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CRRAB II Part 2 Respiratory > Respiratory Drugs (Trachte) - W3 > Flashcards

Respiratory Drugs (Trachte) - W3 Flashcards

1
Q

Sympathetic receptors

A
  • Nicotinic
  • Alpha1
  • Beta2
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2
Q

Parasympathetic receptors

A
  • nicotinic
  • muscarinic
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3
Q

How does the nicotinic receptor work? What binds? location?

A
  • located on adrenal medulla
  • causes activation of medulla by acting as pore for sodium –> releases epinephrine.
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4
Q

What is a nicotine agonist used for smoking cessation?

A

Varenicline (Chantix)

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5
Q

What stimulates the alpha1 receptor? How does it work? Where is it found?

A
  • stimulated by epi=NE >> isoproterenol
  • stimulates phospholipase C –> generates inositol triphosphate –> elevates caclium concentrations –> contraction of vascular smooth muscle
  • NOT ON BRONCHIOLES
  • majorly acts on vasculature (contraction)
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6
Q

What stimulates the beta2 receptor?

What does it do?

A
  • isoproterenol > epi >> NE
    • NE not very effective
  • works to RELAX SMOOTH MUSCLE of bronchioles
  • activates adenyly cyclase –> glycogenolysis
  • cholera toxin works through it (GS-alpha)
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7
Q

What are 2 nicotinic antagonists?

A

Trimethaphan & Hexamethonium

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8
Q

Stimulators of NE release from the sympathetic system:

A

Tyramine

Amphetamine

Ephedrine

Metaraminol

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9
Q

Inhibitors of NE release from sympathetic system

A

Reserpine

Guanethidine

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10
Q

Stimulators of sypmathetic on effect organ (NE effect)

A
  1. NE
  2. Epinephrine
  3. isoproterenol
  4. ephedrine
  5. phenylephrine
  6. metaraminol
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11
Q

Inhibitors of sympathetic effect on effector organ:

A
  1. Phentolamine
  2. Phenoxybenzamine
  3. propranalol
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12
Q

What do parasympathetic receptors tend to cause?

A

contract smooth muscle!! (except in vasculature)

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13
Q

Primary constrictor of the vasculature:

A

alpha1 receptor (how decongestants work)

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14
Q

primary dilator of bronchioles:

A

B2 receptor via sympathetics (epinephrine)

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15
Q

Primary bronchiole constrictor and cause secretion

A

parasympathetic muscarinic receptors

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16
Q

What is the most effective therapy for ACUTE BRONCHOSPASM?

list some.

A
  • B2 agonists
  • metaproterenol - inhaled
  • terbutaline
  • albuterol
  • Pirbuterol
  • isotharine
17
Q

What are the long duration B2 agonists?

A
  • Salmeterol - inhalation - more fat solube sto sticks around membrane and has longer duration of action.
  • Formoterol
  • Arformoterol
18
Q

What are the major side effects of B2 agonists and what receptors do they act through?

A
  • tachcardia - B1
  • palpitations - B1
  • tremor - B2
  • headache
19
Q

Epinephrine

mechanism

metabolism

contraindications

use

A
  • relax bronchioles (parental for anaphylaxis, ocular or inhaled)
  • metabolized by MAO and COMT
  • contraindications: hyperthyroidism, hypertension, halogen-hydrocarbon anesthetics.
  • Use:
    • bronchospasm (B2) - not asthma
    • hypersensitivity reactions
20
Q

Why may you give corticosteroids with asthma?

A

they upregulate B2 receptors

21
Q

Isoproterenol

use

administration

metabolism

A
  • relax bronchioles via B2
    • used w/respiratory disease.
  • parental or aerosol
  • metabolized by COMT
22
Q

How does ephedrine work?

A
  • releases NE and has direct effects
    • constricts vessels –> reduces stuffiness and secretions
    • increases BP
    • relaxes bronchioles
23
Q

What is ephedrine used for?

A
  • bronchospasm
  • allergy
  • narcolepsy
  • Stokes-Adams syndrome (in medications for colds)
24
Q

what is pseudoephedrine

A

Sudafed - used similar to ephedrine (just a stereoisomer)

25
Q

What is an alpha1 agonist and what is it used for?

A

phenylephrine - used as a decongestant by constricting vasculature

26
Q

What are 2 muscarinic receptor ANTAGONISTS?

What are they used for?

A
  • Ipratropium - bronchodilator 4x/day
  • Tiotropium - longer acting 1x/day

Used for COPD. May also reduce secretion due to sympathetic stimulation.

27
Q

What are 2 ways to increase cGMP?

A
  • NO acting through receptor to stimulate guanylate cyclase
  • ANP
28
Q

What is roflumilast? What is it used for?

A
  • phosphodiesterase 4 inhibitor
  • used for bronchodilation w/COPD
    • improves FEV1
  • nausea is AE.
29
Q

How is COPD distinguished from asthma?

A

Asthma = reversible.

COPD = not reversible.

30
Q

What drugs cause mucosal stuffiness

A
  • alpha blockers
    • Phentolamine
    • Phenoxybenzamine
    • prazosin
    • terazosin - used for prostatic hypertrophy to ease urination
31
Q

What drugs increase airway resistance?

A
  • beta blockers
    • propranolol
    • timolol
    • pindolol
    • labetalol (alpha1 and beta)
    • metoprolol
    • atenolol
    • esmolol
32
Q

What is an example of a muscarinic agonist?

A

Bethanecol

33
Q

What two things could cause mucosal congestion (drug classes)

A
  • alpha 1 antagonists
  • NE depleting agents (like guanethidine)
34
Q

What is a common side effect of lisinopril? Why?

A

Cough and angioedema

Bradykinin isn’t inactivated (builds up)

35
Q

What is an anticholinesterase that can cause bronchoconstriction?

A

neostigmine

physostigmine

pyridostigmine

edrophonium

ecothiophate

parathion

malathion

soman

chlorpyritos

CRRAB II Part 2 Respiratory (18 decks)

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