Term
What is th action of Albuterol? |
|
Definition
Short acting Beta 2 Adrenergic Agonist |
|
|
Term
What are the Short-Acting Beta 2 Adrenergic Agonists? |
|
Definition
Albuterol, Metaproterenol, and Terbutaline |
|
|
Term
What are the Long-Acting Beta 2 Adrenergic Agonists? |
|
Definition
Salmeterol and Fermoterol |
|
|
Term
|
Definition
Budesonide, and Fluticasone?,Glucocorticoids |
|
|
Term
What are the Leukotriene Receptor Antagonists? |
|
Definition
Zafirlukast and Montelucast |
|
|
Term
What is the action of Ipratropium Bromide? |
|
Definition
Muscarinic Receptor Antagonist |
|
|
Term
What is the IgE antibody? |
|
Definition
|
|
Term
What are the PDE inhibitors? |
|
Definition
Aminophylline and Theophylline |
|
|
Term
What are the PDE inhibitors also know as? |
|
Definition
Methylxanthines, most potent inhibitors of Adenosine receptors |
|
|
Term
What is episodic narrowing of the bronchi |
|
Definition
inflammation, and hyper-reactivity?,Asthma |
|
|
Term
What is the basic treatment of Asthma? |
|
Definition
Relax Bronchial Smooth Muscle and Decrease Airway Inflammation |
|
|
Term
What is the signaling pathway associated with a Beta 2 Adrenergic Agonist? |
|
Definition
Activates Adenyl Cyclase/cAMP/pKa leading to relaxation of smooth muscle |
|
|
Term
What is the MOA of theophylline? |
|
Definition
|
|
Term
How does a PDE inhibitor lead to bronchial relaxation? |
|
Definition
Extends the period of Time cAMP is active |
|
|
Term
What is the effect of adenosine and acetylcholine on brinchial smooth muscle? |
|
Definition
|
|
Term
What is the potent bronchoconstrictor? |
|
Definition
Leukotrienes, 100x more potent than Histamine |
|
|
Term
What is the big problem with diagnosing and treating asthma? |
|
Definition
It only has one name for many different types of triggers |
|
|
Term
What can potentially trigger an asthma attack? |
|
Definition
Allergens, Exercise, Work Related Causes, and some are unknown |
|
|
Term
What effect on airway smooth muscle does a Beta 2 Agonist have? |
|
Definition
Leads to Hyperpolarization and relaxation mediated by increasing cAMP |
|
|
Term
What are the side effects of Beta 2 agonists if used properly? |
|
Definition
None, but if too much is swallowed instead of inhaled can lead to systemic exposure |
|
|
Term
What prevents Beta 2 agonists from being swallowed? |
|
Definition
Putting a Spacer on the Inhaler |
|
|
Term
What can prevent inhaled corticosteroids from being swallowed? |
|
Definition
Washing your mouth out after use |
|
|
Term
What are the Short Acting Beta 2 Agonists? |
|
Definition
Albuterol, Metaproterenol, Terbutaline |
|
|
Term
|
Definition
Metaproterenol, and Terbutaline highly selective for Beta 2 Receptors?,Yes |
|
|
Term
What are the Beta 2 agonists used to treat? |
|
Definition
Acute Bronchospasm, 1-5 min onset lasting for 2-5 hours |
|
|
Term
What are the Long Acting Beta 2 Agonists? |
|
Definition
Salmeterol and Fermoterol |
|
|
Term
Are the Long Acting Beta 2 agonists highly selective for Beta 2 receptors? |
|
Definition
|
|
Term
What is the duration of action of the long acting Beta 2 agonists? |
|
Definition
|
|
Term
Why are Salmeterol and Fermoterol longer acting Beta 2 agonists? |
|
Definition
|
|
Term
What works synergistically with the Beta 2 agonists to treat asthma? |
|
Definition
|
|
Term
When are Glucocorticoids used for asthma? |
|
Definition
Prophylactically to inhibt the inflammation |
|
|
Term
What are the inhaled Glucocorticoids? |
|
Definition
Beclomethasone, Budesonide, and Fluticasone |
|
|
Term
What is the benefit of using Glucocorticoids? |
|
Definition
Fewer Symptoms and Less Dependence on Rescue Inhaler |
|
|
Term
What are the side effects of the inhaled glucocorticoids? |
|
Definition
Suppress Hypothalamic/Pituitary/Adrenal Axis and Inhibit Bone Resorption in Women |
|
|
Term
What is the advantage of the newer inhaled glucocorticoids like Beclomethasone |
|
Definition
Budesonide, and Fluticasone?,Low Oral Bioavailiabilty, High First Pass Metabolism leads to fewer systemic effects |
