Term
| Antitussives inhibit cough reflex by |
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Definition
| Reduce sensory receptor activation: menthol, bencocaine and Depressing a cough center in the brain: opiods (codeine) agonist at opiod receptor |
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Term
| Mucolytics reduce viscosity of bronchial secretions by |
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Definition
| cleaving disulfide bonds crosslinking mucous glycoprotein molecules |
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Term
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Definition
| vasocontriction of the mucosal blood vessels of the nose, and a reduction of edema and secretions |
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Term
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Definition
| topical decongestant, it is an indirect acting sympathomimetic that is condraindicated in children, diabetes, HTN, and hyperthyroidism |
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Term
| Side effect of decongestants |
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Definition
| rebound nasal congestion on withdrawl |
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Term
| Beta 2- Adrenoceptor Agonists examples |
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Definition
| Terbutaline, albuterol , metaproterenol, salmeterol, formoterol |
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Term
| Beta 2- Adrenoceptor Agonists MOA |
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Definition
| stimulate adenylyl cyclase, increase cyclic AMP, increase broncodilation |
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Term
| Beta 2- Adrenoceptor Agonists side effects |
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Definition
| muscle tremor, tachycardia, arrhythmia, tolerance |
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Term
| Methylxanthines examples: |
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Definition
| theophylline, theobromine, caffeine. Theophylline is used in asthma. Both slow and rapid release forms. Metabolized by p450. Clearance varies with age (highest in adolescent) |
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Term
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Definition
| Inhibit PDE, increase cAMP, causes bronchodiliation, CNS stimulation, cardiac stimulation, increased G.I. motility |
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Term
| Methylxanthines side effects: |
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Definition
| G.I distress, nausa, vomitting, tremor, convulson, overdose toxicty: treated with beta blockers |
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Term
| Muscarinic antagonist examples and uses |
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Definition
| Ipratropium, atropine: used in COPD, asthma |
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Term
| Muscarinic antagonist MOA |
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Definition
| blocks muscarinic 2 receptors , reverses bronchoconstriction |
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Term
| muscarinic antagonist side effects |
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Definition
| minimum, does not cause tremor , arrhythmia |
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Term
| Cromolyn and Nedocromil uses and side effects |
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Definition
| use: asthma, given as aerosol; SE cough, irritation |
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Term
| cromolyn and Nedocromil MOA |
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Definition
| decrease histamine, leukotrienes release from mast cells. Prevent bronchoconstriction, locally active |
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Term
| Corticosteroids uses and side effects |
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Definition
| use: asthma, COPD, inhaled corticosteroids-first line therapy in severe asthma; SE: candidiasis, adrenal suppression |
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Term
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Definition
| reduce synthesis of arachidonic acid by phosphlipase A2, inhibit expression of COX-2, increase B2 receptor sensitivity |
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Term
| Zeleuton uses and side effects |
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Definition
| leukotriene antagonist; orally active, used in asthma, aspirin allergy; SE:elevation of liver enzymes |
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Term
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Definition
| selectively inhibits 5-lipooxygenase, decreases leukotrienes, prevents both exercise and antigen induced bronchospam |
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Term
| Zafirlukast, montelokast uses and MOA |
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Definition
| uses: same as zeleuton; MOA: block LTD4 and LTE5 receptors |
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Term
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Definition
| Diphenhydramine, Ceirizine, Desloratadine, Fexofenaldine |
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Term
| Drugs that increase serum concentration of theophylline |
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Definition
| oral contraceptives, erythromycin, calcium antagonists, cimetidine |
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Term
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Definition
| Beta 2 Adrenergic Agonist, Corticosteroids, Cromolyn, nedocromil, Ipatropium, montelukast, zafirlukast, zileuton, omalizumab, theophylline |
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Term
| Drugs used in allergic rhinitis |
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Definition
| alpha-adrenergic agonists, antihistamines, corticosteroids, cromolyn |
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Term
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Definition
| Beta adrenergic agonists, corticosteroids, ipratropium |
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Term
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Definition
| Dextromethorphan, opiates |
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Term
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Definition
| PDE4 (phoshodiesterase) inhibitor, selective, orally active, used in COPD |
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Term
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Definition
| PDE4 (phosphodiesterase) inhibitor, used in genetic deficiency of PDE4 related to emphysema |
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Term
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Definition
| The most effective antitussive agents are opioids such as morphine, diamorphine, and codeine which, in all probability, act both centrally on brainstem opioid receptors and on receptors located peripherally on sensory nerve endings in the airways. Addictive |
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Term
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Definition
| is an opioid-like drug that binds to and acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptors. Non-addictive |
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Term
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Definition
| expectorant; promotes drainage of mucus from the lungs by thinning the mucus and also lubricates the irritated respiratory tract. |
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Term
Guaifenesin:
Adverse effects |
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Definition
diarrhea, drowsiness, nausea/vomiting
stomach pain
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Term
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Definition
Guaifenesin
dextromethorphan
pseudoephedrine
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Term
| oral (systemic) decongestants |
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Definition
Pseudoephedrine
Phenylpropanolamine
Phenylephrine
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Term
Which of the following drugs is classified as an adrenergic agonist, but has no physiological relevant or clinically useful effects on airway smooth muscle tone?
A.albuterol
B.epinephrine
C.salmeterol
D.terbutaline
E.norepinephrine
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Definition
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Term
A 15-yr-old girl treated for asthma develops skeletal muscle tremors that are drug-induced. Which of the following was the most likely cause?
