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0001 STEP ONE RAPID REVIEW DX > Respiratory pharmacology > Flashcards

Respiratory pharmacology Flashcards

1
Q

H1 blockers - first gen

A

Diphenhydramine
dimenhydrinate
chlorpheniramine

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2
Q

When to use H1 blockers (diphenhydramine, dimenhydrinate, chlorpheniramine) - first gen

A

allergy, motion sickness, sleep aid

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3
Q

toxicity of H1 blockers - first gen

A

sedation, antimuscarinic, anti-alpha-adrenergic

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4
Q

second generation H1 blockers

A

loratadine
fexofenadine
cetrizine

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5
Q

clinical use H1 - 2nd gen

A

allergy

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6
Q

guaifenesin

A

expectorant - thins respiratory secretions; does not suppress cough

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7
Q

N-Acetylcysteine

A

expectorant - can loosen mucous plugs in CF patient by dirupting disulfide bonds. Also used as an antidote for acetaminophen overdose

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8
Q

antidote for acetaminophen overdose

A

N-acetylcysteine

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9
Q

Dextromethorophan

A

Antitussive (antagonizes NMDA glutamate receptors) - synthetic codeine analog. Has mild opioid effect when used in excess. Naloxone can be given for overdose. Mild abuse potential
may cause serotonin syndrome if combined with other serotonergic agents

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10
Q

pseudoephedrine / phenylephrine

A

alpha adrenergic agonists - used as nasal decongestants -

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11
Q

clinical use of pseudoephedrine / phenylephrine

A

reduce hyperemia, edema, nasal congestion, open obstructed eustachian tubes

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12
Q

pulmonary hypertension drugs

A

endothelin receptor antagonists
PDE-5 inhibitors
Prostacyclin analogs

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13
Q

endothelin receptor antagonists

A

Bosentan

competitively antagonize endothelin-1 receptors which leads to decreased pulmonary vasculature resistance

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14
Q

what do you need to worry about with endothelin receptor antagonists? (bosentan)

A

hepatotoxic montior LFT

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15
Q

PDE5 inhibitors

A

(like sildenafil - the boner drug) - used in pulmonary hypertension - inhibits cGMP PDE5 and prolong vasodilatory effect of NO

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16
Q

Prostacyclin analogs

A

include epoprostenol and iloprost
These are lovely because prostacyclins (PGI2) have direct vasodilatory effects on the pulmonary vasculature and inhibit platelet aggregations

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17
Q

epoprostenol

A

prostacyclin analog used in Pulmonary htn
also use iloprost
direct vasodilatory effect of pulm

18
Q

side effects of prostacyclin analogs (epoprostenol, iloprost)

A

flushing and jaw pain

19
Q

albuterol

A

asthma drug - relaxes bronchial smooth muscle (b2 agonist) used during acute exaceration

20
Q

what are the two long acting beta-2 agonists used in the treatment of asthma for prophylaxis?

A

salmeterol
formoterol

note: adverse side effects include tremor and arryhthmia

21
Q

Corticosteroids used in teh treatment of astchma

A

fluticasone

budesonide

22
Q

how do gluticasone and budesonide help asthmatics

A

they inhibit the synthesis of all cytokines - they inactivate NF-kB, the transcription factor that induces the production of TNF-alpha and other inflammatory agents
FIRST LINE THERAPY

23
Q

Ipratropium (tiotropium)

A

This is a muscarinic antagonist used in the treatment of asthma - it works by competetiviely blocking muscarinic receptors, preventing bronchoconstirction, - also used in COPD

Long acting version ()

24
Q

Montelukast

Zafirlukast

A

These are antiluekotrienes used in the treatment of asthma - the block leukotriene receptors (CysLT1) - espcially good for aspirin induced asthma

25
Q

Zileuton

A

This is an antiluekotriene used in teh treatment of asthma - it is a 5-lipoxgenase pathway inhibitor - blocks the coversion of arachnidonic acid to leukotrienes -
DANGER HEPATOTOXIC

26
Q

Omalizumab

A

this is a monoclonal IgE antibody used in the treatment of asthma
it binds mostly to unbound serum IgE and blocks binding to FcER1 - used in alleric asthma resistant to inhaled steroid and long acting b2 agonists

27
Q

what is theophyilline?

A

This is a methylxanthine used in the treatment of asthma - it likely causes bronchodilation by inhibiting phosphodiesterase which increases cAMP

also blocks the actions of adenosine (adenosine causes bronchoconstriction)

28
Q

Worries about theophyilline

A

even though it is lovely that theophylline causes bronchodilation it is also
CARDIOTOXIC
NEUROTOXIC
metabolized by p450

29
Q

methacholine

A

this is a muscarininc receptor (M3) agonist - used in bronchial challenge to help diagnose asthma

30
Q

Glucocorticoids (inhaled) are lovely but can increase the risk of? and so what do we do

A

increase risk of oral candidiasis so rinse your mouth

31
Q

Bosentan

A

endothelin receptor antagonist - used in the treatment of PAH - endothelin is a potent vasocontrictor that also stimulates endothelial proliferation - makes shit worse

32
Q

If you are an alcoholic and inhale / aspirate something and get a lung abscess, what is a nice AB for me to give you so that I cover not only typical shit like STREP but also common mouth flora (anaerobes like bacteroides)

A

Clindamycin - 50s :)

nice coverage of both gram positive aerobes and also oral anaerobes

33
Q

Prophylaxis in AIDS for MAC - acid fast grows best at 41 - causes diarrhea and reticuloendothelial shit

A

Azithromycin

34
Q

Prophylaxis in AIDS for Histoplasma

A

Itraconzole

35
Q

Prophylaxis in AIDS for Pneumocystis jirovecii?

A

TMP-SMX

36
Q

Prophylaxis in AIDS for Toxoplama gondii

A

TMP-SMX

37
Q

Why would I give someone with thrush nystatin and not griseofulvin

A

griseofulvin is for dermatophytes

nystatin can be swished and swallowed :)

38
Q

why wouldnt we use ciprofloxacin or cefazolin (first gen ceph) in an alcoholic who aspirated

A

because not good against anaerobes

39
Q

Specific marker = chromogranin

what are you thinking?

A

small cell lung cancer

40
Q

Reid index

A

for bronchiectasis

mucous layer : (epithelium through to (to to) cartilage)

0001 STEP ONE RAPID REVIEW DX (25 decks)

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