Respiratory Pharmacology Flashcards

1
Q

Diphenhydramine

A
  • 1st generation H1 blocker
  • Reversible inhibitor of H1 histamine receptor
  • Uses:
    • allergy
    • Motion sickness
    • Sleep aid
  • Toxicity:
    • Sedation
    • Antimuscarinic
    • Anti-alha-adrenergic
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2
Q

Dimenhydrinate

A

1st generation H1 blocker

  • Reversible inhibitor of H1 histamine receptor
  • Uses:
    • allergy
    • Motion sickness
    • Sleep aid
  • Toxicity:
    • Sedation
    • Antimuscarinic
    • Anti-alha-adrenergic
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3
Q

Chlorpheniramine

A

1st generation H1 blocker

  • Reversible inhibitor of H1 histamine receptor
  • Uses:
    • allergy
    • Motion sickness
    • Sleep aid
  • Toxicity:
    • Sedation
    • Antimuscarinic
    • Anti-alha-adrenergic
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4
Q

Loratadine

A
  • 2nd generation H1 blocker
  • Reversible inhibitor of H1 histamine receptors
  • Uses: allergy
  • Toxicity: less sedation than 1st generation b/c less into CNS
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5
Q

Fexofenadine

A
  • 2nd generation H1 blocker
  • Reversible inhibitor of H1 histamine receptors
  • Uses: allergy
  • Toxicity: less sedation than 1st generation b/c less into CNS
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6
Q

Desloratadine

A
  • 2nd generation H1 blocker
  • Reversible inhibitor of H1 histamine receptors
  • Uses: allergy
  • Toxicity: less sedation than 1st generation b/c less into CNS
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7
Q

Certirizine

A
  • 2nd generation H1 blocker
  • Reversible inhibitor of H1 histamine receptors
  • Uses: allergy
  • Toxicity: less sedation than 1st generation b/c less into CNS
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8
Q

Isoproterenol

A
  • Non specific beta agonist
  • Treat asthma
  • relaxes bronchial smooth muscle (beta 2)
  • Adverse effect: tachycardia via beta 1
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9
Q

Albuterol

A
  • Beta 2 agonist
  • treat asthma
  • Relaxes bronchial smooth muscle via beta 2
  • Use during acute exacerbation
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10
Q

Salmeterol

A
  • Beta 2 agonist
  • Treat asthma
  • long acting agent for prophylaxis
  • ≥12 hour duration (versus 1-4 hours) (great for nocturnal asthma attacks)
  • long duration due to high lipid solubility
  • Adverse effects: tremor & arrhythmia
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11
Q

Theophylline

A
  • Methylaxamine (also includes caffeine and theobromine)
  • Treats Asthma
  • Bronchodilation by inhibiting phosphodiesterase
    • Decreases cAMP hydrolysis
  • Limited use due to narrow therapeutic index
    • Cardiotoxicity and neurotoxicity
    • Caffeine like symptoms
  • Metabolized by P-450
  • Blocks action of adenosine
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12
Q

Ipratropium

A
  • Competitive block of muscarinic receptors
    • Same as atopine
    • Also, tiotropium long acting
  • Treats asthma
  • Prevents bronchoconstriction
  • Also used for COPD
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13
Q

Cromolyn

A
  • Prevents release of mediators from mast cells
  • Effective only for prophylaxis of asthma
  • Not effective during acute asthma attack
  • Toxicity is rare
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14
Q

Prednisone

A
  • Corticosteroid
    • beclomethasone, fluticasone, budesonide inhaled
  • Inhibits synthesis of all cytokines
  • Inactivates NF-kappa B
    • NF-kappa B: transcription factor inducing TNF alpha
  • 1st line therapy for chronic asthma
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15
Q

Zileuton

A
  • Antileukotrienes
  • 5 lipoxygenase pathway inhibitor
  • Blocks conversion of arachidonic acid to leukotrienes
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16
Q

Zafirlukast & Montelukast

A
  • Block leukotriene receptors

- Especially good for aspirin induced asthma

17
Q

Epinephrine

A
  • Non selective beta agonist
  • relaxes bronchial smooth muscle via B2 activation
  • effective & rapidly acting when given s.c. or inhaled as an aerosol
  • side-effects:
    • tachycardia, arrhythmias, aggravated angina
18
Q

terbutaline

A

Short Acting β2 Agonists
• inhaled or oral
• albuterol, terbutaline, metaproterenol, and
bitolterol are equivalent to isoproterenol (in
terms of bronchodilation) when given by
inhalation
• only terbutaline is available s.c. (emergency
therapy)

19
Q

Omalizumab

A

-Recombinant humanized IgG1 monoclonal anti-IgE antibody
• Binds IgE preventing interaction w/mast cells
-blocks IgE-dependent mast cell activation.
-Binds Fc region.
-Useful for patients with persistent asthma
-Particularly w/ evidence of a sensitization to allergens
Side effects:
-increased upper respiratory infections
-headache
-Possible slight increase in incidence of cancer

20
Q

Drugs for COPD:

A

-Bronchodilators:
-Short acting beta-2 agonists: albuterol
-Long acting beta-2 agonists: salmeterol
-Short acting anticholinergics: ipratropium bromide
-Long acting anticholinergics: tiotropium bromide
-In COPD patients, the use of anticholinergics is associated
with increased risk of cardiovascular events (MI)
-Prophylactic antibiotic: Chronic azithromycin (hearing loss)