β-agonists

:
-salbutamol, pibuterol, terbutaline, albuterol. -salmeterol. -formoterol.
MOA: effects: uses: ADR: PHK:
1)stimulates: β-2 receptors in bronchial SM of lung. 1)relaxation: of proximal 1)mild asthma: with occasional, 1)tachycardia 1)short acting & onset:
2)result in: activation of a"c. & distal SM airway. intermittent symptoms. 2)hyperglycemia, 15-30 m, relief for 4-6 hours.
3)a"c form: cAMP from ATP. 2)inhibition: of mast cell 2)dyspnea symptoms: for chronic hypokalemia, 2)given by: inhalation, & for
4)cAMP: activate PKA. mediator release. obstructive pulmonary disease (COPD) hypomagnesemia asthmatic by IV.
5)PKA inhibit: MLC & ↓ Ca C 3)increase: muco-cilliary 3)no effect: on chronic inflammation. 3)muscle tremor 3)salmeterol: long acting.
6)this: 1)relax: bronchial SM , & ↓ airway resistance clearance. 4)restlessness relief for 12+ hours.
2)inhibit: release of broncho-constrictors 5)hypoxemia 4)formoterol: long acting,
(like histamine) from mast cells. rapid onset. relief for12+ h.

corticosteroids:
-inhaled: budesonide, beclomethasone, triamcinolone, fluticasone. -IV: hydrocortisone, methyl-prednisone. -oral: prednisolone
MOA: effects: uses: ADR:
glucocorticoid receptors :‫] עם הערות‬A1[ 1)action: 1)enter: target cells. 2)bind: GR in cytoplasm. 1)reduce & prevent: 1)inhaled: for moderate to severe 1)local ADR: 1)dysphonia.
3)transport: the complex to the nucleus inflammatory component in asthma, & COPD. 2)oropharyngeal candidtis (5%). 3)caugh.
2)then: bind to glucocorticoid responsive elements in promoter chronic asthma. need regular bronchodilator (< 1 2)systemic ADR:
region of target genes. 2)no direct affect: on inhalation of β2-agonist daily). 1)suppression: adrenal & growth.
3)this results in: ↑ or ↓ gene transcription. contractile responses of 2)systemic (IV, oral): severe 2)bruising. 3)osteoporosis. 4)psychiatric.
4)if GR interact directly with protein transcription factor: result in airway SM exacerbation of asthma. 5)eyes: cataract & glaucoma.
protein synthesis, & independent interaction with nucleus DNA.

cromones: -cromolin. -nedocromil.
MOA: effects: uses: ADR:
1)"mast cell stabilizer": delay Cl channels in cell 1)block: allergen-induced & exercise-induced 1)anti-inflammatory agent: but not for acute minor=
membrane, thus inhibiting cell activation. bronchoconstriction. attack. 1)throat irritation
2)in mast cell: inhibit mediator (histamine) release 2)block: early & late asthmatic response to allergens. 2)asthma: mild to moderate. 2)nausea.
3)in eosinophils: inhibit inflammatory response to 3)action duration: short. 3)safe: for pregnant. ADR are rare. 3)headache.
inhalation of allergens. 4)not bronchodilator: has no direct effect on SM. 4)in long term use: reduce bronchial hyperactivity.

anticholinergic agents:
MOA: use: -ipratropium bromide: -tiotropium:
M receptors: :‫] עם הערות‬A2[ 1)antagonist: of specific muscarinic receptor. 1)for asthma patient with: 1)non-selective antagonist: for M1, M2, M3 1)binds with equal affinity: to M1, M2, M3
M1-CNS, stomach. 2)block: ACH action by prevent M receptor bind 1)intolerance to β-agonist 2)do not: distributed well across lipid membrane. 2)has a kinetic receptor subtype selectivity:
M2- heart, CNS, airway SM.
M3- CNS, airway SM, vascular endothelial cells, salivary glands. 3)result: ↓ in phospholipase, IP3, DAG, & Ca. 2)with asthma + COPD. 3)action duration: 6 hour (peak=1-2h). slow onset dissociate rapid from M2, & slow from M1 & M3
4)taken by: inhalation. 3)action duration: long. allows for 1 daily using.
effect: ADR: -minimal:
1)produce: bronchodilation. dry mouth, RT discomfort
2)reduce: volume of respiratory secretion.

