Pulmonary Pharmacology from First Aid 2013
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| Antihistamines block which receptor? | H1
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| First generation H1 blockers treat what? Name some. | Allergy, motion sickness, sleep aid. They are more sedating because they cross into the CNS.
Diphenhydramine, dimenhydrinate, chlorpheniramine.
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| Second generation H1 blockers treat what? Name some. | Allergy only. They're far less sedating.
Loratadine, fexofenadine, desloratadine, ceterizine (usually end in "-adine")
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| What is the classic beta-2 agonist used in acute asthma? | Albuterol
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| What are salmeterol, formoterol? What are their side effects? | Long-acting beta-2 agonists used in the prophylactic treatment of asthma.
SFX: tremor, arrhythmia
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| Theophylline: MOA, Use, Tox | MOA: inhibits PDE, increasing cAMP
Use: bronchodilation in asthma
Tox: CYP450, nephro- and cardiotoxicity.
Blocks action of adenosine***
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| Ipratropium: MOA, Use, Tox | MOA: blocks muscarinic receptors
Use: prevents bronchoconstriction in asthma
Also used in COPD.
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| How are corticosteroids used in asthma? | "-asones" inhibit the synthesis of all cytokines and inactivate NF-kB, the TF that induces TNFa. First line therapy for chronic asthma prevention.
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| How are anti-leukotrienes used in asthma treatment? | They block leukotriene receptors or LOX acitivity and so are especially good for aspirin-induced asthma.
Montelukast, zafirlukast - block receptors
Zileuton - inhibit LOX
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| Omalizumab: MOA, Use, Tox | Anti-IgE antibody, used in asthma resistant to other treatment.
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| Which asthma therapies target the early response (symptoms), and which target the late response (inflammation)? | Early: beta-agonists, theophylline,
anti-muscarinics
Late: steroids, anti-leukotrienes
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| What are cromolyn drugs? | They block mast cell degranulation. They used to be common in asthma treatment but have since been replaced by anti-leukotrienes.
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| Guaifenesin: MOA, Use | Expectorant that thins mucus secretions but does not suppress the cough reflex.
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| What is N-acetylcysteine's use in the context of the respiratory system? | It is a mucolytic that can loosen mucus plugs in CF patients.
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| Bosentan: MOA, Use | MOA: Competitively antagonizes endothelin-1,
decreasing PVR.
Use: Treats pulmonary artery HTN.
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| Dextromethorphan: MOA, Use, Tox | MOA: as an anti-tussive, stimulates NMDA
glutamate receptors.
Tox: as a codeine analog, has mild opioid
effects; Rx O/D with naloxone
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| Pseudoephedrine, phenylephrine: MOA, Use, Tox | MOA: sympathetic a-agonists, decongestant
Use: reduce nasal hyperemia, congestion
Tox: HTN, and a stimulant (weight loss)
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| Methacholine: MOA, Use | MOA: muscarinic receptor agonist
Use: used in asthma challenge testing
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