First Aid Respiratory Pharm (Steve)

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H1 Blockers

Back 1

reversible inhibitors of H1 histamine receptors

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1st gen H1 blocker

Back 2

diphenhydramine, dimenhydrinate, chlorpheniramine
reversible inhibitors of H1
clinical uses: allergy, motion sickness, sleep aid
toxicity: sedation, antimuscarinic, anti-alpha-adrenergic

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diphendydramine

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1st gen h1 blocker
reversible inhibitors of H1
clinical uses: allergy, motion sickness, sleep aid
toxicity: sedation, antimuscarinic, anti-alpha-adrenergic

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dimenhydrintate

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1st gen h1 blocker
reversible inhibitors of H1
clinical uses: allergy, motion sickness, sleep aid
toxicity: sedation, antimuscarinic, anti-alpha-adrenergic

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chlorpheniramine

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1st gen h1 blocker
reversible inhibitors of H1
clinical uses: allergy, motion sickness, sleep aid
toxicity: sedation, antimuscarinic, anti-alpha-adrenergic

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2nd gen H1 blocker

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Loratadine, fexofendadine, desloratadine, cetirizine (ends in -adine)
clinical use: allergy
toxicity: far less sedating than 1st gen b/c decreased entry into CNS

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loratadine

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2nd gen h1 blocker
clinical use: allergy
toxicity: far less sedating than 1st gen b/c decreased entry into CNS

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fexofenidine

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2nd gen h1 blocker
clinical use: allergy
toxicity: far less sedating than 1st gen b/c decreased entry into CNS

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desloratadine

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2nd gen h1 blocker
clinical use: allergy
toxicity: far less sedating than 1st gen b/c decreased entry into CNS

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cetirizine

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2nd gen h1 blocker
clinical use: allergy
toxicity: far less sedating than 1st gen b/c decreased entry into CNS

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asthma drugs

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Bronchoconstriction medicated by 1) inflammatory processes 2) parasympathetic tone

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albuterol

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b2 agonist;
relaxes bronchial smooth muscle (b2).
Use during ACUTE exacerbation

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salmeterol

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long-acting agent for prophylaxis.
Adverse effects are tremor and arrythmia

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formoterol

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long-acting agent for prophylaxis.
Adverse effects are tremor and arrythmia

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Theophylline

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class: methylxanthine;
MOA: bronchodliation by (inhibiting phosphodiesterase>>decrease cAMP hydrolysis);also blocks actions of adenosine (adenosine causes bronchoconstriction)
clinical use: asthma.
Toxicity: Usage limited by narrow therapeutic index (cardio toxicity, nephrotoxicity);
metabolism: p450

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ipatropium

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use: asthma COPD;
-muscarinic antagonist
-MOA: competitive block of muscarinic receptors, preventing bronchoconstriction (block Ach)
-

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tiotropium

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use: asthma COPD;
-muscarinic antagonist
-MOA: competitive block of muscarinic receptors, preventing bronchoconstriction (block Ach)
-

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Beclomethasone

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corticosteroid
use: 1st line for CHRONIC ASTHMA
MOA: inhibit synthesis of cytokines; inactivate NF-kB (the transcription factor that produces TNFa and other inflammatory agents)

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fluticasione

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corticosteroid
use: 1st line for CHRONIC ASTHMA
MOA: inhibit synthesis of cytokines; inactivate NF-kB (the transcription factor that produces TNFa and other inflammatory agents)

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Montelukast

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antileukotriene
use: asthma (especially aspirin induced asthma)
MOA: block leukotriene receptors

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zafirlukast

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antileukotriene
use: asthma (especially aspirin induced asthma)
MOA: block leukotriene receptors

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zileuton

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asthma
anti leukotriene
MOA: 5-Lipoxygenase inhibitor
-blocks conversion of arachidonic acid to leukotrienes

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omalizumab

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asthma drug; used in allergic asthma resistant to inhaled steroids and long-acting B2-agonists
-MOA: monocloncal IgE antibody; binds mostly unbound serum IgE
-

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guiafenicin

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expectorant: thins respiratory secretions
does not suppress cough reflex

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N-acetylcysteine

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mucolytic: loosens mucus plugs in CF patients
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antidote for acetominophen overdose

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bosentan

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use: pulmonary arterial HTN
-MOA: competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance

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dextromethorphan

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use: antitussive
MOA: (antagonizes NMDA glutamate receptors)
-synthetic codeine analog, mild opiod effect in large doses
overdose: nalaxone
mild abuse potential

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pseudoephedrine

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MOA: sympathomimetic a-adrenergic agonist; non-prescription nasal decongestant
-use: reduce hyperemia, edema, and nasal congestion; open obstructed eustachian tubes
-toxicity: hypertension, CNS stimulation/anxiety

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phenylephrine

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MOA: sympathomimetic a-adrenergic agonist; non-prescription nasal decongestant
-use: reduce hyperemia, edema, and nasal congestion; open obstructed eustachian tubes
-toxicity: hypertension,

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methacholine

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muscarinc receptor agonist;

asthma challege test