Questions and Answers
What is the primary mechanism of action of mast cell stabilizers?
What is a common side effect of acute administration of mast cell stabilizers?
What is the primary use of cromolyn sodium?
What is the mechanism of action of lipoxygenase inhibitors?
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What is a common adverse effect of lipoxygenase inhibitors?
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How often should liver enzymes be monitored during treatment with lipoxygenase inhibitors?
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What is the class of medications that includes cromolyn sodium and nedocromil?
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What is the consequence of mast cell degranulation?
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What is the purpose of pre-administering a β2 agonist before using mast cell stabilizers?
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What is the primary toxic effect of PPA?
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Which of the following drugs is NOT recommended for treating hypertension caused by PPA overdose?
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What is the recommended treatment for arrhythmias caused by PPA overdose?
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Which of the following is a common side effect of PPA overdose?
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What is the mechanism of action of PPA in causing hypertension?
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Which of the following drugs is used to enhance elimination of PPA, ephedrine, and pseudoephedrine?
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What is the recommended treatment for a patient with bradycardia caused by PPA overdose?
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Which of the following is NOT a symptom of PPA overdose?
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Which of the following drugs has more beta-adrenergic stimulation than PPA?
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What is the mechanism of action of corticosteroids?
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What is the most effective way to decrease the systemic adverse effects of corticosteroid therapy?
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What is the side effect of inhaled topical corticosteroids?
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When is oral or inhaled corticosteroids most effective for prevention of nocturnal asthma?
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What is the effect of Montelukast and Zafirlukast?
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What is Churg-Strauss syndrome?
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What is the management of oropharyngeal candidiasis caused by inhaled corticosteroids?
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Which of the following is an oral corticosteroid?
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What is the effect of leukotriene receptor blockers?
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What is the primary use of dextromethorphan?
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What is a key characteristic of dextromethorphan compared to opioid analgesics?
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What is the recommended adult daily dose of dextromethorphan?
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What may occur at a toxic dose of dextromethorphan exceeding 10mg/kg?
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Which symptom is associated with mild intoxication from dextromethorphan?
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What is a common effect of severe poisoning from dextromethorphan?
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How long after ingestion are the effects of dextromethorphan generally noticeable?
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In which formulations is dextromethorphan commonly found?
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What age group is the recommended dosage of dextromethorphan up to 30 mg/d for?
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What can happen if a patient overdoses on Esmolol with more than 50 mg/kg?
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Which mechanism of action is associated with β2-agonists?
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Which drug is the first-line treatment for acute exacerbations of bronchial asthma (BA)?
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What is the onset time for Ephedrine when administered via inhalation?
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Which of the following is true about the use of beta-blockers in patients with a history of asthma?
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What suffix is common to bronchodilators that are β2-agonists?
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Which route is commonly used for administering Terbutaline?
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What is the primary effect of β2-agonists on mucociliary clearance?
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What is a contraindication for using non-selective β-blockers?
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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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Description
Learn about respiratory drugs, including Dextromethorphan, PPA, Theophylline, and Anti-inflammatory Agents, their characteristics, and toxicity. Understand their uses, effects, and properties.
