Test 2- Assignments

What is Allergic Rhinitis?

Allergic Rhinitis is the inflammation of the mucosa in the nasal cavity due to exposure to allergens.

What are viral respiratory infections?

Viral respiratory infections, such as the common cold, flu, and COVID-19, are illnesses caused by viruses that impact the nose, throat, and lungs, causing symptoms like sore throat, sneezing, coughing, fever, and chills.

Name three triggers of asthma.

1. Tobacco smoke 2. Air pollution 3. Strong odors and sprays.

What are some additional triggers of asthma?

4. Pollen from trees, grass, weeds 5. Animal dander 6. Drugs (e.g., aspirin, ibuprofen, beta blockers) 7. Emotional stress, strong emotions, or anxiety 8. Exercise in cold, dry climates 9. Bacterial/fungal/viral respiratory infections 10. Preservatives (sulfites and benzalkonium chloride).

How do first generation antihistamines assist with respiratory problems?

They help treat respiratory problems associated with allergies by blocking H1 receptors, preventing histamine from causing symptoms like sneezing, runny nose, and itching.

What is a key difference between first and second generation antihistamines?

Second generation antihistamines also block H1 receptors but do not cross the blood-brain barrier, making them less sedating and better suited for daytime use.

Name two examples of first generation antihistamines.

1. Diphenhydramine 2. Promethazine.

Name two examples of second generation antihistamines.

1. Loratadine (Claritin) 2. Cetirizine (Zyrtec).

What is the action of intranasal corticosteroids in treating allergic rhinitis?

They apply glucocorticoids directly to the nasal mucosa, alleviating symptoms like sneezing and nasal congestion by decreasing secretion of inflammatory mediators.

What is an example of an intranasal corticosteroid?

Fluticasone (Flonase).

What is the role of mast cell stabilizers in asthma management?

Mast cell stabilizers inhibit the release of histamine and other inflammatory agents from mast cells, helping to reduce inflammation and prevent asthma attacks.

What is Ipratropium used for?

Ipratropium (Atrovent) is an anticholinergic bronchodilator used to manage conditions such as COPD by causing bronchodilation.

What is Montelukast and its use?

Montelukast (Singulair) is an antileukotriene used to manage asthma.

What are common symptoms of viral respiratory infections?

Symptoms include sore throat, sneezing, coughing, fever, and chills.

How do OTC antihistamines assist with cold and flu symptoms?

They often contain an adrenergic agent and acetaminophen to relieve symptoms like pain and congestion.

What is the significance of the blood-brain barrier in antihistamines?

Second generation antihistamines do not cross the blood-brain barrier, reducing sedation compared to first generation antihistamines.

What is the action of antihistamines in treating allergies?

Antihistamines block H1 receptors to prevent the effects of histamine, alleviating allergy symptoms.

What is the mechanism of action of intranasal corticosteroids?

They decrease tissue edema and cause minor vasoconstriction, reducing inflammation of the nasal passages.

What are the common side effects of first generation antihistamines?

They can cause sedation due to their ability to cross the blood-brain barrier.

What is the primary therapeutic use of second generation antihistamines?

They are primarily used to manage allergy symptoms during the daytime without causing significant sedation.

What is the primary treatment approach for allergic rhinitis?

Intranasal corticosteroids are considered the first-line treatment.

What is the role of emotional stress in asthma?

Emotional stress can trigger asthma attacks by affecting the respiratory system.

What is Montelukast used for?

Managing chronic asthma, exercise-induced bronchospasms, and allergic rhinitis.

How does Montelukast work?

It blocks leukotriene receptors in the airway, preventing edema and inflammation.

What is the mechanism of action of intranasal decongestants like oxymetazoline?

They stimulate alpha adrenergic receptors, leading to vasoconstriction of nasal passages, which decreases swelling and congestion.

What are the two types of antitussives?

Opioids (e.g., codeine, hydrocodone) and non-opioids (e.g., dextromethorphan).

How do opioid antitussives work?

They increase the cough threshold, making it harder for the body to trigger a cough.

What is the function of non-opioid antitussives?

They anesthetize stretch receptors in the lungs, suppressing the cough reflex.

What is the primary use of expectorants like Guaifenesin?

To increase bronchial secretions, thin mucus, and facilitate its removal from the respiratory tract.

What is Cystic Fibrosis?

A disease caused by two defective copies of the CFTR gene, leading to thick and sticky mucus due to poor exchange of water, chloride, and salt.

How do mucolytics help patients with Cystic Fibrosis?

They break down the chemical structure of mucus, making it thinner and easier to cough out.

What is acetylcysteine (Mucomyst) and its side effect?

A mucolytic that triggers bronchospasm and has a smell like rotten eggs.

What is dornase alfa (Pulmozyme) used for?

It breaks down the DNA in mucus, making it less viscous and is used as maintenance therapy for thick bronchial secretions.

What is asthma?

A chronic pulmonary disease characterized by inflammatory and bronchospasm components, often with exacerbations and remissions.

What are common triggers for asthma attacks?

