Respiratory Pharm EC

Question 1

Diphenhydramine, Dimenhydrinate, Chlorpheniramine (MOA, Use, Tox)

Answer 1

First generation H1 Blockers

Used in allergy, motion sickness, sleep aid

Tox=Sedation, antimuscarinic, anti-alpha-adrenergic

Question 2

Loratadine, Fexofenadine, Desloratadine (MOA, Use, Tox)

Answer 2

Second generation H1 Blocker

Used in allergy

Far less sedating (does not enter CNS)

Question 3

Albuterol (MOA, Use)

Answer 3

Beta-2 agonist (relaxes bronchial smooth muscle)

Used during acute asthma exacerbation

Question 4

Salmeterol, Formoterol (MOA, Use, Tox)

Answer 4

Beta-2 agonists (long acting)

Used for prophylaxis of asthma

Can cause tremor and arrhythmia

Question 5

Theophylline (MOA, Use, Tox)

Answer 5

Methylxanthine (INHIBIT PDE)

Used to in asthma

Narrow TI: causes cardiotoxicity and neurotoxicity
metabolized by p450
blocks actions of adenosine

Question 6

Ipratropium (MOA, Use)

Answer 6

Muscarinic antagonist (prevent bronchoconstriction)

Used in Asthma, COPD

Question 7

Beclomethasone, Fluticasone (MOA, Use)

Answer 7

Corticosteroids
(inhibit cytokine synthesis by inactivating NF-kB which is the transcription factor that induces production of TNF-alpha)

First line for chronic asthma

Question 8

Montelukast, Zafirlukast (MOA, Use)

Answer 8

Block Leukotriene receptors

Especially useful in aspirin-induced asthma (COX inhibitors cause shunting down 5-lipoxygenase/Leukotriene pathway)

Question 9

Zileuton (MOA, Use)

Answer 9

5-Lipoxygenase Inhibitor (blocks conversion of arachidonic acid to leukotrienes)

Used in asthma

Question 10

Omalizumab (MOA, Use)

Answer 10

Monoclonal antibody to IgE

Used in allergic asthma resistant to other treatment

Question 11

Guaifenesin (Use)

Answer 11

Expectorant - thins respiratory secretions

Does not suppress cough reflex

Question 12

N-acetylcysteine (Use)

Answer 12

Expectorant

Loosens mucus plugs in CF patients

Antidote for acetaminophen OD (replenishes glutathione)

Question 13

Cromolyn Sodium (MOA, Use)

Answer 13

Stabilizes mast cells - inhibiting histamine release

Used in sports induced asthma - must be taken before exposure

Question 14

Bosentan (MOA, Use)

Answer 14

Endothelin-1 Receptor Antagonist (decreasing pulmonary vascular resistance)

Used to treat pulmonary arterial hypertension

Question 15

Dextromethorphan (MOA, Use)

Answer 15

NMDA-glutamate receptor Antagonist
Synthetic codeine analog (mild opioid)

Used as antitussive

Question 16

Pseudoephedrine, Phenylephrine (MOA, Use, Tox)

Answer 16

Alpha-agonists (nasal decongestants)

Reduce hyperemia, edema, and nasal congestion
Open obstructed eustachian tubes
Pseudoephedrine also used as a stimulant

Can cause hypertension
Pseudoephedrine can also cause anxiety

Question 17

Methacholine (MOA, Use)

Answer 17

Muscarinic Receptor Agonist

Used in asthma challenge testing