Respiratory Drugs- First Aid

Front 1

1st generation H1 blockers

Back 1

Diphenhydramine, Dimenhydrinate, Chlorpheniramine
Clinical uses: Allergy, motion sickness, sleep aid
Toxicity: Sedation, antimuscarinic, anti-alpha-adrenergic

Front 2

2nd generation H1 blockers

Back 2

Loratadine, fexofenadine, desloratadine, cetirizine
Clinical uses: Allergy
Toxicity: Far less sedating than 1st generation because of decreased entry into the CNS

Front 3

Isoproterenol

Back 3

Nonspecific Beta-agonist
Relaxes bronchial smooth muscle (B2); Adverse effect of tachycardia is due to B1

Front 4

Albuterol

Back 4

B2 agonist
Relaxes bronchial smooth muscle; Use during acute exacerbation

Front 5

Theophylline

Back 5

Methylxanthine
Likely causes bronchodilation by inhibiting PDE, thereby decreasing cAMP hydrolysis. Usage is limited because of narrow therapeutic index (cardiotoxicity- tachycardia, neurotoxicity- seizures); metabolized by P450, blocks the actions of adenosine. Treat toxicity with beta blockers

Front 6

Ipratropium

Back 6

Muscarinic antagonist
Competitive block of muscarinic receptors, preventing bronchoconstriction. Also used for COPD.

Front 7

Cromolyn

Back 7

Prevents the release of mediators from mast cells. Effective only for the prophylaxis of asthma. Not effective during an acute asthmatic attack. Toxicity is rare.

Front 8

Corticosteroids

Back 8

Beclomethasone, predinisone
Inhibit the synthesis of virtually all cytokines, inactivate NF-kB, the TF that induces the production of TNF-a, among other inflammatory agents. 1st line against chronic asthma.

Front 9

Zileuton

Back 9

5-lipoxygenase pathway inhibitor
Blocks the conversion of arachidonic acid to leukotrienes

Front 10

Zafirlukast, Montelukast

Back 10

Block LKT receptors
Good for aspirin-induced asthma

Front 11

Guaifenesin

Back 11

Expectorant- removes excess sputum; does not suppress cough reflex

Front 12

N-acetylcysteine

Back 12

Mucolytic- can loosen mucous plugs in CF patients. Also used as an antidote for acetaminophen overdose.

Front 13

Bosentan

Back 13

Used to treat pulmonary hypertension. Competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance.