Respiratory- GOOD Flashcards
Of the following anti-histamines, which are first generation and which are second?
How do we know they are antihistamines in the first place?
- loratadine
- diphenhydramine
- chlorpheniramine
- desloratadine
- fexofenadine
- cetirizine
- dimenhydrinate
- loratadine: 2
- diphenhydramine: 1
- chlorpheniramine: 1
- desloratadine: 2
- fexofenadine: 2
- cetirizine: 2
- dimenhydrinate: 2
First gen contains en/ine or en/ate.
Second gen ends in –adine, with the exception of cetirizine, the odd ball.
Guaifenesin & N-acetylcystiene MOA in resp. disease?
*What is an additional use for NAC?
- guaifenesin: thins secretions
- NAC: thins mucus by disrupting disulfide bonds
- NAC: antidote for acetaminophen OD
Dextromethorphan:
- MOA
- treatment for OD
- avoid combination with?
- NMDA glut antagonist –> cough suppression
- naloxone for OD (mild opioid)
- can cause serotonin syndrome: no SSRIs, MAOis, or linezolid.
Pseudophedrine/ phenylephrine:
- MOA
- use
- a agonists –> vasoconstriction = reduced hyperemia and edema
- nasal congestion, open obstructed Eustachian tubes
- *FUN FACT:
- Leah took pseudophedrine once when she was really sick. Normal dose. She proceeded to faint in the shower, hit her face, and killed two front teeth. She needed two root canals. Also, during this time, she had mono + strep + an allergic reaction to her antibiotic. She lost 20 pounds. IT WAS EXHILIRATING. DONT TAKE THIS SHIT. It keeps you awake, It makes you dizzy, hypertensive, tachycardic. DONT.
What are your options for treatment of PulmHTN?
- bosentan
- sildenafil
- epoprostenol/ iloprost
What is the MOA for:
bosentan
sildenafil
epoprostenol/ iloprost?
bosENtan: –I Endeothelin 1
sildenafil: –I cGMP PDE5
epoprostenol/ iloprost:PGI2 analog
Which of the PulmHTN drugs is hepatotoxic and requires monitoring of LFTs?
-bosentan SHOWS THE LIVER WHO IS BOSS!!!
Of the B2 agonists for asthma, which are long acting?
-salmeterol, formoterol
albuterol = short acting rescue
MC ADR for B2 agonists in asthma treatment?
-tremor, arrhythmia
In addition to long acting B2 agonists, what should be given to chronic asthma patients?
- steroids (flucticasone, budesonide)
- like all steroids, they inactivate NF-kB
Two muscarinic antagonists used in COPD? Which lasts longer?
- ipratropium
- tiotropium (longer lasting)
Monelu[kast] and zafirlu[kast] are especially good at treating what kind of asthma? (although this is NOT their only use)
How do they work?
- block CysLT1 leukotriene receptor
- aspirin induced asthma
Zileuton:
- MOA
- important ADR?
- 5-lipoxy path inhibitor –> no leukotrienes made
- hepatotoxic
Omalizu”mab” is an ab against what?
- IgE/FceR1
- second line treatment in allergic asthma not responding to inhaled steroids + BBers
Methacholine is used to dx asthma. We all know this.
How does it work?
-M3 agonist
