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PLAB Pharmacology > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

1
Q

antihistamines–mechanism

A
  • reversible inhibitors of H1 histamine receptors
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2
Q

name 3 first generation antihistamines

A
  • diphenhydramine
  • dimenhydrinate
  • chlorpheniramine
    • names contain “-en/-ine” or “-en/-ate”
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3
Q

first generation antihistamines–use

A
  • allergy
  • motion sickness
  • sleep aid
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4
Q

first generation antihistamines–toxicity

A
  • sedation
  • antimuscarinic
  • anti alpha adrenergic
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5
Q

name 4 2nd gernation antihistamines

A
  • loratadine
  • fexofenadine
  • desloratadine
  • ceterizine
    • names usually end in “-adine”
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6
Q

2nd generation antihitamines–use

A
  • allergy
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7
Q

why are 2nd generation antihistamines less sedating than 1st generation?

A
  • b/c of dec entry into CNS
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8
Q

name 2 expectorants

A
  • guaifenesin
  • N-acetylcysteine
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9
Q

guaifenesin–mechanism/use

A
  • expectorant–thins respiratory secretions
  • does not suppress cough reflex
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10
Q

N-acetylcysteine–mechanism/use

A
  • mucolytic–liquefies mucus in COPD pts by disrupting disulfide bonds
  • also used as an antidote for acetaminophen overdose
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11
Q

dextromethorphan–mechanism

A
  • antitussive–antagonizes NMDA glutamate receptors
  • synthetic codeine analog
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12
Q

dextromethorphan–toxicity

A
  • has mild opiod effect when used in excess
  • mild abuse potential
  • may cause serotonin syndrome if combined with other serotonergic agents
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13
Q

dextromethorphan–antidote

A
  • naloxone can be given for overdose
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14
Q

pseudoephedrine, phenyephrine–mechanism

A
  • alpha adrenergic agonists
  • used as nasal decongestants
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15
Q

pseudoephedrine, phenyephrine–use

A
  • reduce hypermia, edema, nasal decongestion
  • open obstrucated eustachian tubes
  • pseudoephedrine can be used illicitly to make methamphetamine
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16
Q

pseudoephedrine, phenyephrine–toxicity

A
  • HTN
  • can be used to cause CNS stimulation/anxiety
    • pseudophedrine
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17
Q

name 4 pulmonary hypertension drugs

A
  • Bosentan
  • sildenafil
  • epoprostenol
  • iloprost
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18
Q

BosENtan–mechanism

A
  • competitively antagonizes ENdothelin-1 receptors –> decrease pulmonary vascular resistance
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19
Q

Bosentan–toxicity

A
  • hepatotoxicity
    • monitor LFTs
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20
Q

Sildenafil–mechanism

A
  • inhibits cGMP PDE-5
  • prolongs vasodilatory effect of nitric oxide
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21
Q

what is another use for Sildenafil beside pulmonary hypertension?

A
  • erectile dysfunction
22
Q

epoprostenol, isoprost–mechanism

A
  • PGI2 (prostacyclin) with direct vasodilatory effects on pulmonary and systemic arterial vascular beds
  • inhibits platelet aggregation
23
Q

epoprostenol, isoprost–toxicity

A
  • flushing
  • jaw pain
24
Q

how is bronchoconstriction mediated?

A
  • inflammatory processes
  • parasympathetic tone
25
Q

classes of asthma drugs

A
  • beta 2 agonists
  • inhaled corticosteroids
  • muscarinic antagonists
  • antileukotrienes
  • anti-IgE monoclonal therapy
  • methylxanthines
26
Q

what are 3 asthma drugs that are beta 2 agonists?

A
  • albuterol
  • salmeterol
  • formoterol
27
Q

Albuterol–mechanism

A
  • (beta 2 agonist asthma drug)
  • relaxes bronchial smooth muscle–short acting beta 2 agonist
28
Q

albuterol–use

A
  • (beta 2 agonist asthma drug)
  • acute exacerbation
29
Q

salmeterol, formoterol–use

A
  • (beta 2 agonist asthma drug)
  • long acting agent for prophylaxis
30
Q

salmeterol, formoterol–toxicity

A
  • tremor
  • arrhythmia
31
Q

name 2 inhaled corticosteroids used for asthma

A
  • fluticasone
  • budesonide
32
Q

inhaled corticosteroids–use

A
  • first line for chronic asthma
    • fluticasone, budesonide
33
Q

inhaled corticosteroids–mechanism

A
  • (fluticasone, budesonide)
  • inhibit the synthesis of virtually all cytokines
  • inactivate NK-kappa B–transcription factor that induces production of TNK-alpha and other inflammatory agents
34
Q

name the muscarinic antagonist used to treat asthma

A
  • ipratropium
35
Q

ipratropium–use

A
  • asthma
  • COPD
36
Q

muscarinic antagonists–mechanism

A
  • (ipratropium)
  • competitively blocks muscarinic receptors, preventing bronchoconstriction
37
Q

what is a muscarinic antagonist used for asthma that is long acting?

A
  • tiotropium
38
Q

name 3 antileukotrienes that are used to treat asthma

A
  • montelukast
  • zafirlukast
  • zileuton
39
Q

montelukast, zafirlukast–mechanism

A
  • (antileukotrienes asthma drug)
  • block leukotriene receptors (CysLTI)
40
Q

montelukast, zafirlukast–use

A
  • (antileukotriene)
  • aspirin induced astham
41
Q

zileuton–mechanism

A
  • (antileukotriene)
  • 5 lipoxygenase pathway inhibitor
  • blocks conversion of arachidonic acid to leukotrienes
42
Q

zileuton–toxicity

A
  • (antileukotrienes)
  • hepatotoxic
43
Q

name the anti IgE monoclonal therapy used to treat asthma

A
  • omalizumab
44
Q

omalizumab–mechanism

A
  • (anti IgE monoclonal therapy for asthma)
  • binds mostly unbound serum IgE and blocks binding to FcERI
45
Q

omalizumab–use

A
  • (anti IgE monoclonal therapy)
  • used in allergic asthma with increased IgE levels resistant to inhaled steroids and long acting beta 2 agonists
46
Q

name the methylxanthine used to treat asthma

A
  • theophylline
47
Q

theophylline–mechanism

A
  • (methylxanthine asthma drug)
  • likely causes bronchodilation by inhibiting phosphodiesterase –> inc cAMP levels due to dec cAMP hydrolysis
  • metabolized by cytochrome P-450
  • blocks action of adenosine
48
Q

why is the use of theophylline limited?

A
  • (methylxanthine)
  • limited b/c of narrow therapeutic index
    • cardiotoxicity
    • neurotoxicity
49
Q

methacholine–mechanism

A
  • muscarinic receptor (M3) agonist
50
Q

methacholine–use

A
  • used in bronchial challenge test ot help diagnose asthma

PLAB Pharmacology (17 decks)

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