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Questions and Answers
What is the primary cause of most common colds?
Which histamine receptor type is primarily associated with bronchoconstriction?
What is the effect of antihistamines on the H1 receptor sites?
What role does histamine play in allergic reactions?
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Which of the following is NOT a treatment goal for managing symptoms of the common cold?
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Which condition is associated with histamine-mediated disorders?
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How do antihistamines function in preventing the action of histamine?
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What is a common characteristic shared by antihistamines?
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What is the primary pharmacodynamic action of diphenhydramine?
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What is the peak time for diphenhydramine when administered intravenously?
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Which of the following is a significant side effect of diphenhydramine?
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In which scenario should diphenhydramine be used with caution?
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What is the elimination route for diphenhydramine metabolites?
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What is a contraindication for the use of diphenhydramine?
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What is the recommended intravenous dose of diphenhydramine for a patient weighing over 50 kg?
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What is the half-life of diphenhydramine?
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What role does surfactant play in the alveoli?
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What characterizes bronchial asthma?
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What is the primary function of the drug salbutamol (Ventolin)?
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Which statement best describes the pharmacodynamics of salbutamol?
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What are common diseases affecting the upper respiratory tract?
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What is a characteristic feature of lower respiratory tract diseases?
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What does the term allergen refer to?
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How is salbutamol primarily eliminated from the body?
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What is the primary pharmacological classification of Dexamethasone?
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Which mechanism of action primarily describes how Dexamethasone exerts its effects?
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What is the main action of Atrovent® in the management of COPD?
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Which of the following statements about the absorption of Dexamethasone is true?
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What is the effect of using higher doses of Dexamethasone?
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Which of the following best describes the action of Xanthine derivatives like Theophylline?
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What is a common adverse reaction associated with the use of Xanthine medications?
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What is the mechanism through which Salmeterol acts to provide bronchial dilation?
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What is the primary indication for the use of Salbutamol (Ventolin®)?
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What is the maximum single dose of Salbutamol delivered via nebulization for a patient weighing 25kg?
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Which type of adrenergic drug selectively stimulates only beta2 receptors?
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What is a common side effect of inhaled corticosteroids?
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In the stepwise therapy for managing asthma, what is recommended for moderate persistent asthma?
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What role do anticholinergic drugs play in respiratory treatment?
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Which medication should be taken 15 to 20 minutes before physical activity to prevent exercise-induced asthma?
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When is the use of Salbutamol contraindicated?
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What is the action of leukotriene receptor antagonists such as Singulair®?
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Study Notes
Common Cold
- Most colds are caused by viral infections, with rhinovirus and influenza being the most common culprits.
- The virus invades the mucosa of the upper respiratory tract, including the nose, pharynx, and larynx.
- Symptoms include excessive mucous production, leading to a sore throat, coughing, and upset stomach.
- Treatment focuses on reducing symptoms, as antibiotics are ineffective against viral infections.
Histamine
- Histamine is an organic compound that triggers inflammatory and local immune responses.
- Histamine receptors H1 through H4 are found on smooth muscle, endothelium, and central nervous system tissue.
- Stimulation of histamine receptors causes vasodilation, bronchoconstriction, smooth muscle activation, separation of endothelial cells (responsible for hives), and pain and itching due to insect stings.
Antihistamines
- Antihistamines act directly on histamine receptor sites, blocking the action of histamine.
- They have antihistaminic, anticholinergic, and sedative properties.
- They work by competing with histamine for binding at unoccupied receptors, preventing the adverse consequences of histamine stimulation such as vasodilation, increased GI and respiratory secretions, and increased capillary permeability.
- Antihistamines are more effective in preventing the actions of histamine rather than reversing them.
Diphenhydramine (Benadryl)
- Diphenhydramine is one of the oldest antihistamines and is a common treatment for allergic reactions.
- It antagonizes the effects of histamine at the H1 receptor sites, blocking its effects rather than inhibiting its production and release.
