Pharm I: Respiratory Drugs

Front 1

This bronchodilator has lots of drug interactions via decreasing CYP availability

Back 1

Theophylline

Front 2

This bronchodilator is falling out of favor

Back 2

Theophylline

Front 3

This bronchodilator affects all vascular beds

Back 3

Theophylline

Front 4

This bronchodilator is a metabolite of caffeine

Back 4

Theophylline

Front 5

Levels of this bronchodilator would be increased in smokers, high protein diets, cystic fibrosis patients, and children

Back 5

Theophylline

Front 6

Metabolism of Theophylline

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Hepatic: CYP

Front 7

Side effects of Theophylline

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CNS (anxiety, tremor, insomnia)
GI (nausea, vomiting)
CVS (tach, palpations, arrhythmia, hypotension)
late CNS (twitching, seizures)
Increased BMR, renal diuresis

Front 8

T/F: Decreased cAMP leads to decreased Ca levels, which promotes relaxation

Back 8

False. *Increased* cAMP leads to a decrease in Ca, which promotes muscle relaxation in the airways

Front 9

Onset of Salmeterol

Back 9

Short (15 min)

Front 10

Duration of Salmeterol

Back 10

Long (12 h)

Front 11

This is the mechanism by which Salmeterol increases its duration of effect

Back 11

Embeds in lipid membrane

Front 12

This drug has an increased risk of sudden death when used in conjunction with steroids

Back 12

Salmeterol

Front 13

This drug must not be used with inhaled steroids (eg, Beclamethasone)

Back 13

Salmeterol

Front 14

This drug is a short-acting beta-agonist

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Albuterol

Front 15

These drugs can result in hypokalemia, which promotes arrhythmias

Back 15

Beta-2 agonists

Front 16

This percentage of inhaled beta agonist reaches systemic circulation

Back 16

8-15%

Front 17

T/F: Deep and slow inhalation of inhaled respiratory drugs is preferred over fast inhalation

Back 17

True

Front 18

Metabolism of Albuterol and Salmeterol

Back 18

COMT, MAO

Front 19

Bioavailability of Albuterol and Salmeterol

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15-70%

Front 20

Half life of Albuterol and Salmeterol

Back 20

Long (6-8 h)

Front 21

Pharmacodynamics of beta-2 agonists

Back 21

Inhaled: short (minutes)
Oral: 30-60 m onset, 1-3 h peak, 6-8 h duration

Front 22

Clearance of beta-2 agonists (Albuterol, Salmeterol)

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Renal (urine)

Front 23

This is the mechanism by which anticholinergic dilators have their effect

Back 23

They inhibit M3 receptors. M3 receptors promote constriction when activated, thus removing this effect leads to dilation

Front 24

Duration of Ipratropium Bromide

Back 24

Long (6-8 h)

Front 25

Clearance of Ipratropium Bromide

Back 25

Inactive metabolites are excreted in urine

Front 26

This drug is particularly bad-tasting, which can affect compliance among patients

Back 26

Ipratropium Bromide

Front 27

This drug has, as a rare side effect, paradoxical bronchoconstriction

Back 27

Ipratropium Bromide

Front 28

Onset of Glucocorticosteroids

Back 28

Slow (6-8 h), because they are nuclear hormones, setting transcriptional activities in motion

Front 29

This drug is used as prophylaxis against antigen and exercise-induced asthma, allergic rhinitis, and conjuctivitis

Back 29

Sodium Cromoglycate

Front 30

This anti-inflammatory drug used to treat respiratory disorders is notable for being very safe

Back 30

Sodium Cromoglycate

Front 31

This drug has its effect by inhibiting mast cells

Back 31

Sodium Cromoglycate

Front 32

This drug suppresses kinins, and may also inhibit C-fibers to thereby reduce cough in patients

Back 32

Sodium Cromoglycate

Front 33

Oral thrush is a side effect of these drugs

Back 33

Inhaled glucocorticosteroids

Front 34

Inhaled glucocorticosteroids are used to treat asthma in these situations

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Mild to moderate (prophylactic), chronic severe (treatment)

Front 35

Systemic glucocorticosteroids are used to treat asthma in these situations

Back 35

Acute severe ("status asthmaticus"), chronic maintenance

Front 36

Ciclesonide is special because of these features

Back 36

It is a pro-drug and therefore is not associated with increased incidence of oral thrush, since it is an inactive compound (the pro-drug) that is deposited in the throat mucosa

Front 37

These are the side effects of inhaled glucocorticosteroids

Back 37

Thrush (candida albicans), dysphonia (hoarseness, due to myopathy)

Front 38

Aspirated as aerosol formulations, glucocorticosteroids may have these systemic effects at high doses

Back 38

Insidious myopathy, increased adrenaline, bone growth inhibition, behavioral disturbances

Front 39

Taken orally or parenterally, glucocorticosteroids have these side effects

Back 39

Cushingoid appearance ("moon face", etc.)

Front 40

These two drugs are used in the treatment of asthma, but not in the treatment of COPD

Back 40

Sodium Cromoglycate, Montelukast

Front 41

These are the only two important classes are drugs that are NOT used in the treatment of COPD, but rather are only used for asthma

Back 41

Sodium Cromoglycate, Montelukast

Front 42

This drug is an H1 receptor blocker

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Fexofenadine

Front 43

This is the half life of Fexofenadine

Back 43

Long (25 h)

Front 44

This is the administration of Fexofenadine

Back 44

Orally

Front 45

This is the metabolism of Fexofenadine

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Hepatic

Front 46

This drug has a large Vd, and therefore enters the CNS/CSF readily

Back 46

Fexofenadine

Front 47

These drugs are used for nasal decongestion

Back 47

Alpha-1 agonists: Phenylephrine, Pseudoephedrine

Front 48

Half life of Phenylephrine

Back 48

Short (2-3 h)

Front 49

Half life of Pseudoephedrine

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Medium (5-8 h)

Front 50

Metabolism of Phenylephrine

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Liver

Front 51

Excretion of Pseudoephedrine

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Kidney

Front 52

These drugs are used to treat cough

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Opiates: Dextromethorphan, Codeine

Front 53

Half life of Codeine

Back 53

Short (3-4 h)

Front 54

Metabolism of anti-tussives

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Hepatic (Codeine, Dextropmethorphan)

Front 55

This drug is an IgE inhibitor

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Omalizumab

Front 56

This drug is possibly associated with lymphoma

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Omalizumab

Front 57

Half life of Omalizumab

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Long (10-14 d)

Front 58

Administration of Omalizumab

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Subcutaneous

Front 59

This drug is a leukotriene receptor antagonist

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Montelukast

Front 60

This drug is a lipoxygenase inhibitor

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Zileuton

Front 61

T/F: Montelukast is taken before exercise to alleviate symptoms of asthma

Back 61

False. It has a long onset time (1-2 h).

Front 62

Duration of Montelukast

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Long (10-14 h)

Front 63

Half life of Montelukast

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Medium (3-6 h) (up to 20 h in the elderly)

Front 64

Metabolism and clearance of Montelukast

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Hepatic metabolism, cleared in the bile and feces

Front 65

This drug is useful for treatment of patients with aspirin-induced asthma

Back 65

Montelukast

Front 66

Diphenhydramine is this type of drug

Back 66

It is a first-generation antihistamine (therefore it causes drowsiness)

Front 67

Clearance of histamine

Back 67

Urine

Front 68

Metabolism of histamine

Back 68

Two pathways, including MAO (monamine oxidase, used in the breakdown of catecholamines)