Comlex Respiratory And Endocrine Pharm

Front 1

What are the first gen H1 blockers?

Back 1

Diphenhydramine
Dimenhydramine
chlorpheniramine

Front 2

Mech of action for H1 blockers?

Back 2

Reversible inhibitors of H1 histamine receptors

Front 3

Uses for first gen H1 blockers?

Back 3

Allergy, motion sickness, sleep aid

Front 4

Toxicity for first gen H1 blockers?

Back 4

Sedation, antimuscarinic, anti-a-adrenergic

Front 5

What are the 2nd gen H1 blockers?

Back 5

Loratidine, fexogenadine, desloratadine, cetrizine

Front 6

Clinical uses of 2nd gen H1 receptor blockers

Back 6

Allergies

Front 7

Toxicity for 2nd gen H1 blockers?

Back 7

Far less sedating than 1st gen because of lowered entry into the CNS.

Front 8

What are the B2 agonists used in treating asthma?

Back 8

Albuterol, salmeterol, formoterol

Front 9

How does albuterol work and when is it used?

Back 9

Relaxes smooth muscle in bronchial

Used during an acute exacerbation

Front 10

When are salmeterol and formoterol used and how do they work?

Back 10

They are long acting agents used for prophylaxis.

Front 11

What is theophylline used for and how does it work?

Back 11

Treating asthma, although rarely due to bad side effects.

causes bronchodilation by inhibiting phosphodiesterase, which lowers cAMP hydrolysis.

Also blocks action of adenosine

Front 12

Why is theophylline rarely used?

Back 12

narrow therapeutic index due to cardio and neuro toxicity.

Front 13

What muscarinic antagonist is used in treating asthma?

Back 13

Ipratropium

Front 14

How does ipratropium work?

Back 14

Competitive block of muscarinic receptors, preventing bronchoconstriction.

Can also be used for COPD.

Front 15

What two steroids are used for treatment of chronic asthma?

Back 15

Beclomethasone
Fluticasone

Front 16

How do Beclomethasone and Fluticasone work in treating asthma?

Back 16

They inhibit the synthesis of virtually all cytokines, and inactivate NF-kB, the transcription factor that helps make TNF-a.

Front 17

What are the antileukotrienes used in treating asthma?

Back 17

Montelukast, zafirlukast, zileuton

Front 18

How do montelukast and zafirlukast work?

Back 18

Block leukotriene receptors. Especially useful in treating aspirin-induced asthma

Front 19

How does Zileuton work?

Back 19

inhibits 5-lipoxygenase pathway

Blocks conversion of arachidonic acid to leukotrienes

Front 20

What is omalizumab and what does it treat?

Back 20

Monoclonal anti-IgE antibody. Binds serum iGE.

Used in allergic asthma that is resistant to inhaled steroids and long acting beta agonists.

Front 21

What are the two expectorants commonly used?

Back 21

Guaifenesin - thins respiratory secretions; does not suppress cough.

N-acetylcysteine - loosen mucous plugs in CF patients. Also used in acetaminophin OD.

Front 22

Used to treat pulmonary hypertension, this drug competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance

Back 22

Bosenten

Front 23

What is dextromethorphan, and what effects can it cause?

Back 23

Antitussive (anti cough)
Antagonizes NMDA glutamate receptors
Synthetic codiene analog.
Has mild opioid effect when used in excess. Nalaxone can be given for overdose. Mild abuse potential.

Front 24

Pseudoephedrine and phenylephrine - Uses?

Back 24

Reduce hyperemia, edema, and nasal congestion.
Open obstructed eustacian tubes

Front 25

What is the mech of action for Pseudoephedrine and phenylephrine?

Back 25

Sympathomimetic a-agonist nonprescription nasal decongestant

Front 26

Toxicity for Pseudoephedrine and phenylephrine?

Back 26

Hypertension
CNS stimulation/anxiety (pseudoephedrine)

Front 27

Methacholine - what is it used for?

Back 27

Used in the asthma challenge test. Muscarinic receptor agonist

Front 28

Insulin - mech of action?

Back 28

Bind insulin receptor
Liver: increase glucose stored as glycogen
Muscle: increase glycogen and protein synthesis, K uptake
Fat: aids TG storage

Front 29

Clinical use for insulin?

Back 29

Type I DM, Type 2 DM, Gestational diabetes
life-threatening hyperkalemia
stress-induced hyperglycemia

Front 30

Possible toxicity for insulin use?

Back 30

hypoglycemia
very rarely hypersensitivity rxns

Front 31

Metformin - clinical use?

