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STEP 1 > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

Name the 1st generation H1 blockers

A

“-en/-ine” or “-en/-ate”

diphenhydramine, dimenhydrinate, chlorpheniramine

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2
Q

Uses of 1st gen H1 blockers

A

allergy, motion sickness, sleep aid

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3
Q

Toxicity of 1st gen H1 blockers

A

sedation, antimuscarinic, anti-alpha-adrenergic

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4
Q

Name the 2nd gen H1 blockers

A

“-adine”

loratadine, fexofenadine, desloratidine

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5
Q

Uses of 2nd gen H1 blockers

A

allergy

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6
Q

Toxicty of 2nd gen H1 blockers

A

far less sedating than 1st gen because of decreased CNS entry

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7
Q

Guaifenesin use

A

expectorant

things respiratory secretions; does NOT suppress cough reflex

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8
Q

N-acetylcysteine use

A

mucolytic - can loosen mucus plugs in CF patients by disrupting disulfide bonds
also used as antidote for acetaminophen overdose

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9
Q

Mechanism of of dextromethorphan

A

antitussive (antagonizes NMDA glutamate receptors)

synthetic codeine analog

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10
Q

Use of dextromethorphan

A

has mild opioid effect when used in excess

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11
Q

Toxicity of detromethorphan

A

naloxone can be given for overdose
mild abuse potential
may cause serotonin syndrome if combined with other serotonergic agents

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12
Q

Mechanism of pseudoephedrine, phenylephrine

A

alpha-adrenergic agonist

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13
Q

Use of pseudoephedrine, phenylephrine

A 
nasal decongestant (reduce hyperemia, edema)
open obstructed eustachian tubes
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14
Q

Toxicity of pseudoephedrine, phenylephrine

A

hypertension

can also cause CNS stimulation/anxiety (pseudoephedrine)

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15
Q

Name the pulmonary HTN drug classes

A

Endothelin receptor antagonists
PDE-5 inhibitors
prostacyclin analogs

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16
Q

Name the endothelin receptor antagonists

A

bosentan

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17
Q

Mechanism of endothelin receptor antagonists

A

competitively antagonize endothelin-1 receptors –> decrease pulmonary vascular resistance

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18
Q

Toxicity of endothelin receptor antagonists

A

hepatotoxic (monitor LFTs)

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19
Q

Name the PDE-5 inhibitors

A

Sildenafil

20
Q

Mechanism of sildenafil/PDE-5 inhibitors

A

inhibit PDE5 from breaking down cGMP so it lasts longer and prolongs the vasodilatory effect of nitric oxide

21
Q

Use of sildenafil/PDE-5 inhibitors

A

pulmonary HTN

erectile dysfunction

22
Q

Name the prostacyclin analogs

A

epoprostenol, iloprost

23
Q

Mechanism of prostacyclins

A

PGI2 with direct vasodilatory effects on pulmonary and systemic arterial vascular beds
inhibit platelet aggregation

24
Q

Toxicity of prostacyclins

A

flushing, jaw pain

25
Q

Asthma drugs target pathways

A
  1. inflammatory processes

2. parasympathetic tone

26
Q

Classes of asthma drugs

A 
Beta2-agonists
corticosteroids
muscarinic antagonists
antileukotrienes
Omalizumab
Methylxanthines
Methacholine
27
Q

Short-acting beta2 agonists

A

albuterol

28
Q

Mech and use of albuterol for asthma

A

relaxes bronchial smooth muscle

used for acute exacerbation

29
Q

Long-acting beta2 agonists

A

salmeterol and formoterol

30
Q

Mech and use of salmeterol and formoterol

A

long-acting for prophylaxis

31
Q

Adverse effects of long-acting beta2 agonists

A

tremor and arrhythmia

32
Q

Name the corticosteroids for asthma

A

Fluticasone, budesonide

33
Q

Use of corticosteroids for asthma

A

1st-line therapy for chronic asthma

34
Q

Mech of corticosteroids for asthma

A

inhibit synthesis of virtually all cytokines

inactivate NF-kappaB, the transcription factor that induces production of TNF-alpha and other inflammatory agents

35
Q

Mech of ipratropium

A

competitively inhibits muscarinic receptors, preventing bronchoconstriction

36
Q

Use of ipratropium

A

asthma and for COPD

tiotropium is same but long acting

37
Q

Mech of montelukast, zafirlukast

A

block leukotriene receptors (CysLT1)

38
Q

Use of montelukast, zafirlukast

A

good for aspirin-induced asthma

39
Q

Mech of zileuton

A

5-lipooxygenase pathway inhibitor

blocks conversion of AA to leukotrienes

40
Q

Toxicity of zileuton

A

hepatotoxic

41
Q

Mech of Omalizumab

A

monoclonal ab against IgE

binds unbound serum IgE and blocks binding to Fc receptor

42
Q

Use of omalizumab

A

allergic asthma resistant to inhaled steroids and long-acting beta2-agonists

43
Q

Mech of theophylline

A

likely causes bronchodilation by inhibiting PDE –> increase in cAMP levels doe to decreased cAMP hydrolysis (via PDE)

44
Q

Use of theophylline

A

limited due to narrow therapeutic index (cardiotoxicity, neurotoxicity); metabolized by cytochrom p-450
blocks the action of adenosine

45
Q

Methacholine Challenege Test

A

muscarinic receptor (M3 agonist), used in bronchial challenge to help diagnose asthma

STEP 1 (26 decks)

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