Respiratory Pharmaceuticals

Question 1

What types of medications are used for obstructive respiratory disorders (asthma, COPD, emphysema)

Answer 1

Bronchodilators, glucocorticoids, & other anti-inflammatory agents

Question 2

What are the primary medications for exercise-induced asthma?

Answer 2

rescue inhaler as backup

Question 3

What are 3 classes of bronchodilators?

Answer 3

1. Beta-adrenergic agonists
2. Anti-cholinergics
3. Xanthine derivatives

Question 4

What are beta-adrenergic agonist bronchodilators used for and mechanism of action?

Answer 4

• act on B2 receptors of smooth muscle to induce relaxation & bronchodilation
• administered via inhalation (fast)

Question 5

What are side effects of beta-adrenergic agonists?

Answer 5

Airway irritation, nervousness, restlessness, tremor, increased HR

Question 6

Anti-cholinergic bronchodilators are primarily prescribed for what conditions?

Answer 6

drug of choice for COPD & chronic bronchitis

Question 7

How do anti-cholinergic bronchodilators work?

Answer 7

Inhaled to block muscarinic cholinergic receptors to prevent acetylcholine-induced bronchoconstriction

Question 8

What are side effects of anti-cholinergics?

Answer 8

Dry mouth, constipation, urinary retention, confusion, blurred vision

Question 10

What are glucocorticoids used for and how do they work?

Answer 10

• most effective for controlling asthma
• induce anti-inflammatory effects via inhibition of the pro inflammatory proteins and promotion of anti-inflammatory proteins
• inhibit migration of neutrophils and monocytes

Question 11

What are the side effects of glucocorticoids?

Answer 11

Thrush, catabolic effect on support tissues (osteoporosis, skin & muscle wasting), aggravation of diabetes mellitus, and hypertension (HTN)
-decreased symptoms if inhaled (except for thrush)

Question 12

What are cromone anti-inflammatory medications used for and how do they work?

Answer 12

• used to prevent asthma and can be used via nasal spray or in nebulizer
• inhibits inflammatory mediators (leukotrienes & histamine) from pulmonary mast cells

Question 13

What are the side effects of cromone anti-inflammatories?

Answer 13

Free of serious adverse effects

Question 14

What are leukotriene inhibitor anti-inflammatories and how do they work?

Answer 14

Often used in combination with glucocorticoids for COPD and asthma management. Works by inhibiting lipoxygenase enzyme, which mediate airway inflammation.

Question 15

What are the side effects of leukotriene inhibitors?

Answer 15

Few adverse effects, mild liver impairment

Question 16

What are side effects of xanthine derivatives?

Answer 16

Theophylline toxicity: nausea, confusion, irritability, seizures, arrhythmias. Avoid long-term use

Question 17

What are antitussives used for?

Answer 17

• suppress cough, often in conjunction with acetaminophen
• short term use
• questionable efficacy, especially for over the counter

Question 18

What are decongestants and how do they work?

Answer 18

• alpha-1 adrenergic agonists
• stimulate nasal vasoconstriction
• can cause CNS excitation (headache, dizziness, nervousness, HTN, palpitations
• may cause rebound congestion when used long-term

Question 19

What are antihistamines and how do they work?

Answer 19

• histamines regulate normal function of gastric secretions, CNS neural modulation, and allergies
• work by blocking H1 receptors
• decreases nasal congestion, mucosal irritation & discharge, and conjunctivitis
• able to cross blood-brain barrier

Question 20

What are mucolytics (Acetylcysteine) & expectorants (guaifenesin) and how do they work?

Answer 20

Acetylcysteine- breaks disulfide bonds of mucoproteins to thin them
Guaifenesin- increases production of pulmonary secretions, encouraging the ejection of mucus and phlegm (side effect: GI upset)

Question 21

What is COPD?

Answer 21

• obstructive pulmonary disease= flow is impacted; patient has difficulty exhaling (gas gets trapped in lungs)
• combination of emphysema and chronic bronchitis

Question 22

What is the management philosophy for COPD?

Answer 22

• prevent airflow restriction & maintain airway patency with anticholinergics/beta-adrenergic blockers
• short-term: oral glucocorticoids
• combined preparations of medications

Question 23

How do xanthine derivative bronchodilators work?

Answer 23

Administered orally as a CNS stimulant for reversible airway obstruction (bronchitis, emphysema). Works on smooth muscles to bronchodilate and has anti-inflammatory effect by inhibiting phosphodiesterase enzyme.

Question 29

What medications are primarily used for congestive respiratory disorders (cold, allergies, bronchitis, etc)?

Answer 29

Antitussives, decongestants, expectorants, mucolytics, & antihistamines