Respiratory Drugs

hezikry's version from 2015-08-15 00:14


Question Answer
DIphenhydramine, dimenhydrinate, chlorpheniramine MOA1st gen. H1 histamine receptor blocker with muscarinic blockade
diphenhydramine clinical useallergy, motion sickness, sleep aid
Diphenhydramine, dimenhydinate, chlorapheniramine, hydroxyzine toxicity1st gen. H1 histamine receptor blocker
Sedation, antimuscarinic, anti-α-adrenergic
Cetirizine, loratadine, fexofenadine, desloratdine uses2nd gen H1 histamine receptor blocker
Tox of 2nd gen H1 histamine receptor blockersLoratadine, fexofenadine, desloratadine, cetirizine
Far less sedating than 1st gen d/t ↓ entry into CNS
1st gen H1 receptor blockersDiphenhydramine, dimenhydrinate, chlorpheniramine
Di, Di, chlor
2nd gen H1 receptor blockersLoratadine, fexofenadine, desloratadine, cetirizine
Lor, fex, des, cet
Dextromethorphan clinical useAntitussive
Dextrometothorphan MOAantagonizes NMDA glutamate receptors
Synthetic codeine analog
Mild opioid effect when used in excess
Give if dextrometothorphan overdosenaloxone
N-acetylcysteine clinical use Mucolytic expectorant. loosens mucous plugs in CF patients
Antidote for acetaminophen overdose
N-acetylcysteine MOAbreaking of disulfide bonds between glycoproteins in mucus
does not suppress cough reflex
Bosentan clinical useUsed to treat pulmonary arterial hypertension
Bosentan MOACompetitively antagonized endothelin-1 receptors, decreasing pulmonary vascular resistance
Pseudoephrine, phenylephrine MOAalpha agonists, used as nasal decongestants
Clinical use of pseudoephrine, phenylephrinereduce hyperemia, edema, nasal congestion. Decongestant.
Toxicity of pseudoephrine and phenylephrinehypertension. Can cause CNS stimulation/ anxiety (pseudoephrine)
Sildenafil moainhibits cGMP degradation and prolongs vasodilatory effect of NO
Sildenafil clinical usepulmonary hypertension and erectile dysfunction
Epoprostenol, iloprost moaPGI2 with direct vasodilatory effects. inhibits platelet aggregation
clinical use of epoprostenol, iloprostpulmonary hypertension

Asthma Drugs

Question Answer
β2-agonistsAlbuterol, Salmeterol, formoterol
Albuterol clinical useUse during acute exacerbation
Mild B1 agonist effects-tacycardia
B2 agonists increaseCAMP by binding to Gs and increasing adenylate cyclase
Salmeterol, Fromoterol clinical uselong-acting agents for prophylaxis
A/E salmeterol, fromoteroladverse effects are tremor and arrhythmia
MOA fluticasone, budesonideinhibit synthesis of virtually all cytokines. Inactivate NF-Kb the transcription factor that induces transcription of TNF-alpha.
Clinical use of fluticasone, budesonidechronic asthma
A/E of fluticasone, budesonideoral canidida infection
Theophylline MOAmethylxanthines
inhibition of PDE → ↓ cAMP hydrolysis → Bronchodilation
A/E theophyllineCardiotoxic and neurotoxic. Seizures are the major cause of morbidity and mortality.
Metabolized by P450
Blocks actions of adenosine
Very liimited therapeutic index!!!
Ipratropium MOAMuscarinic antagonist (decreases parasympathetic vagal tone)
Clinical use of ipratropiumPrevents bronchoconstriction
Used for COPD, as is tiotropium (long acting muscarinic antagonist)
Montelukast, zafirlukast MOAAntileukotriene
blocks leukotriene receptors. blocks LD4
Montelukast, zafirlukast clinical useGreat for aspirin-induced asthma
Zileuton MOAAntileukotriene
a 5-lipoxygenase pathway inhibitor
Blocks conversion of arachidonic acid to leukotrienes
Remember leukotrienes are potent inducers of airway bronchoconstriction
A/E of zileutonhepatotoxic
Omalizumab MOABinds unbound serum IgE
Omalizumab clinical usesallergic asthma resistant to inhaled steroids and long-acting β2-agonists
MethacholineMuscarinic receptor agonist (M3)
Used in asthma challenge testing
Cromolyn and nedocromilmast cell stabilizing agents. Inhibit mast cell granulation. Second line for allergic asthma


Question Answer
beta agonistssalmeterol, formoterol, albuterol
muscarinic antagoniststiotropium


Question Answer
histamine inhibitorscromolyn, nedocromil
steroidsfluticasone, budesonide
immune modulatorsomalizumab

Leukotriene antagonists

Question Answer
lipooxygenase inhibitorzileuton
leukotriene receptor antagonistmontelukast, zafirlukast