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47 Cards in this Set
- Front
- Back
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Diphenhydramine
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1st generation H1 antagonist
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Meclizine
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1st generation H1 antagonist
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Fexofenadine
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2nd generation H1 antagonist
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Loratadine
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2nd generation H1 antagonist
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Histamine does what to nasal mucosa?
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NO induced vasodilation
^ vascular permeability Both cause -> Nasal Congestion |
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Triple response in skin?
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NO induced vasodilation -> Red spot
Vessel leakage -> Wheal Axon reflex - peripheral dilation -> Flare |
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H1's in the ___ deal with wakefullness
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Hypothalamus
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What receptor is most important to block in the vomit center?
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M
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Differences in 1st and 2nd generation antihistamines?
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1st have: Shorter duration, more sedation, & more anti-muscarinic
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Cromolyn
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Inhibits mast cell release of histamine
Used as prophylaxis |
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Fluticasone
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Inhaled corticosteroid
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Budesonide
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Inhaled corticosteroid
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Inhaled corticosteroid MOA
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Potentiate Beta-adrenergic agents by enhancing cAMP production and up-regulating receptor level
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Inhaled corticosteoids do what?
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Used for prevention of exacerbations
Improve peak flow Decrease airway hyperresponsiveness |
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Prednisone
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Oral systemic steroid
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Prednisolone
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Oral systemic steroid
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When are Oral systemic steroids used?
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Moderate to severe exacerbations
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Nedocromil
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Mast cell stabilizer
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When are mast cell stabilizers used?
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Alternative for long term treatment of mild persistent asthma
Prevention tx before exercise or allergen exposure EXERCISED INDUCED ASTHMA |
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Zileuton
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Leukotriene modifier -> Inhibit production
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Montelukast
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Leukotriene modifier -> Blocks receptor
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Zafirlukast
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Leukotriene modifier -> Blocks receptor
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Leukotriene modifier Clinical use
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Oral
Alternative tx for mild persistent asthma Adjunct therapy with corticosteroids |
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Leukotrienes act on SM receptors and cause?
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Bronchoconstriction
Eosinophil migration Edema Viscous mucous secretion |
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Omalizumab
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Binds IgE and prevents biding to mast cells -> histamine release prevention
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Long Acting Beta Agonist
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Salmeterol
Formoterol Arformterol SFA!!! |
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Ipratropium bromide
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M blocker (anticholinergics)
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What type of receptors are in the lungs?
What do they do? |
B2 -> bronchodilation
M3 -> Bronchoconstriction |
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Theophylline
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Inhibits phosphodiesterase
Blocks adenosine receptor Methylxanthine |
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Theophylline MOA
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SM -> Prevents cAMP degradation = Relaxation
T-cells, Eosinophils, Mast cells -> Prevent cAMP degradation & Block adenosine receptors = Anti-inflammatory |
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SABA's used for?
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Acute asthma symptoms and exacerbations
Prevent exercise-induced bronchoconstriction |
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LABA's used for?
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Adjunct to corticosteroids
Used before to prevent EIB DO NOT USE AS MONO-THERAPY Not for acute exacerbations |
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Isoniazid MOA?
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Inhibit cell wall synthesis
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Ethambutol MOA
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Inhibit cell wall synthesis
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Pyrazinamide MOA
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Not sure
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Rifampin MOA
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Inhibits RNA synthesis
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Isoniazide
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Cell wall synthesis inhibitor
1st line TB drug (used alone if latent) Renal independent Can inhibit metabolism of many drugs (Cyp 3A4 inhibitor) Hepatitis (older = worse effect) look for loss of appetite, nausea, vomiting, & jaundice Vit B6 deficiency |
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Rifampin
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Alternative to isoniazide
Can be used alone in latent but not active infection RNA polymerase inhibitor Potent CYP450 INDUCER -> ^ elimination of many drugs Rash & fever & Red/Orange urine, feces, etc. |
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Pyrazinamide
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Unknown MOA
Works best in ACIDIC environment Most hepatotoxic Hyperuricemia |
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RIP??
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Rifampin
Isoniazide Pyrazinamide All 3 are hepatotoxic and used 1st line |
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Ethambutol
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Inhibit cell wall synthesis
Bacteriostatic Started initially, but discontinued when cultures/tests confirm no resistance Optic neuritis -> decreased visual acuity & impaired red-green vision Hyperuricemia |
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Streptomycin
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Protein synthesis inhibitor
More serious TB infections IM injection only Penetrates TB cavities and caseous tissue Ototoxicity & Nephrotoxicity |
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Regimen for treating active TB Infection
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Initially for 2 months: INH + RIF + PZA + ETB(removed after proof of no resistance)
Continuation for 4 months: INH + RIF |
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Regimen for treating INH resistant TB
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Initial for 6 months: RIF + PZA + ETB
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TB drugs with hepatoxicity (most to least)
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Pyrazinamide > Isoniazid > Rifampin
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Isoniazid cause what drug metabolism side effect?
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Inhibits CYP 3A4
This causes inhibition of metabolism of many drugs -> increased levels floating around |
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Rifampin causes what drug metabolism side effect?
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Induces CYP450
This causes increase elimination of many drugs -> decreased levels floating around |
