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Lungs/Respiratory > Respiratory Pharmacology > Flashcards

Respiratory Pharmacology Flashcards

1
Q

When can long acting beta 2 agonists be used alone?

A

COPD

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2
Q

What is the mechanism of H1 blockers?

A

Reversible inhibitors of H1 histamine receptors

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3
Q

What are three examples of 1st generation H1 blockers?

A
  1. Diphenhydramine
  2. Dimenhydrinate
  3. Chlorpheniramine
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4
Q

What are the clinical uses for 1st generation H1 blockers?

A

Allergy, motion sickness, sleep aid

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5
Q

What are toxicities associated with 1st generation H1 blockers?

A

Sedation, anti-muscarinic, anti-alpha-adrenergic

urinary retention, dry mouth, blurry vision, delirium

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6
Q

What are four examples of 2nd generation H1 blockers?

A
  1. Loratadine
  2. Fexofenadine
  3. Desloratadine
  4. Cetirizine
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7
Q

What are the clinical uses for 2nd generation H1 blockers?

A

Allergies

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8
Q

What is the major difference between between 1st and 2nd generation H1 blockers?

A

2nd generation H1 blockers cause far less sedation because of decreased entry into CNS

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9
Q

What is the mechanism of action of Guaifenesin?

A

Expectorant that thins mucus secretions

Think “fenesin” sounds like fenestrate like it is poking holes in the mucus to break it up

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10
Q

Does Guaifenesin suppress the cough reflex?

A

No

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11
Q

What is the mechanism of action of N-acetylcysteine?

A

Mucolytic that can loosen mucous plugs in CF patients by disrupting disulfide bonds

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12
Q

Besides its mucolytic properties, what else is N-acetylcysteine effective in treating?

A

acetaminophen overdose

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13
Q

What is the mechanism of action of Dextromethorphan?

A

Antitussive, which antagonizes the NMDA glutamate receptors. It’s a synthetic codeine analog.

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14
Q

What do you use to treat a Dextromethorphan overdose?

A

Naloxone

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15
Q

What are the side effects of Dextromethorphan?

A

Has mild opioid effect when used in excess, so has mild abuse potential

May cause serotonin syndrome if combined with other serotonergic agents

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16
Q

What is the mechanism of action for Pseudoephedrine and Phenylephrine?

A

alpha-adrenergic agonists, used as nasal decongestants (act as vasoconstrictors of nasal arteries)

17
Q

What are the clinical uses for Pseudoephedrine and Phenylephrine?

A

Reduce hyperemia, edema, nasal congestion; open obstructed eustachian tubes

Pseudoephedrine is also illicitly used to make methamphetamine

18
Q

What are the toxicities associated with Pseudoephedrine and Phenylephrine?

A

Hypertension

Can also cause CNS Stimulation/anxiety (pseudoephedrine)

19
Q

What are the three classes of drugs used to treat pulmonary hypertension?

A
  1. Endothelian Receptor Antagonists
  2. PDE-5 inhibitors
  3. Prostacyclin Analogs
20
Q

What is an example and what is the mechanism of an endothelial receptor antagonist?

A

Bosentan (primary drug used to treat pulmonary hypertension)

Competitively antagonize endothelin-1 receptors (decreased pulmonary vascular resistance)

21
Q

What toxicity is associated with endothelial receptor antagonists?

A

Hepatotoxic (monitor LFTs)

22
Q

What is an example and what is the mechanism of an PDE-5 inhibitors?

A

Sildenafil

Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide

(also used to treat erectile dysfunction)

23
Q

What are two examples of and what is the mechanism of prostacyclin analogs?

A

Epoprostenol and Iloprost

Prostacyclins (PGI2) with direct vasodilatory effects on pulmonary and systemic arterial vascular beds. Inhibit platelet aggregation

24
Q

What are the side effects associated with prostacyclin analogs?

A

flushing, jaw pain

25
Q

What are the two ways in which bronchoconstriction in asthma is mediated?

A
  1. inflammatory processes
  2. parasympathetic tone

(asthma therapy is directed at these two pathways)

26
Q

What type of drug is used during an acute exacerbation of asthma?

A

Beta 2 agonists (relax bronchial smooth muscle)

Example: Albuterol

27
Q

What type of drug is used for prophylaxis of asthma?

A

Long acting Beta 2 agonists

Ex. Salmeterol, formoterol

28
Q

What are the side effects associated with long acting Beta 2 agonists?

A

Tremor and arrhythmias

29
Q

What are two examples of corticosteroids that act as front line therapy for chronic asthma and what is the mechanism of action?

A

Fluticasone, Budesonide

Inhibit the synthesis of virtually all cytokines. Inactivate NF-kB, the transcription factor that induces the production of TNF-alpha and other inflammatory agents.

30
Q

What is an example of a short-acting and a long-acting muscarinic antagonist and what is their mechanism of action?

A

Short-acting: Ipratropium

Long-acting: Tiotropium

Competitively blocks muscarinic receptors, preventing bronchoconstriction

(also used to treat COPD)

31
Q

Which antileukotriene drugs block leukotriene receptors (CYsLT1) and are especially good for treating aspirin-induced asthma?

A

Montelukast, zarfirlukast

32
Q

What antileukotriene drug is a 5-lipoxygenase pathway inhibitor and what is its main side effect?

A

Zileuton (blocks the conversion of arachidonic acid to leukotriences)

Hepatoxic

33
Q

What kind of drug is Omalizumab, what is its mechanism of action, and when is it used?

A

Monoclonal anti-IgE antibody; binds mostly unbound serum IgE and blocks binding to FcERI (on mast cells and basal cells)

Used in allergic asthma that is resistant to inhaled steroids and long acting beta 2 agonists

34
Q

Do increased or decreased levels of cAMP lead to bronchodilation?

A

Increased

(both beta 2 agonists which increase AC and theophyline which inhibits the breakdown of cAMP, increase the levels of cAMP in cells thus increasing bronchodilation)

35
Q

What is the main example of methylxanthines used to treat asthma and COPD and what’s its mechanism of action?

A

Theophylline; likely causes bronchodilation by inhibiting phosphodiesterase, increasing the levels of cAMP by decreasing cAMP hydrolysis

36
Q

What are the toxicities associated with Theophylline?

A

Usage is limited due to the narrow therapeutic index (cardiotoxicity and neurotoxicity + nausea, vomiting arrhythmias, seizures)

metabolized by cytochrome P-450

37
Q

What drug does theophylline block the action of?

A

Adenosine

38
Q

What drug is used in the bronchial challenge test to help diagnose asthma?

A

Methacholine (Muscarinic receptor M3 agonist)

Lungs/Respiratory (4 decks)

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