resp.pharm Flashcards
what are the H1 blockers?
reversible inhibitors of H1 histamine receptors
what are the 1st generation H1 blockers
diphenhydramine, dimenhydrinate, chlorpheniramine
what are the clinical uses of 1st gen H1 blockers
allergy, motion sickness, sleep aid
what is the toxicity associated with 1st gen H1 blockers
sedation antimuscarinic, anti-alpha adrenergic
what are the 2nd generation H1 blcokers
loratidine, fexofenadine, desloratadine, ceterizine
what are the clinical uses of 2nd gen H1 blockers
allergy
what is the toxicity associated with 1st gen H1 blockers
far less sedating than 1st gen because of decreased entry into CNS
what are the expectorants?
guaifenesin, N-acetylcysteine
what is guiafenesin?
expectorant that things respiratory secretions but does nto suppress cough reflex
what is N-acetylcysteine
mucolytic - loosesn mucous plugs in CF patients. Used as an antidote for acetaminophen overdose
what is dextromethorphan?
antitussive. Antagonizes NMDA glutamate receptors. Synthetic codeine analod that has mild opioid effects when used in excess.
how do you treat dextromethorphan overdose?
naloxone. {Mild abuse potential}
MOA of pseudoephedrine and phenylephrine
sympathomimetic alpha-agonistic nonprescription nasal decongestants
what is the clinical use of pseudoephedrine and phenylephrine
reduce hyperemia, edema and nasal congestion
open obstructed eustachian tubes
what is the toxicity of pseudoephedrine, phenylephrine
hypertension. Can cause CNS stimulation/anxiety (pseudoephedrine)
what are the two pathways leading to bronchoconstriction in asthma?
inflammatory and parasympathetic tone
what are the types of asthma drugs?
beta 2 agonists, methylxanthines, muscarinic agonists, corticosteroids, antileukotrienes, omalizumab, methacholine, bosentan
what beta 2 agonists are used to treat asthma?
albuterol, salmeterol, formoterol
what drugs are methylxanthines?
theophylline
what muscarinic antagonists are used to treat asthma
ipratropium, tiotropium
what corticosteroids are used to treat asthma?
beclomethasone, fluticasone
what antileukotrienes are used to treat asthma?
montelukast, zafirlukast, zileuton
what does albuterol do?>
relaxes bronchial smooth muscles (b2). Use during acute exacerbation
what do salmeterol and formoterol do?
long acting agents for prophylaxis. Adverse effects are tremor and arrhythmias
what does theophylline do?
bronchodilation by inhibiting phosphodiesterase –> increased cAMP levels due to decreased cAMP hydrolysis. The usage is limited because of narrow theraputic index (cardiotoxicity, neurotoxicity), metabolized by cP450. Blocks actions of adenosine
what does ipratropium do?
competive block of muscarinic receptors, preventing bronchocontstriction. Used for COPD, as is tiotropium, a long acting muscarinic antagonist
what do beclomethasone and fluticasone do?
inhibit the synthesis of all cytokines
inactivate NF-kb which no longer induces production of TNFa and other inflammatory agents. 1st line for chronic asthma
what do montelukast and zafirlukast do?
block leukotriene receptors, especially for aspirin induced asthma
what does zileuton do?
5 lipoxygenase pathway inhibitor that blocks conversion of arachidonic acid to leukotrienes
what does omalizumab?
monoclonal anti-IgE Ab. Binds unbound serum IgE and blocks binding to FceRI. Used in allergic asthma resistant to inhaled steroids and long acting beta2 agonists
what does methacholine do?
muscarinic receptor antagonist. Used in bronchial provocation challenge to help diagnose asthma
what does bosentan do?
used to treat pulmonary arterial hypertension. Competitively antagonises endothelin-1 receptors, decreases pulmonary vascular resistance
diphenhydramine
1st gen H1 blocker
dimenhydrinate
1st gen H1 blocker
chlorpheniramine
1st gen H1 blocker
loratadine
2nd gen H1 blocker
fexofenadine
2nd gen H1 blocker
desloratadine
2nd gen H1 blocker
cetirizine
2nd gen H1 blocker
guaifenesin
expectorant
N-acetylcysteine
expectorant
dextromethorphan
NMDA receptor antagonist
pseudoephedrine
sympathomimetic alpha agonist
phenylephrine
sympathomimetic alpha agonist
albuterol
SA beta2 agonist
salmeterol
LA beta2 agonist
formoterol
LA beta2 agonist
theophylline
methylxanthines: phosphodiesterase inhibitors
ipratropium
muscarinic receptor antagonist
beclomethasone
corticosteroid
fluticasone
corticosteroid
montelukast
antileukotrienes
zafirlukast
antileukotrienes
zileuton
antileukotrienes
omalizumab
anti-IgE antibody
methacholine
muscarinic receptor agonist
bosentan
endothelin-1 receptor competitive antagonist
