Respiratory Pharmacology

Question 1

antitussives treat…

Answer 1

congestion

Question 2

antitissives

• MOA
• often used in conjunction with…
• what type of cough it is used for
• short or long term
• efficacy

Answer 2

suppresses coughing
often used in conjunction with acetaminophen
used for a non-productive cough
short term use
efficacy is questionable, especially for non-prescription products

Question 3

decongestants

• MOA
• side effect

Answer 3

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 4

drugs classes for congestion

Answer 4

antitissives
decongestants
antihistamines
mucolytics and expectorants

Question 5

what does histamine do

Answer 5

regulates normal function

• gastric secretion
• CNS neural modulation
• allergies

Question 6

antihistamines

• MOA
• function
• side effect

Answer 6

decreases nasal congestion, mucosal irritation, and discharge, and conjunctivitis
able to cross blood-brain barrier
-sedation

Question 7

mucolytics and expectorants side effect

Answer 7

GI upset

Question 8

mucolytic (Acetylcysteine)

• MOA
• used in combo with…

Answer 8

breaks disulfide bonds of mucoproteins, forming less viscous secretion
used in combo with other decongestants or antihistamines

Question 9

expectorant (guaifenesin)

-MOA

Answer 9

increases production of pulmonary secretions, encouraging the ejection of mucus and phlegm

Question 10

respiratory drugs for obstruction

Answer 10

bronchodilators

anti-inflammatory

Question 11

bronchodilator drug classes

Answer 11

beta-adrenergic agonists
anti-cholinergics
xanthine derivatives

Question 12

anti-inflammatory drug classes

Answer 12

glucocorticoids (corticosteroids)
cromones
leukotriene inhibitors

Question 13

bronchodilators: beta-adrenergic agonists
- MOA
- administration route
- side effects

Answer 13

act on B-2 receptors on respiratory smooth muscle cells to cause relaxation and bronchodilation
administered by inhalation
-metered-dose inhalers
-dry power inhalers
-nebulizers
side effects
-airway irritation, nervousness, restlessness, tremor, increased HR

Question 14

bronchodilators: anti-cholinergics
- MOA
- drugs of choice for…
- administration route

Answer 14

block muscarinic cholinergic rectpors to prevent bronchoconstriction
drugs of choice for COPD, chronic bronchitis
inhaled for Tx of respiratory disorders

Question 15

anti-cholinergics

-side effects

Answer 15

dry mouth
constipation
urinary retention
confusion
blurred vision

Question 16

bronchodilators: xanthine derivatives
- MOA
- administration route
- how common

Answer 16

MOA
-CNS stimulant for reversible airway obstruction
-works on smooth muscle cells to bronchodilate
-anti-inflammatory effect
administered orally
not used frequently anymore
-toxicity

Question 17

anti-inflammatory: glucocorticoids

• most effective agents for _____
• MOA
• administration route

Answer 17

most effective for controlling asthma
induce anti-inflammatory effects
inhaled (leads to decrease side effects) or oral

Question 18

anti-inflammatory: glucocorticoids

-side effects

Answer 18

thrush
osteoporosis, skin and muscle wasting
aggravation of diabetes mellitus
HTN

Question 19

what is thrush

Answer 19

fungal infection

Question 20

anti-inflammatory: cromones

• function
• MOA
• administration route
• side effects

Answer 20

can be used prophylactically to prevent asthma
inhibit inflammatory mediators from pulmonary mast cells
nasal spray, nebulizer
no serious side effects

Question 21

anti-inflammatory: leukotriene inhibitors

• MOA
• can be combines with…
• side effect

Answer 21

inhibits lipoxygenase enzyme
-leukotrienes mediate airway inflammation
can be combined with glucocorticoids for optimal COPD and asthma management
few adverse effects, mild liver impairment

Question 22

asthma pathophysiology

Answer 22

dual components of inflammation and bronchospasm

inflammation of airway sensitizes it to bronchospasms

Question 23

asthma long-term management

Answer 23

shift recently to more anti-inflammatory drugs
long acting beta-blockers should not be used alone
rescue inhalers as a backup
combined preparations (glucocorticoid + bronchodilator)

Question 24

COPD management philosophy

Answer 24

prevent airflow restriction, maintain airway patency = anticholinergics/beta-adrenergic blockers
short-term
-oral glucocorticoids
-combined preparations

Question 25

conclusions and summary points

Answer 25

exercise can exacerbate asthma
bring rescue inhaler to treatment sessions
be aware of side effects of bronchodilators
-increased HR
-arrhythmais
-nervousness, confusion, signs of toxicity
make adjustments to tissue loading in the case of long-term glucocorticoid use