB NOT cause drowsiness Longer duration of action
78
Mucokinetic antihistamine - for cold pick
1st gen drugs
79
Mucokinetic antihistamine - for allergies and need to be productive throughout day pick
2nd gen drugs

Semester 5 PMCP Exam 3 (6 decks)

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