Respiratory, USMLE

Question 1

T/F H1 blockers are REVERSIBLE inhibitors of H1 receptors

Answer 1

T

Question 2

1st vs 2nd gen H1 blocker: Diphenhydramine

Answer 2

1st

Question 3

1st vs 2nd gen H1 blocker: Loratadine

Answer 3

2nd

Question 4

1st vs 2nd gen H1 blocker: Desloratadine

Answer 4

2nd

Question 5

1st vs 2nd gen H1 blocker: Chlorpheniramine

Answer 5

1st

Question 6

1st vs 2nd gen H1 blocker: Cetirizine

Answer 6

2nd

Question 7

1st vs 2nd gen H1 blocker: Levocetirizine

Answer 7

3rd

Question 8

2nd gen antihistamine is far less sedating than 1st gen due to

Answer 8

Less entry into CNS

Question 9

SABA

Answer 9

Albuterol/Salbutamol

Question 10

LABA

Answer 10

1) Salmeterol

2) Formoterol

Question 11

Adverse effects of LABA (2)

Answer 11

1) Tremor

2) Arrhythmia

Question 12

Methylxanthine

Answer 12

Theophylline

Question 13

Theophylline MOA

Answer 13

Bronchodilation by inhibition of PDE thereby decreasing cAMP hydrolysis

Question 14

Theophylline use is limited by

Answer 14

1) Cariotoxicity

2) Neurotoxicity

Question 15

Muscarinic antagonist, short-acting

Answer 15

Ipratropium

Question 16

Muscarinic antagonist, long-acting

Answer 16

Tiotropium

Question 17

Muscarinic antagonist, long-acting: Use

Answer 17

COPD

Question 18

1st line therapy for chronic asthma

Answer 18

Corticosteroids

Question 19

Beclomethasone/fluticasone characteristic MOA

Answer 19

Inactivates NF-kB (transcription factor that induces production of TNF-α

Question 20

Especially good for aspirin-induced asthma

Answer 20

Antileukotrienes

Question 21

Antileukotrienes

Answer 21

Montelukast, Zafirlukast

Question 22

Zileuton, MOA

Answer 22

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

Question 23

Monoclonal anti-IgE antibody

Answer 23

Omalizumab

Question 24

Omalizumab, MOA

Answer 24

Binds mostly unbound IgE

Question 25

Omalizumab, use

Answer 25

Allergic asthma resistant to inhaled steroids and LABA

Question 26

β-agonist MOA

Answer 26

Increases cAMP causing bronchodilation

Question 27

Guaifenesin MOA

Answer 27

Thins respiratory secretions but does not suppress cough

Question 28

N-acetylcysteine MOA

Answer 28

Mucolytic by loosening mucous plugs

Question 29

N-acetylcysteine uses

Answer 29

1) CF | 2) Acetaminophen overdose

Question 30

Used to treat pulmonary arterial hen by competitively antagonising endothelia 1 receptors, decreasing pulmonary vascular resistance

Answer 30

Bosentan

Question 31

Dextromethorphan MOA

Answer 31

Antitussive by antagonising NMDA glutamate receptors

Question 32

Synthetic codeine analog hence has mild opioid effect when used in excess

Answer 32

Dextromethorphan

Question 33

Dextromethorphan antidote

Answer 33

Naloxone

Question 34

Pseudoephedrine, phenylephrine MOA

Answer 34

Sympathomimetic α-agonist

Question 35

Pseudoephedrine, phenylephrine use

Answer 35

1) Reduce hyperemia, edema, and nasal congestion | 2) Open obstructed eustachian tube

Question 36

Pseudoephedrine, phenylephrine toxicity

Answer 36

Htn and anxiety

Question 37

Used in asthma challenge testing

Answer 37

Methacholine

Question 38

Methacholine MOA

Answer 38

Muscarinic receptor agonist