Respiratory System Drugs Flashcards by Dillon Pryor

Mechanism:

Sildenafil

Tadalafil

(-afil)

Pulmonary HTN drug (also treats ED):

Inhibits PDE-5 → increasing cGMP → prolonging vasodilatory effect of nitric oxide (NO)

How well did you know this?

Not at all

Perfectly

Mechanism: Theophylline

Inhibits phosphodiesterase (PDE) → increasing cAMP (due to decrease cAMP hydrolysis) → bronchodilation

How well did you know this?

Not at all

Perfectly

Adverse effects: Theophylline

Cardiotoxicity
Neurotoxicity

Usage limited due to narrow therapeutic index

Metabolized by cytochrome P-450 (substrate)

How well did you know this?

Not at all

Perfectly

Mechanism: Albuterol

Short-acting beta-2 agonist:

Relaxes bronchial smooth muscle

Used during acute exacerbation

How well did you know this?

Not at all

Perfectly

Mechanism: Montelukast

Antileukotriene:

Block leukotriene receptors (CysLT1)

Especially good for:

Aspirin-induced
Exercise-induced asthma

How well did you know this?

Not at all

Perfectly

Class: Promethazine

1st generation antihistmaine

How well did you know this?

Not at all

Perfectly

Clinical use:

Tiotropium

Ipratropium

(-tropium)

Asthma

COPD

How well did you know this?

Not at all

Perfectly

Class: Hydroxyzine

1st generation antihistmaine

How well did you know this?

Not at all

Perfectly

Adverse effects:

Pseudoephedrine

Phenylephrine

Hypertension
Rebound congestion if used more than 4-6 days
Pseudoephedrine: CNS stimulation/anxiety

How well did you know this?

Not at all

Perfectly

Clinical use:

Beclomethasone

Fluticasone

Budesonide

1st-line therapy for chronic asthma

How well did you know this?

Not at all

Perfectly

Mechanism:

Tiotropium

Ipratropium

(-tropium)

Muscarinic antagonists:

Competitively block muscarinic receptors, preventing bronchoconstriction

Tiotropium = long-acting

How well did you know this?

Not at all

Perfectly

Class: Cetirizine

2nd generation antihistamine

How well did you know this?

Not at all

Perfectly

Class/mechanism: Pseudoephedrine

Alpha-adrenergic agonists

Used as nasal decongestants

How well did you know this?

Not at all

Perfectly

Clinical use: 1st generation antihistamines

Allergy

Motion sickness

Sleep aid

How well did you know this?

Not at all

Perfectly

Mechanism of antihistamines

Reversible inhibitors of H₁ histamine receptors

How well did you know this?

Not at all

Perfectly

Mechanism: Omalizumab

Anti-IgE monoclonal therapy:

Binds mostly unbound serum IgE and blocks binding to FceRI

How well did you know this?

Not at all

Perfectly

Mechanism: Formoterol

Long-acting beta-2 agonist used for asthma prophylaxis

How well did you know this?

Not at all

Perfectly

Adverse effects:

Bosentan

Ambrisentan

(-sentan)

Hepatotoxic (monitor LFTs)

How well did you know this?

Not at all

Perfectly

Class/mechanism: Phenylephrine

Alpha-adrenergic agonists

Used as nasal decongestants

How well did you know this?

Not at all

Perfectly

Adverse effects: 1st generation antihistamines

Sedation

Antimuscarinic

Anti-alpha-adrenergic

Mechanism: Zileuton

Antileukotriene:

5-lipoxygenase pathway inhibitor → blocks conversion of arachidonic acid to leukotrienes

Class: Diphenhydramine

1st generation antihistamine

Class: Desloratadine

2nd generation antihistamine

Adverse effects:

Epoprostenol

Iloprost

Treprostinil

(-prost-)

Flushing
Jaw pain

Class/action: N-acetylcysteine

1. **Mucolytic:** Liquifies mucus in chronic bronchopulmonary diseases (e.g., COPD, CF) by disrupting _disulfide bonds_ 2. Andidote for **acetaminophone OD**

Mechanism: Beclomethasone Fluticasone Budesonide

**Inhaled corticosteroids:** Inhibits the synthesis of virtually all cytokines. Inactivates **NF-kB**, the transcription factor that induces production of TNF-alpha and other inflammatory mediators.

Mechanism: Bosentan Ambrisentan **(-sentan)**

**Pulmonary HTN drug:** Competitively antagonizes **endothelin-1 receptors** → decreasing pulmonary vascular resistance

Class: Fexofenadine

2nd generation antihistamine

Mechanism: Epoprostenol Iloprost Treprostinil **(-prost-)**

**Pulmonary HTN drug:** **PGI₂ (prostacyclin)** with direct vasodilatory effects on pulmonary and systemic arterial vascular beds Inhibits platelet aggregation

Clinical use: 2nd generation antihistamines

Allergy

Clinical use: Pseudoephedrine Phenylephrine

1. Reduce hyperemia, edema, nasal decongestion 2. Open obstructed eustachian tubes

Class/action: Guaifenesin

**Expectorant:** Thins respiratory secretions Does not suppress cough reflex

Bronchoconstriction is mediated by ___ and \_\_\_; thus therapy is directed at these two pathways.

Inflammatory process Parasympathetic tone

Mechanism: Zafirlukast

**Antileukotriene:** Block **leukotriene receptors (CysLT1)** Especially good for: * Aspirin-induced * Exercise-induced asthma

Theophylline blocks bronchoconstriction effects of \_\_\_

Adenosine

Mechanism: **Crom**olyn Nedo**crom**il

Mast cell stabilizers

Adverse effects: Salmeterol Formoterol

1. Tremor 2. Arrhythmia

Mechanism: Methacholine

**Nonselective muscarinic receptor (M₃) agonist** Used in **methacholine challenge test** to help diagnose **asthma**

Class/action: Dextromethorphan

**Antitussive** (antagonizes NMDA glutamate receptors) Synthesic codeine analog

Adverse effects: 2nd generation antihistamines

Far less sedating than 1st generation because decreased entry into CNS

Class: Loratadine

2nd generation antihistamine

Class: Chlorpheniramine

1st generation antihistamine

Mechanism: Salmeterol

Long-acting **beta-2 agonist** used for asthma prophylaxis

Adverse effects: Beclomethasone Fluticasone Budesonide

Oral thrush

Adverse effects: Zileuton

Hepatotoxic

Clinical use: Omalizumab

**Allergic asthma** with increased IgE levels resistant to inhaled steroids and long-acting beta-2 agonists

Class: Dimenhydrinate

1st generation antihistamine

Adverse effects: Dextromethorphan

1. Mild opioid effect when used in excess 2. Mild abuse potential 3. Serotonin syndrome (if combined with other serotonergic agents) **Naloxone** given in OD