Respiratory, USMLE Flashcards
T/F H1 blockers are REVERSIBLE inhibitors of H1 receptors
T
1st vs 2nd gen H1 blocker: Diphenhydramine
1st
1st vs 2nd gen H1 blocker: Loratadine
2nd
1st vs 2nd gen H1 blocker: Desloratadine
2nd
1st vs 2nd gen H1 blocker: Chlorpheniramine
1st
1st vs 2nd gen H1 blocker: Cetirizine
2nd
1st vs 2nd gen H1 blocker: Levocetirizine
3rd
2nd gen antihistamine is far less sedating than 1st gen due to
Less entry into CNS
SABA
Albuterol/Salbutamol
LABA
1) Salmeterol
2) Formoterol
Adverse effects of LABA (2)
1) Tremor
2) Arrhythmia
Methylxanthine
Theophylline
Theophylline MOA
Bronchodilation by inhibition of PDE thereby decreasing cAMP hydrolysis
Theophylline use is limited by
1) Cariotoxicity
2) Neurotoxicity
Muscarinic antagonist, short-acting
Ipratropium
Muscarinic antagonist, long-acting
Tiotropium
Muscarinic antagonist, long-acting: Use
COPD
1st line therapy for chronic asthma
Corticosteroids
Beclomethasone/fluticasone characteristic MOA
Inactivates NF-kB (transcription factor that induces production of TNF-α
Especially good for aspirin-induced asthma
Antileukotrienes
Antileukotrienes
Montelukast, Zafirlukast
Zileuton, MOA
5-lipoxygenase pathway inhibitor, hence blocks conversion of arachidonic acid to leukotrienes
Monoclonal anti-IgE antibody
Omalizumab
Omalizumab, MOA
Binds mostly unbound IgE
Omalizumab, use
Allergic asthma resistant to inhaled steroids and LABA
β-agonist MOA
Increases cAMP causing bronchodilation
Guaifenesin MOA
Thins respiratory secretions but does not suppress cough
N-acetylcysteine MOA
Mucolytic by loosening mucous plugs
N-acetylcysteine uses
1) CF
2) Acetaminophen overdose
Used to treat pulmonary arterial hen by competitively antagonising endothelia 1 receptors, decreasing pulmonary vascular resistance
Bosentan
Dextromethorphan MOA
Antitussive by antagonising NMDA glutamate receptors
Synthetic codeine analog hence has mild opioid effect when used in excess
Dextromethorphan
Dextromethorphan antidote
Naloxone
Pseudoephedrine, phenylephrine MOA
Sympathomimetic α-agonist
Pseudoephedrine, phenylephrine use
1) Reduce hyperemia, edema, and nasal congestion
2) Open obstructed eustachian tube
Pseudoephedrine, phenylephrine toxicity
Htn and anxiety
Used in asthma challenge testing
Methacholine
Methacholine MOA
Muscarinic receptor agonist