- It also has antiemetic effects and significant sedative side effects.
- It is available in various forms, including oral, intravenous, and intramuscular.
Salbutamol (Ventolin)
- Salbutamol is a selective beta 2 adrenergic receptor stimulant that promotes bronchodilation by relaxing muscle fibers in the bronchi.
- It has some beta 1 effects, particularly with repeated doses, and little or no alpha stimulation.
- It is available in various forms, including metered-dose inhalers (MDIs) and nebulizer solutions.
- It is used for quick relief of bronchospasm in patients experiencing respiratory distress.
Beta Adrenergic Drugs
- Beta-adrenergic drugs are classified based on receptor selectivity:
- Nonselective adrenergics: stimulate alpha, beta1 (cardiac), and beta2 (respiratory) receptors (e.g., epinephrine).
- Nonselective beta-adrenergics: stimulate both beta1 and beta2 receptors (e.g., isoproterenol).
- Selective beta2 drugs: stimulate only beta2 receptors (e.g., salbutamol).
Anticholinergic Drugs
- Acetylcholine (ACh) causes bronchial constriction and narrowing of the airways.
- Anticholinergics bind to ACh receptors, preventing ACh from binding.
- This results in bronchodilation, preventing bronchoconstriction.
- They are not used for acute asthma exacerbations, but are primarily used for long-term management of airway obstruction.
- Examples include ipratropium bromide (Atrovent) and Combivent (salbutamol/ipratropium).
Inhaled Corticosteroids
- Inhaled corticosteroids like fluticasone (Flovent) are potent locally acting anti-inflammatory and immune modifiers.
- They are commonly used for long-term management of asthma, decreasing the frequency of asthma attacks and preventing pulmonary damage associated with chronic asthma.
- Adverse reactions include hoarseness, oropharyngeal fungal infections, dry mouth, and esophageal/oral candidiasis (thrush).
Exercise-Induced Asthma
- Prevention strategies include:
- Short-acting beta2 agonists, taken 15-20 minutes before activity.
- Increased fluid intake.
- Staying indoors when air quality is poor.
Epinephrine for Asthma Exacerbation
- Epinephrine is a nonselective adrenergic drug that is used to treat severe asthma exacerbations.
- It is typically administered intramuscularly with a concentration of 1mg/ml (1:1,000).
- The dose is 0.01 mg/kg, with a maximum single dose of 0.5mg.
- It should only be administered once in a 24-hour period.
Dexamethasone (Decadron)
- Dexamethasone is a corticosteroid that binds to the glucocorticoid receptor, inhibiting pro-inflammatory signals and promoting anti-inflammatory signals.
- It can be administered orally, intravenously, or intramuscularly.
- It can be administered for long-term management of asthma or for short-term treatment of acute exacerbations.
COPD (Chronic Obstructive Pulmonary Disease)
- COPD is a chronic lung disease that causes airflow obstruction.
- It is characterized by the following:
- Chronic bronchitis: persistent inflammation of the bronchial tubes.
- Emphysema: destruction of the tissues that support the alveoli.
- Asthma: reversible bronchospasm and inflammation of the airways.
Treatment of COPD
- Management of COPD often involves a combination of medications, including:
- Bronchodilators to open the airways:
- Atrovent (ipratropium bromide)
- Salmeterol (Serevent)
- Theophylline (Theo-Dur)
- Corticosteroids to reduce inflammation:
- Solu-Medrol (methylprednisolone)
- Oral corticosteroids such as prednisone.
- Oxygen therapy:
- To supplement oxygen levels in the blood.
- Pulmonary rehabilitation:
- To improve lung function and exercise tolerance.
- Bronchodilators to open the airways:
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Description
This quiz covers the essentials of the common cold, including its viral causes, symptoms, and treatment options. Additionally, it delves into histamine's role in the body, its receptors, and the function of antihistamines. Test your understanding of these important topics in respiratory health and immunology.
