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28 Cards in this Set
- Front
- Back
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dextromethorphan
-class -charecteristics |
1) centrally acting antitussive
2) no sedative/anagesic/addictive/tolerance effects |
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codiene
-class -charecteristics -use for -S/e |
1) centrally acting antitussive
2) slight sedative/anagesic effects. Drying action on resp. mucosa 3) painful cough 4) N/V/C, tolerance |
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chlophedianol
levopropoxyphene noscapine |
Non narcotic, centrally-acting antitussives
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hydrocodone
hydromorphone methadone morphine |
Narcotic, centrally-acting antitussives
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What are the classes of peripherally acting antitussives?
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Demulcents
Local anestetics Humidifying aerosols Steam inhalations Either work on afferent or efferent part of cough |
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What do demulcents do and what are some examples?
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1) Useful for coughs originating above the larynx--protective coating over irritated pharyngeal mucosa
2) syrups, lozenges, honey |
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Local anestetics
--Examples --use |
-caine, benzonatate
Used to inhibit cough reflex for procedures Work by nonspecific central depression, depression of pulm stretch recptrs |
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Humidifying aerosols
--MOA --efficacy |
Act as a demulcent and decreases viscosity of bronchial secretions
Efficacy of added medicants not clearly proven |
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Expectorants
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MOA: Expel secretions by decreasing viscosity AND increasing amt of resp. fluid (demulcent action) via rflx irritation OR direct action on sec. cells
Not evidence-based |
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Iodides
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--liquefy bronchial secretions
--taste horrible, skin s/e & possible hypothyroidsm --work reasonably well |
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guaifenesin
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--most common expectorant
--doesn't work |
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acetylcysteine
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--Mucolytic --> reduce mucous viscosity
--used in CF --via nebulizer, sometimes w/ B2 agonist to prevent bronchoconstriction |
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dornase alpha
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--mucolytic enzyme for grossly purulent sputum (deoxyribonuclease)
--may become important in CF treatment |
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What is the MOA of decongenestants?
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a adrenergic agonists which vasoconstrict nasal blood vessels to reduce mucosal surface area
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phenylephrine
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--short acting topical decong.
--rebound hyperemia w repeated use |
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pseudoephedrine
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--long-acting systemic decongestant
--use w caution in pts w/HTN, MAO inhib --(ephedrine, phenylpropanolamine off market) |
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early mediators in asthma
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histamine
tryptase leukotrienes prostaglandins |
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late mediators of asthma
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GM-CSF
IL 4, 5 (attract eosinophils, stim IgE production) |
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cromolyn & nedocromil
1) MOA 2) admin 3) other |
MOA: ihhibit mast cell degran via Cl channel block
Admin: ONLY USE PROPHL!, inhaled Other: 4wk test trial, 50% efficacy, better in kids |
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Methylxanthienes (theophylline)
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MOA: PDE inhib --> inc cAMP (reduces breakdown) --> bronchodilation via inactiv. of MLCK
Admin: Oral (lots of sys. s/e), monitor plasma levels No longer first line therapy |
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MOA of B agonists
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promote bronchodilation via increase in cAMP
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B agonists for asthma
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short acting: albuterol, metoproterenol, terbutaline, pierbuterol
long acting: salmeterol, formeterol (12h, not 1st line) |
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ipratropium bromide
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muscuranic antagonsit for asthma
onset in 45min, effects long-lasting used more for COPD |
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beclomethasone
triamcinolone fluticasone |
inhaled corticosteroids for asthma
used in chronic/proph tx wash out mouth to avoid candida infection |
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zileuton
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--5-lipoxtgenase inhibitor, blocks production of leukotrienes
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monteleukast
zafirleucast (oral) |
LTD4 receptor antagonists
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treatment regements for asthma
mild multiple times a week more severe refractory |
mild: B agonists, PRN
multiple times a week: inhaled corticosteroid or cromolyn prophalaxis more severe: inhaled corticosteroids w B agonist (salmeterol) refractory: oral corticosteroids until sx under control |
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Control of COPD
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mild: short acting B2 agonist w ipratropium PRN
more severe: above but 3-4x/d theophilyine=second line |
