Respiratory Drugs: Overview and Characteristics
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Questions and Answers

What is the primary mechanism of action of mast cell stabilizers?

  • Inhibiting chloride ion conduction
  • Stimulating mast cell degranulation
  • Inhibiting histamine release
  • Increasing chloride ion conduction (correct)

    • What is a common side effect of acute administration of mast cell stabilizers?

  • Bronchodilation
  • Bronchospasm (correct)
  • Hypertension
  • Tachycardia

    • What is the primary use of cromolyn sodium?

  • Treatment of allergic rhinoconjunctivitis
  • Treatment of hepatotoxicity
  • Prophylaxis of exercise-induced bronchospasm (correct)
  • Treatment of asthma exacerbations

    • What is the mechanism of action of lipoxygenase inhibitors?

    <p>Inhibiting leukotriene synthesis</p> Signup and view all the answers

    What is a common adverse effect of lipoxygenase inhibitors?

    <p>Hepatotoxicity</p> Signup and view all the answers

    How often should liver enzymes be monitored during treatment with lipoxygenase inhibitors?

    <p>Monthly for 3 months, then annually</p> Signup and view all the answers

    What is the class of medications that includes cromolyn sodium and nedocromil?

    <p>Mast cell stabilizers</p> Signup and view all the answers

    What is the consequence of mast cell degranulation?

    <p>Bronchoconstriction</p> Signup and view all the answers

    What is the purpose of pre-administering a β2 agonist before using mast cell stabilizers?

    <p>To reduce the risk of bronchospasm</p> Signup and view all the answers

    What is the primary toxic effect of PPA?

    <p>Blood vessel constriction</p> Signup and view all the answers

    Which of the following drugs is NOT recommended for treating hypertension caused by PPA overdose?

    <p>Propranolol</p> Signup and view all the answers

    What is the recommended treatment for arrhythmias caused by PPA overdose?

    <p>Propranolol</p> Signup and view all the answers

    Which of the following is a common side effect of PPA overdose?

    <p>Headache</p> Signup and view all the answers

    What is the mechanism of action of PPA in causing hypertension?

    <p>Directly stimulating alpha1-adrenergic receptors and indirectly enhancing norepinephrine release</p> Signup and view all the answers

    Which of the following drugs is used to enhance elimination of PPA, ephedrine, and pseudoephedrine?

    <p>Urinary acidification</p> Signup and view all the answers

    What is the recommended treatment for a patient with bradycardia caused by PPA overdose?

    <p>Avoid administering beta-blockers</p> Signup and view all the answers

    Which of the following is NOT a symptom of PPA overdose?

    <p>Hypothermia</p> Signup and view all the answers

    Which of the following drugs has more beta-adrenergic stimulation than PPA?

    <p>Ephedrine</p> Signup and view all the answers

    What is the mechanism of action of corticosteroids?

    <p>Bind to glucocorticoid receptors on the cytoplasm of cells</p> Signup and view all the answers

    What is the most effective way to decrease the systemic adverse effects of corticosteroid therapy?

    <p>Aerosol treatment</p> Signup and view all the answers

    What is the side effect of inhaled topical corticosteroids?

    <p>Oropharyngeal candidiasis</p> Signup and view all the answers

    When is oral or inhaled corticosteroids most effective for prevention of nocturnal asthma?

    <p>In the late afternoon</p> Signup and view all the answers

    What is the effect of Montelukast and Zafirlukast?

    <p>Prevent the binding of LTD4 to its receptor</p> Signup and view all the answers

    What is Churg-Strauss syndrome?

    <p>Inflammation of small to medium-sized blood vessels</p> Signup and view all the answers

    What is the management of oropharyngeal candidiasis caused by inhaled corticosteroids?

    <p>Gargle water and spit after each inhaled treatment</p> Signup and view all the answers

    Which of the following is an oral corticosteroid?

    <p>Prednisone</p> Signup and view all the answers

    What is the effect of leukotriene receptor blockers?

    <p>Prevent the binding of LTD4 to its receptor</p> Signup and view all the answers

    What is the primary use of dextromethorphan?

    <p>Cough suppression</p> Signup and view all the answers

    What is a key characteristic of dextromethorphan compared to opioid analgesics?

    <p>It has no analgesic effect</p> Signup and view all the answers

    What is the recommended adult daily dose of dextromethorphan?

    <p>60-120 mg/d</p> Signup and view all the answers

    What may occur at a toxic dose of dextromethorphan exceeding 10mg/kg?

    <p>Respiratory depression</p> Signup and view all the answers

    Which symptom is associated with mild intoxication from dextromethorphan?

    <p>Visual hallucinations</p> Signup and view all the answers

    What is a common effect of severe poisoning from dextromethorphan?

    <p>Coma</p> Signup and view all the answers

    How long after ingestion are the effects of dextromethorphan generally noticeable?

    <p>15-30 minutes</p> Signup and view all the answers

    In which formulations is dextromethorphan commonly found?