|
|
Term
What are the Systemis Glucocorticoids used for asthma? |
|
Definition
Predisone and Methylprednisone |
|
|
Term
What is the use of Predisone and Methylpredisone? |
|
Definition
Treatment of acute Exacerbations of Asthma |
|
|
Term
What can the systemic glucocorticoids cause? |
|
Definition
Adrenal Suppression, should dissipate in 2 weeks |
|
|
Term
What are the Leukotriene Antagonists? |
|
Definition
Zafirlukast and Montelukast |
|
|
Term
What effect does Zafirlukast/Montelukast have on the Inhaled Steroids and Beta Agonists? |
|
Definition
Decreases the Amount needed |
|
|
Term
How are the leukotriene inhibitors administered? |
|
Definition
|
|
Term
Which drug type for asthma is very effective in a certain subset or patients? Kina like it works or it doesnt? |
|
Definition
The Leukotrien Inhibitors |
|
|
Term
How do leukotrienes act as potent Bronchoconstrictors? |
|
Definition
Activate cys-LT1 Receptor Gi, which increases intracellular Calcium leading to Muscle Contraction |
|
|
Term
What is the potential side effect of Zafirlukast? |
|
Definition
|
|
Term
What are the Anticholinergic M3 Receptor Agonists used to treat Asthma? |
|
Definition
Ipratropium Bromide and Tiotropium (Analog of Ipratropium Bromide) |
|
|
Term
What is the effect of Iprtropium Bromide? |
|
Definition
M3 Antagonist causing Bronchial Smooth Muscle Relaxation |
|
|
Term
How long is Ipratropium Bromide active? |
|
Definition
Supresses Symptoms for 6 Hours |
|
|
Term
What is often used along with Ipratropium Bromide in the treatment of Acute Asthma Attacks? |
|
Definition
|
|
Term
What drug is effective in the treatment of COPD and Emphysema? |
|
Definition
Tiotropium, the M3 Antagonist |
|
|
Term
What is the monoclonal IgE antibody used to treat Asthma? |
|
Definition
|
|
Term
What is the effect of Omalizumab? |
|
Definition
Prevents IgE from binding to mast Cells |
|
|
Term
What are the side effects seen with Omalizumab? |
|
Definition
|
|
Term
What are the Phosphodiesterase Inhibitors used to treat Asthma? |
|
Definition
Aminophylline and Theophylline |
|
|
Term
What is another name for the PDE inhibitors? |
|
Definition
Methylxanthines because Block Adenosine Receptors |
|
|
Term
What is the MOA of Aminophylline and Theophylline? |
|
Definition
PDE inhibitor so increases cAMP and cGMP by blocking their hydrolysis |
|
|
Term
What are the side effects of the PDE inhibitors? |
|
Definition
Many due to to Systemic Effects, Cardiac Arrythmias, Hypotension, Headache, Dizziness, Nausea |
|
|
Term
What PDE inhibitor has a Narrow Therapeutic Window due to variable sensitvities to Cardiac arrthymias? |
|
Definition
|
|
Term
What is the last ditch drug given to treat Acute Asthma Attacks before intubation? |
|
Definition
|
|
Term
What is the definiton of INtermittent Asthma? |
|
Definition
Attacks Less than 2 times per week requiring Short Acting Beta 2 agonists, or are woken by symptoms less than twice a month |
|
|
Term
What is the definiton of Persistent Asthma? |
|
Definition
More attacks than intermittent, divided into Mild, Moderate, and Severe |
|
|
Term
What is Mild Persistent Asthma? |
|
Definition
More than 2 days a week or Awakened by symptoms 3-4 times a week |
|
|
Term
What is Moderate Persistant Asthma? |
|
Definition
Woken with Symptoms Once a week, Daily Symptoms, and Some Limitations to Activity |
|
|
Term
What is Severe Persitent Asthma? |
|
Definition
Daily Symptoms throughout the day and severly inhibits daily activity |
|
|
Term
what is used to treat acute attacks of Asthma? |
|
Definition
Inhaled Short Acting Beta 2 agonists |
|
|
Term
What is used to treat mild persistent Asthma? |
|
Definition
|
|
Term
What is used for Moderate Persistent Asthma? |
|
Definition
Long Acting Beta 2 agonists and Inhaled Corticosteroids |
|
|
Term
What is used for Severe Asthma? |
|
Definition
High Dose Inhaled Corticosteroids |
|
|
Term
What can be used for allergy induced asthma? |