A. albuterol
B. beclomethasone
C. cromolyn
D. ipratropium
E. montelukast
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Definition
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Term
1.A 12-year-old girl with a childhood history of asthma complained of cough, dyspnea, and wheezing after visiting a riding stable. Her symptoms became so severe that her parent brought her to the emergency room. Physical examination revealed diaphoresis, dyspnea, tachycardia, and tachypnea. Her respiratory rate was 42 breaths per min, pulse rate 110 beats per minute, and blood pressure 132/65 mm Hg. Which of the following is the most appropriate drug to rapidly reverse her bronchoconstriction?
A. Inhaled cromolyn
B. Inhaled beclomethasone
C. Inhaled albuterol
D. Intravenous propranolol
E. inhaled ipratopium
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Definition
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Term
Which of the following is NOT an action of terbutaline?
A.vasodilation
B.bronchodilation
C.bradycardia
D.increased release of glucagon
E.slightly decreased peripheral resistance
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Definition
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Term
A patient consumes a large dose of theophylline and develops toxicity in respose to the drug. Which of the following is the most likely consequence of this?
A. Bradycardia
B. Hepatotoxicity
C. Seizure
D. Paradoxical bronchospasm
E. Drowsiness progressing to sleep and then coma
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Definition
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Term
One of the effects of theophylline in biologic
tissues is
A. stimulation of Na+K+ ATPase
B. inhibition of Na+K+ ATPase
C. inhibition of cyclic nucleotide phosphodiesterase
D. stimulation of cyclic nucleotide phosphodiesterase
E. stimulation of adenylyl cyclase
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Definition
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Term
One of the effects of theophylline in biologic
tissues is
A. stimulation of Na+K+ ATPase
B. inhibition of Na+K+ ATPase
C. inhibition of cyclic nucleotide phosphodiesterase
D. stimulation of cyclic nucleotide phosphodiesterase
E. stimulation of adenylyl cyclase
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Definition
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Term
Cough suppression is indicated
A. if phlegm production is excessive
B. if there is severe rhinitis
C. if there is bronchiectasis
D. if the cough is induced by extra bronchial irritation
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Definition
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Term
Prominent antitussive activity produced by
therapeutic doses is characteristic of
A. morphine
B. theophylline
C. albuterol
D. dexamethasone
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Definition
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Term
When applied to the airways of an asthmatic individual, drug X causes bronchodilation. The effect is not blocked by propanolol. Drug X does not normally have any central nervous system effect and, if it is given by mouth, has a bioavailability of less than 40%. Drug X is most likely
A.atropine
B.Scopolamine
C.terbutaline
D.ipratropium
E.albuterol
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Definition
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Term
Acute administration of the following drugs
induces bronchodilation except
A.metaproterenol
B.aminophylline
C.cromolyn sodium
D.epinephrine
E.theophylline
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Definition
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Term
A 16-year-old boy with breathing difficulty is seen in the emergency department. He is diagnosed with asthma and given urgent care. The next day he visits his primary physician, who starts him on therapy with albuterol, to be inhaled "as needed" (for acute symptom control-rescue therapy). After several weeks the patient says he needs to use the inhaler several times a day, nearly every day, because "breathing just gets real hard; I can't get much air in." The physician's assessment is that symptom severÂity and frequency are getting progressively and quickly worse.
Which initial therapeutic modification for outpatient management would be most reasonable, with the greatest likelihood of controlling the asthma?
A. Add an inhaled corticosteroid
B. Add cromolyn
C. Add oral prednisone
D. Add theophylline
E. Double the albuterol dose to be taken with each episode
F. Replace the albuterol with salmeterol
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Definition
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Term
A 23-year-old with asthma has what is described as "aspirin sensitivity" and experiences severe bronchospasm in response to even small doses of the drug. The most likely explanation for this is that the aspirin
A. Blocks synthesis of endogenous prostaglandins that have bronchodilator activity
B. Induces formation of antibodies directed against the salicylate on airway mast cells
C. Induces hypersensitivity of HI receptors on airway smooth muscles
D. Induces hypersensitivity of muscarinic receptors on airway smooth muscles
Prevents or reduces epinephrine binding to
beta2-radrenergic receptors (airways and elsewhere)
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Definition
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Term
A young boy, in obvious respiratory distress from a severe asthma attack, presents in the emergency department. One drug ordered by the physician, to be administered by the respiratory therapist, is N-acetylcysteine. Which of the following is the purpose of this drug?
A. Block receptors for the cysteinylleukotrienes
B. Inhibit metabolic inactivation of epinephrine or /32 agonists that were administered
C. Inhibit leukotriene synthesis
D. Promptly suppress airway inflammation
E. Reverse ACh-mediated bronchoconstriction
F. Thin airway mucus secretions for easier removal by suctioning
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Definition
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Term
A young boy is diagnosed with asthma. His primary symptom is frequent cough, not bronchospasm or wheezing. Other asthma medications are started, but until their effects develop fully we wish to suppress the cough without running a risk of suppressing ventilatory drive or causing sedation or other unwanted effects. Which of the following would best meet these needs?
A. Codeine
B. Dextromethorphan
C. Diphenhydramine
D. Hydrocodone E.
E. Promethazine
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Definition
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Term
An adult patient with asthma begins taking furosemide for another indication. After several weeks on the diuretic he complains of more breathing difficulty than he had before. Pulmonary function tests confirm his perceptions. Which of the following is the most likely mechanism by which the furosemide worsened the clinical picture?
A. Blocking the endogenous bronchodilator effects of circulating epinephrine
B. Causing greater bronchoconstriction by releasing more ACh in the airways
C. Directly causing bronchoconstriction
D. Drying the airways, increasing mucus viscosity
E. Enhancing metabolic clearance of other asthma medications (lowering their serum levels)
E. Releasing histamine
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Definition
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