Back 31

Oral - first line therapy in Type 2 DM.
Can be used in pts without islet fxn.

Front 32

Toxicity of metofrmin?

Back 32

GI upset
Most serious is lactic acidosis (contraindicated in renal failure)

Front 33

Sulfonylureas - mech of action?

Back 33

Close K channel in B-cell membrane - cell depolarizes and triggers insulin release via Ca influx.

Front 34

What are the sulfonylureas?

Back 34

1st gen: tolbutamide, chlorpropramide
2nd gen: Glyburide, glimeprimide, glipizide

Front 35

Clinical use for sulfonylureas?

Back 35

Stimulate release of endogenous insulin in type 2 DM. Useless in Type 1

Front 36

Toxicity of sulfonylureas?

Back 36

1st gen: disulfuram-like effects
2nd gen: hypoglycemia

Front 37

Glitazone mech of action?

Back 37

increase insulin sensitivity in peripheral tissue. Binds PPAR-y nuclear transcription regulator

Front 38

Clinical use for glitazones?

Back 38

Monotherapy in Type 2 DM or combined with other agents

Front 39

Toxicity of glitazones

Back 39

weight gain, edema, liver tox, heart failure

Front 40

a-glucosidase inhibitors mech of action?

Back 40

inhibit brush border a-glucosidases
Delayed sugar hydrolysis and glucose absorption
Lowers postprandial hyperglycemia

Front 41

Clinical uses for a-glucosidase inhibitors?

Back 41

Monotherapy in Type 2 DM or with other agents

Can cause GI disturbances

Front 42

What are the a-glucosidase inhibitors?

Back 42

Acarbose
Miglitol

Front 43

Mech of action for pramlintide (amylin analog)?

Back 43

Lowers glucagon

Front 44

Clinical use for pramlintide?

Back 44

Type 1 and 2 DM

Front 45

Toxicity for Pramlintide?

Back 45

Hypoglycemia, nausea, diarrhea

Front 46

What are the GLP-1 analogs?

Back 46

Exenatide
Liraglutide

Front 47

Mech of action for GLP-1 analogs?

Back 47

Increase insulin and decrease glucagon release

Used in Type 2 DM

Front 48

Toxicity for GLP-1 analogs?

Back 48

N/V
pancreatitis

Front 49

DPP-4 inhibitors?

Back 49

Linagliptin
Saxagliptin
Sitagliptin

Front 50

Mech of action for DPP-4 inhibitors?

Back 50

Increase insulin, decrease glucagon

Front 51

Use for DPP-4 inhibitors?

Back 51

Type 2 DM

Front 52

Toxicity for DPP-4 inhibitors?

Back 52

Mild urinary or respiratory infections

Front 53

Propothiouracil and methimazole - Mech of action?

Back 53

Block peroxidase, inhibiting organification of iodide and coupling of thyroid hormone synthesis. PTU also blocks 5-deiodinase, which lowers conversion of T4 to T3

Front 54

Propothiouracil and methimazole - clinical use?

Back 54

Hyperthyroidism

Front 55

Propothiouracil and methimazole - Toxicity?

Back 55

skin rash, agranulocytosis, aplastic anemia, hepatotoxicity. Methimazole = possible teratogen.

Front 56

Levothyroxine and triiodothyronine - mechanism of action?

Back 56

Thyroxine replacement

Front 57

Levothyroxine and triiodothyronine - clinical use?

Back 57

Hypothyroidism and myxedema

Front 58

Levothyroxine and triiodothyronine - Toxicity?

Back 58

tachycardia, heat intolerance, tremors, arrhythmias

Front 59

GH use?

Back 59

GH deficiency, turner syndrome

Front 60

Somatostatin use?

Back 60

acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices

Front 61

Oxytocin use?

Back 61

Stimulates labor, uterine contractions, milk let-down, controls uterine hemorrhage

Front 62

ADH use?

Back 62

Pituitary (central) Diabetes insipidous

Front 63

Demeclocycline - mechanism of action?

Back 63

ADH antagonist

Front 64

Demeclocycline - clinical use?

Back 64

SIADH

Front 65

Demeclocycline - Toxicity?

Back 65

Nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Front 66

Glucocorticoids - mechanism of action?

Back 66

lowers production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2

Front 67

Glucocorticoids - Clinical use?

Back 67

addison's disease, inflammation, immune suppression, asthma

Front 68

Glucocorticoids - Toxicity?

Back 68

Cushing's syndrome - buffalo hump, central obesity, purple striae, moon facies, muscle wasting, thin skin, easy buisability, osteoporosis, adrenocortical atrophy, peptic ulcers, diabetes.