|
Definition
IgE Inhibitor or Leukotriene Blocker |
|
|
Term
What is the progression of treatments for a patient Presenting to the ER with Asthma? |
|
Definition
Oxygen/Beta 2 Agonist/Corticosteroids/M3 Inhibitors/Aminophylline/Intubate |
|
|
Term
What is the MOA of Chromalin in an Acute Asthma attack? |
|
Definition
Blocks Cl- channels, Mast Cell Mediator Release, and Eoisinophil recruitment |
|
|
Term
What are the First Generation Antihistamine Drugs? |
|
Definition
Diphenhydramine, Dimenhydrinate, Meclizine, Cyclizine, and Promethazine |
|
|
Term
What are the Second Generation Antihistamines? |
|
Definition
Loratadine, Fexofenadine, Cetrizine |
|
|
Term
What drugs are used for Cough and Cold remedys? |
|
Definition
Guaifenesin, Dextromethorpan, Chlorpheniramine, Pseudoephdrine |
|
|
Term
Where in the body is Histamine Found? |
|
Definition
High in Lung, Skin, GI, Mast Cells, and Basophils |
|
|
Term
What is the precursor to Hitamine? |
|
Definition
|
|
Term
What is stored in the granules of Mast Cells |
|
Definition
Basophils, and Enterochromaffin Like Cells in the Stomach?,Histamine |
|
|
Term
What happens to hitamine if it is not stored in granules? |
|
Definition
|
|
Term
What is the most important Pathophysiological release of Histamine? |
|
Definition
From Mast Cells and Basophils |
|
|
Term
Where are H1 Histamine Receptors found? |
|
Definition
|
|
Term
Where are H2 receptors found? |
|
Definition
In the Gut (Gastric Secretion) or CNS |
|
|
Term
Where are H3 receptors found? |
|
Definition
Presynaptic Autoreceptors |
|
|
Term
Where are H4 receptors found? |
|
Definition
In cells of Hemopoietic Lineage |
|
|
Term
What Histamine Receptor is responsible for alertness in the hypothalamus? |
|
Definition
|
|
Term
Which Histamine receptors are responsible for Reddening and Halo formation in the skin? |
|
Definition
|
|
Term
What is the signalling pathway for H1 receptors? |
|
Definition
Gq increase Calcium, IP3, and DAG |
|
|
Term
What is the signalling pathway H2 receptors? |
|
Definition
|
|
Term
What is the Signalling pathway of H3 receptors? |
|
Definition
|
|
Term
What are the characteristics of First Generation anti-Histamines? |
|
Definition
Orally Active, Metabolized by CYP450, excreted in the Urine |
|
|
Term
What are the First generation anti-hitamines? |
|
Definition
Brompheniramine and Chlorpheniramine |
|
|
Term
What age group should not use Bromopheniramine and Chlorpheniramine? |
|
Definition
|
|
Term
What Histamine Receptors do First Generation Anti-Hitamines work on? |
|
Definition
H1, found in the GI, Uterus, Large Blood Vessels, and Bronchial Smooth Muscle |
|
|
Term
What is the main function of Bromopheniramine and Chlopheniramine? |
|
Definition
Suppress Edema associatted with Histamine |
|
|
Term
Should First Generation Anti HIstamines be used with MAOIs? |
|
Definition
No they have low level Anticholinergic Activity |
|
|
Term
Can First Generation anti-Histamines cross the Placental Barrier and Get into Breast Milk? |
|
Definition
|
|
Term
What effects of pheniramine and Chlorpheniramine cause sedation? |
|
Definition
Antagonism of Central Histaminergic Receptos |
|
|
Term
What are some other side effects of Anti-Histamines? |
|
Definition
Nausea, Dry Mouth, anxiety, Increased heart rate |
|
|
Term
Which first generation Anti Histamine has Antidepressant Properties? |
|
Definition
|
|
Term
What are the H1 Receptor Blocking Ethanolamines that block H1 receptors? |
|
Definition
Dimenhydrinate and Diphenhydramine |
|
|
Term
What group of AntiHIstamines have Muscarinic Antagonist Activity? |
|
Definition
Ethanolamines, Dimenhydrinate and Diphenhydramine |
|
|
Term
What are the side effects of the Ethanolamine Anti-Hitamine Blockers? |
|
Definition
|
|
Term
What is used to treat motion sickness? |
|
Definition
Dramamine, a Ethanolamine Antihistamine |
|
|
Term
What are the Piperazines used for blocking H1 Receptors? |
|
Definition
|
|
Term
What are the effects of the Piperazines? |
