Usmle Step 1 Fa Respiratory-Pharmacology

Front 1

H1 blocker action

Back 1

Reversible inhibitors of H1 histamine receptors

Front 2

1st generation H1 blockers
(a) common names
(b) clinical uses
(c) toxicities

Back 2

(a) diphenydramine, dimenhydrinate, chlorpheniramine
(b) allergy, motion sickness, sleep aid
(c) sedation, antimuscarinic, anti alpha adrenergic

Front 3

2nd generation H1 blockers
(a) common names
(b) clinical uses
(c) toxicity

Back 3

(a) loratadine, fexofenadine, desloratadine, cetirizine
(b) allergy
(c) far less sedating than 1st generation b/c of decr entry into CNS

Front 4

Major classes of asthma drugs

Back 4

Beta agonists
Beta 2 agonists
Methylxanthines
Muscarinic antagonists
Cromolyn
Corticosteroids
Antileukotrienes

Front 5

Asthma drugs: non specific beta agonists
(a) major drug (s)
(b) mode of action/use
(c) adverse effect

Back 5

(a) isoproterenol
(b) relaxes bronchial smooth muscle (beta 2)
(c) tachycardia (beta 1)

Front 6

Beta 2 agonists
(a) major drug (s)
(b) mode of action/use
(c) adverse effect

Back 6

(a) albuterol, salmeterol
(b) albuterol: relaxes bronchial smooth muscle (beta2)
Salmeterol: long acting agent for prophylaxis
(c) tremor and arrhythmia

Front 7

Methylxanthines
(a) major drug (s)
(b) mode of action/use
(c) adverse effect

Back 7

(a) theophylline
(b) likely causes bronchodilation by inhibiting phosphodiesterase decr cAMP hydrolysis
(c) usage limited b/c of narrow therapeutic index (cardiotoxicity, neurotoxicity); metaolized by p450

Front 8

Muscarinic antagonists
(a) major drug (s)
(b) mode of action/use
(c) adverse effect

Back 8

(a) ipratropium
(b) competitive block of muscarinic receptors preventing bronchoconstriction; also used for COPD
(c) n/a

Front 9

Cromolyn
(a) mode of action
(b) adverse effect/use

Back 9

(a) prevents release of mediators from mast cells; useful only for prophylaxis nor for acute attach
(b) toxicity rare

Front 10

Corticosteroids
(a) major drug(s)
(b) mode of action/use

Back 10

(a) beclomethasone, prednisone
(b) inhibit synth of virtually all cytokines; inactivate NF kappa B (TF that induces production of TNF alpha etc). 1st line therapy for chronic asthma

Front 11

Antileukotriences
(a) major drug (s)
(b) mode of action/use
(c) adverse effect

Back 11

(a) Zileuton; Zafirlukast, Montelukast
(b) Zileuton: 5-lipooxygenase pathway inhibitor; blocks conversion of arachidonic acid to leukotrienes
Zafr and Monte: block leukotrience receptors; esp good for aspirin induced asthma)

Front 12

Guaifenesin (robitussin) MOA

Back 12

Removes excess sputum but large doses necessary; does not suppress cough reflex

Front 13

N acetylcysteine

Back 13

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