& can cause bronchoconstriction & mucus secretion. 3)good for children: available in chewable tablets. restlessness. -zileuton. . & ↓ his binding affinity to his receptor on mast cell & basophils. 2)cys-leukotriens: produced in asthma. 1)asthma: mild to moderate. 1)relief of airway obstruction: high carb diet. methylxanthines: -theophylline. 1)mild urticaria . LTB-4. release. HF. 2)attenuate: in early & late reaction phase of asthma.derived monoclonal A"B. NO) . 2)cardiac arrhythmias. 4)↑ secretion of gastric acid & enzymes. 3)injection site reactions. 3)this cause: reduce in allergic response. anti-leukotriene drugs: -zafirlukast. smoke. high protein/low carb diet. 2)headeahc. COPD. & ↓ inflammatory response. LTD-4. MOA: ADR: PHK: 1)competitve antagonist: for adenosine receptor A 1)GI: nausea. 2)selectively bind: to IgE. 2)CNS & heart stimulation. meat. 1)allergic: asthma & rhinitis. 3)require: blood C monitoring. vomiting. 2)therapeutic window: narrow. old age. 4)rare: eosinophilia & neuropathy anti-IgE antibody: -omalizumab. 2)also. vascular leak. pranulkast. LTE-4. 2)alternative: to inhaled glucocorticoids. vasculitis 4)zileuton: inhibit synthesis of 5-lipoxigenase = inhibit formation of LTC-4. 2)headache. MOA: use: ADR: 1)block receptors(1): of cys-leukotriens . 4)administration: oral (1) or IV (2). rashes. childhoo cGMP & 5'GMP= ↑ cAMP use: 2)↓ clearance: enzyme inhibition. dyspepsia. & mediators release (histamine. 3)edema. gastric 1)has: drug & food interactions. 3)this: prevent asthmatic bronchospasm. which cause bronchoconstriction & mediator discomfort. chronic asthma. LTD-4. 4)time to peak plasma C: <14 days. basophilic. 3)administrate: SC. and 3)↑ cAMP cause: 1)bronchodilation. 5)half life: 1-4 w 4)eosinophilic vasculitis. liver disease. 1)increase liver enzymes. 3)vasodilator of BV. MOA: use + PHK: ADR: 1)it is a: recombinant DNA. 1)↑ clearance: enzyme induction. inhibit PDE: thus prevent cAMP convers to 3)headaches. -aminophylline. & LTE-4. montelukast. viral infection. 1+2. thus block their effects in LTC-4.

β-2 antagonists. nose & throat. loratadine hypersensitivity 3)cetirizine: is contraindicated in those with known hypersensitivity to hydroxyzine corticosteroids: intranasal corticosteroids: 1)beclomethasone: nasal Inhalation. 4)candidiasis. thrombosis at injection site (IV promethazine). 5)low potential for drug interaction. venous 2)newborn. 7)administration: tablet. 4)stenosing peptic ulcer. sedation. 2)reduction: of pruritus. 3)relaxation: of SM in RT & GI. 2)urticaria. nose & throat (2nd generation). 3)sore throat. urinary retention 7)old age. or oral combined with antihistamines. 3)narrow angle glaucoma. bronchial secretion. 4)use: suppression dry coug . premature infant. disturbed coordination. reflex tachycardia. 2)in long term use: increase the risk for rebound congestion. or 5)genitourinary: urinary frequency. wheezing. adjunctive analgesia for postoperative pain (2. sedation A"H. dry mouth. 1)given: aero-nasal. use: ADR: contraindication: -certain allergic disorders: 1)allergic : photosensitivity. 3)promethazine. 5)in pre-medication or after general anesthesia (2) 4)GI: epigastric distress. 3)100% low bioavailability. orally. rash. drugs used to traeat allergic rhinitis: α-adergenic agonists: -oxymethazoline. abdominal distress (2nd + 3rd generation). 2)budesonide: nasal Inhaler. twice a day. 2)this H1 blockade result in: 1)decrease: vascular permeability.3) 3)CNS: drowsiness. 2)cardiovascular: postural ho"p. 3)respiratory : dry mouth. use: more effective than antihistamines. 3)do not: exert analgesic effect & addiction. effect: PHK: ADR: 1)constrict: dilated arterioles in the nasal mucosa. dermatitis 1)hypersensitivity to specific/structural relate A"H allergic conjunctivitis. dysuria. thickening of 8)dilated patients (cyproheptadine). 4)low plasma variability. 2)CNS: somnolence/ drowsiness. 2)reduce: airway resistance. use: ADR: contraindication: 1)diseases: allergic & vasomotor rhinitis. dizziness. 3)motion sickness & vestibular disturbances (1. 1)few: systematic effects. confus 5)prostate hypertrophy & UB obstruction. urticaria. 2)nosebleed. 4)fluticasone: nasal Inhalation. 6)improved safety profile. -phenylephrine. vomiting. palpitations. 3)flunisolide: nasal Inhalation.3) 6)RT: chest tightness. -loratdine. first generation: 1)diphenhydramine. dermatitis 1)hypersensitivity to specific/structural relate 1)perennial or seasonal allergic rhinitis. anaphylactic shock. 3rd generation: -fexofenadine. 2)highly selective. 1)allergic: photosensitivity. 6)pre & post-operative or obstetric sedation. rash. anti-histamines: MOA: 1)reversible competitive antagonist: of histamine at H1 receptor site. anaphylactic shock. 2)dextrorotatory stereoisomer: of methylated levorphanol derivate. 3)treatment: short term. fatigue. drugs used to treate cough: dextromethorphan: 1)opioid: derivative. epistaxis & nasal burning 2nd generation: -cetirizine. 6)triamcinolone: nasal Inhalation. nursing mothers 2)adjunctive anaphylactic therapy. fatigue. ADR: 1)nasal irritation. 2)onset: rapid. anorexia. headache. 5)mometasone: nasal spray. 8)an improved new option for treatment of COPD. 2)desloratadine: is contraindicated in those with 4)GI: nausea. 4)anti-parkinsonism (1). drugs used for COPD: PDE-4 inhibitor: 1)inhaled bronchodilators: like anti-colinergic. 2)hydroxyzine. bitter taste (nasal spray) 6)MAOI use.

levopropoxyphene.opiates: 1)names: codeine. 6)sweating. . 2)light-headedness. 2)antitussive effect: is achieved at doses lower than those required for analgesia. 3)ADR: 1)sedation. 4)nausea. 3)dizziness. 5)vomiting. noscapine.