|
Definition
|
|
Term
What are the Alkylamines used to block H1 Receptors? |
|
Definition
Bromopheniramine and Chlorpheniramine |
|
|
Term
Why are the Alkylamines used over some of the other anti-histamines? |
|
Definition
|
|
Term
What is the MOA of Phenothiazine? |
|
Definition
H1 Blocker with Muscarinic and Dopaminergic Antagonist effects |
|
|
Term
What is used with Ephedrine in the Coast Guard Cocktail for treating Motion Sickness? |
|
Definition
|
|
Term
What is used to treat Hay Fever Severe Morning Sickness, and used as a Sedative? |
|
Definition
|
|
Term
In what populations should Phenothiazine not be used? |
|
Definition
Children Under 2 and Men with Enlarged Prostates |
|
|
Term
What are the Second Generation Antihistamines? |
|
Definition
Loratidine, Cetirizine, and Fexofenadine |
|
|
Term
Wha is the benefits of the Second Generation H1 Histamine Blockers? |
|
Definition
Longer Duration, Less CNS Penetration (Less Sedation), No Muscarinic Antagonism, and Fewer Cardiac Risks |
|
|
Term
What commonly causes Hallucinations Excitement, Convulsions, and Cardiorespiratory Collapse is Over Dosed? |
|
Definition
Second Generation Anti HIstamines |
|
|
Term
What antihistamine was removed from the market due to arrythmias if used with Grapefruit Juice or Other p450 blockers? |
|
Definition
|
|
Term
Which of the following is the Second Generation Anti-Histamine with lowered risk of triggering arrhytmia? |
|
Definition
Fexofenadine, all others were First Generation |
|
|
Term
What is the only Expectorant listed safe by the FDA? |
|
Definition
|
|
Term
What is the MOA of Guaifenesin for the treatment of Cough and Cold? |
|
Definition
Loosens and Thins Phlegm/Bronchial Secretions |
|
|
Term
What is the MOA of Antitussives used in Cough and cold remedy? |
|
Definition
Act on Cough Center in the Medulla |
|
|
Term
What antitussive is a opiate receptor agonist? |
|
Definition
|
|
Term
Why can Codeine be used as a Cough Suppresent and a Analgesic? |
|
Definition
6 Fold lower dose will suppress cough than required for analgesia |
|
|
Term
What percent of codeine is metabolized to Morphine? To Codeine 6 Glucuronide? |
|
Definition
|
|
Term
What are the side effects of codeine? |
|
Definition
Dependency, Drowsiness, Hypotension, and Constipation |
|
|
Term
What antitussive is the d-stereoisomer of Codeine analog Levorphanol? |
|
Definition
|
|
Term
What is the MOA of Dextromethorpan? |
|
Definition
NMDA antagonist, Dopamine and Serotonin Reuptake Inhibitor |
|
|
Term
What is the advantage of Dextromethorpan over Codeine? |
|
Definition
|
|
Term
What are the side effects of Dextromethorphan? |
|
Definition
Drowsiness, Dizziness, Excitation, and Vomitting |
|
|
Term
What side effect of Dextropethorphan is seen at High Doses? |
|
Definition
|
|
Term
Which antitussive if used with a MAOI can cause Serotonin Syndrome? |
|
Definition
|
|
Term
What is the MOA of pseudoephedrine? |
|
Definition
a-adrenergic agonist, triggers release of Norepi, Causing Vasoconstriction shrinking Mucus Membranes |
|
|
Term
What is the effect of Pseudoephedrine on sinus drainage? |
|
Definition
|
|
Term
What is the main adverse effect of Pseudoephedrine? |
|
Definition
Can Trigger Rebound Congestion increasing Hypertension |
|
|
Term
What is often paired with Pseudoephedrine to prevent Rebound Congestion and Hypertension? |
|
Definition
|
|
Term
What Decongestant can Hypertension |
|
Definition
Tachycardia, and Arrythmias?,Pseudoephedrine |
|
|
Term
What is the state of a patient with Pseudoephedrine OD? |
|
Definition
Nervous/Excited due to CNS Stimulation and Hypertensive |
|
|
Term
What patients should not take pseudoephedrine? |
|
Definition
Diabetics, CV Disease, Hypertension, BPH, and Patients on MAOI |
|
|
Term
What is a more selective alpha 1 adrenergic agonist used as a decongestant? |
|
Definition
|
|
Term
What are the side effects of Phenylephrine? |
|
Definition
Same as Pseudoephedrine but Has much larger therapuetic Window |
|
|