    <p>Cough and cold preparations</p> Signup and view all the answers

    What age group is the recommended dosage of dextromethorphan up to 30 mg/d for?

    <p>Children aged 2-5 years</p> Signup and view all the answers

    What can happen if a patient overdoses on Esmolol with more than 50 mg/kg?

    <p>Levels above 100 mg/L and significant toxicity may occur.</p> Signup and view all the answers

    Which mechanism of action is associated with β2-agonists?

    <p>Activation of adenylyl cyclase and increased CAMP production</p> Signup and view all the answers

    Which drug is the first-line treatment for acute exacerbations of bronchial asthma (BA)?

    <p>Salbutamol (Albuterol)</p> Signup and view all the answers

    What is the onset time for Ephedrine when administered via inhalation?

    <p>5 minutes</p> Signup and view all the answers

    Which of the following is true about the use of beta-blockers in patients with a history of asthma?

    <p>They should be used cautiously.</p> Signup and view all the answers

    What suffix is common to bronchodilators that are β2-agonists?

    <p>-terol</p> Signup and view all the answers

    Which route is commonly used for administering Terbutaline?

    <p>SC injection</p> Signup and view all the answers

    What is the primary effect of β2-agonists on mucociliary clearance?

    <p>Improves mucociliary clearance</p> Signup and view all the answers

    What is a contraindication for using non-selective β-blockers?

    <p>Patients with a history of asthma or wheezing</p> Signup and view all the answers

    Study Notes

    Respiratory Drugs Overview

    • Key categories include Dextromethorphan, PPA and related decongestants, Theophylline, and Anti-inflammatory Agents.

    Dextromethorphan

    • Commonly found in over-the-counter cough and cold medications.
    • Considered an opioid but lacks analgesic effect and addictive properties.
    • Often included in combination products like Nyquil, Robitussin DM, and Triaminic DM.
    • Functions as an antitussive or cough suppressant.

    Characteristics and Toxicity

    • Dextromethorphan is the d-isomer of 3-methoxy-N-methylmorphinan, a synthetic analogue of codeine.
    • Toxic doses typically exceed 10 mg/kg, while the usual adult daily dose is 60-120 mg, and for children aged 2-5, it is up to 30 mg.
    • Overdose symptoms include clumsiness, ataxia, nystagmus, and hallucinations.
    • Severe toxicity can lead to stupor, coma, respiratory depression, and seizures, especially with doses exceeding 20-30 mg/kg.

    PPA (Phenylpropanolamine)

    • Produces mild β1-adrenergic stimulation; acts primarily as a decongestant.
    • Ephedrine and pseudoephedrine exhibit both direct and indirect adrenergic activity.
    • Toxic effects of PPA include hypertension, headache, confusion, seizures, and potential myocardial infarction.

    Treatment of PPA Toxicity

    • Administer phentolamine or nitroprusside for hypertension, ensuring a vasodilator is given before beta-blockers.
    • Use propranolol or esmolol for arrhythmias, avoiding beta-blockers in bradycardia alongside hypertension.
    • Decontamination can involve Ipecac-induced emesis, activated charcoal, and urinary acidification.

    Bronchodilators

    • Function by stimulating ß2-receptors, which activate adenylyl cyclase to promote bronchodilation and reduce inflammation.
    • Suffix “-terol” is common in bronchodilator names.

    Types and Uses

    • Short-acting: Salbutamol (Albuterol) is first-line for acute asthma exacerbations.
    • Long-acting: Controller medications for nocturnal asthma, e.g., Salmeterol.
    • Non-selective: Medication like Epinephrine is restricted for special situations due to cardiac stimulation.

    Anti-inflammatory Agents

    Mast Cell Stabilizers

    • Examples include Cromolyn sodium and Nedocromil, used to prevent bronchoconstriction.
    • Mechanism involves stabilizing mast cell membranes to inhibit degranulation.
    • Side effects can include bronchospasms.

    Lipoxygenase Inhibitor

    • Zileuton inhibits 5-lipoxygenase, preventing leukotriene synthesis and potentially causing hepatotoxicity; requires regular liver function monitoring.

    Leukotriene Receptor Blockers

    • Montelukast and Zafirlukast prevent binding of leukotrienes, particularly effective in NSAID-induced asthma.

    Corticosteroids

    • Mechanism involves binding to glucocorticoid receptors, regulating target gene transcription.
    • Effective for nocturnal asthma when administered in the late afternoon.
    • Side effects may include oropharyngeal candidiasis; management includes gargling with water post-treatment.
    • Examples include budesonide, fluticasone, and beclomethasone, with prednisone as an oral corticosteroid option.

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    Related Documents

    PHCT Respiratory Drugs Reviewer PDF

    Description

    Learn about respiratory drugs, including Dextromethorphan, PPA, Theophylline, and Anti-inflammatory Agents, their characteristics, and toxicity. Understand their uses, effects, and properties.

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