1) Air pollutants, 2) Allergens, 3) Chemicals and food, 4) Respiratory infections, 5) Stress.

What is status asthmaticus?

A severe, prolonged form of asthma that is unresponsive to normal drug therapies, potentially leading to respiratory failure.

What is Chronic Obstructive Pulmonary Disease (COPD)?

A progressive pulmonary disorder characterized by chronic and recurrent airflow obstruction, manifesting as chronic bronchitis and emphysema.

What causes chronic bronchitis in COPD?

Inflammation and irritation of the lower respiratory tract due to cigarette smoke or pollutants.

What causes excessive mucus secretion in the airway leading to dyspnea and chronic cough?

Chronic inflammation.

What is emphysema in the context of COPD?

The final stage of COPD where bronchioles lose elasticity and alveoli dilate to allow more air into the lungs, causing severe dyspnea.

What is the primary use of a rescue inhaler?

To treat acute bronchoconstriction during an asthma attack.

How do rescue inhalers assist in breathing?

They provide rapid bronchodilation by acting as beta 2 adrenergic agonists.

What is the purpose of preventive long-term inhalers?

To maintain control over chronic asthma by being taken regularly regardless of symptoms.

What types of medications are included in preventive long-term inhalers?

Inhaled corticosteroids and long-acting beta 2 adrenergic agonists.

How do short-acting beta adrenergic agonists (SABAs) work?

They target beta 2 receptors in lung smooth muscles, causing relaxation and bronchodilation.

What are examples of short-acting beta adrenergic agonists?

Inhaled albuterol, metaproterenol, levalbuterol, and subcut terbutaline.

What is the difference between short-acting and long-acting beta adrenergic agonists (LABAs)?

LABAs also target beta 2 receptors but keep airways open for longer periods than SABAs.

What is the black box warning associated with long-acting beta adrenergic agonists?

Increased risk of asthma-related deaths.

How do anticholinergics assist in breathing?

They compete with acetylcholine at muscarinic receptors, preventing cholinergic responses and promoting sympathetic nervous system actions.

What are some examples of anticholinergic medications?

Ipratropium (Atrovent), tiotropium (Spiriva), umeclidinium (Eliipta).

How do methylxanthines work in treating asthma?

By relaxing bronchial smooth muscle, leading to bronchodilation.

What are examples of methylxanthines?

Aminophylline and theophylline.

How do traditional corticosteroids function in asthma treatment?

By reducing activation of inflammatory cells and increasing anti-inflammatory mediators to reduce airway obstruction.

What is the role of other corticosteroids in asthma management?

To reduce inflammation and enhance responsiveness of bronchial muscles to beta-agonists.

What is the function of mast cell stabilizers?

To inhibit the release of histamine and other inflammatory mediators from mast cells.

What is an example of a mast cell stabilizer?

Cromolyn.

How do leukotriene modifiers and other enzyme modifiers work?

By blocking the synthesis of leukotrienes or their receptors.

What are examples of leukotriene modifiers?

Montelukast (Singulair), roflumilast, zafirlukast, zileuton.

What are monoclonal antibodies and how do they function?

Monoclonal antibodies (MABs) cause cell death by binding to tumor cells, either directly destroying them via phagocytosis, complement fixation, or apoptosis, or inhibiting their growth by blocking growth factor receptors.

What are the components of combination inhalers for COPD?

Combination inhalers for COPD combine a LABA with an anticholinergic or corticosteroid, providing actions of muscle relaxation, bronchodilation, and inflammation reduction.

What characterizes acute pain?

Acute pain is characterized by intense pain occurring over a brief time period, usually caused by injuries.

How is chronic pain defined?

Chronic pain is characterized by a longer duration that can last for weeks, months, or years.

What is nociceptor pain?

Nociceptor pain is characterized by injury to tissues.

Describe visceral pain.

Visceral pain is a generalized, dull, internal, throbbing, or 'aching' pain.

What is neuropathic pain?

Neuropathic pain is pain caused by direct injury to the nerves.

What is the difference between sharp pain and dull pain?

Sharp pain is well-defined and carried along A delta fibers, while dull pain is poorly localized and carried along unmyelinated C fibers.

What initiates the pathway of pain?

The pathway of pain begins when stimulated nociceptors create a nerve impulse that travels along sensory neurons to the spinal cord.

What happens to pain signals in the spinal cord?

In the spinal cord, neurotransmitters transmit chemical signals to the next set of neurons, which then travel to the brain.

What are the outcomes of pain signals reaching the brain?

Outcomes can vary; A delta fiber signals are associated with immediate reactions, while C fiber signals are linked to persistent aching and mental fatigue.

What are endogenous opioids and their function?

Endogenous opioids, including endorphins, dynorphins, and enkephalins, modify sensory information in the spinal cord for better reception by brain receptors.

Name some alternative therapies for pain management.

Alternative therapies for pain include acupuncture, chiropractic manipulation, guided imagery, heat/cold therapy, and physical therapy.

How does aspirin alter pain perception?

Aspirin blocks the synthesis of COX-1 and COX-2 enzymes, which secrete prostaglandins responsible for pain perception.

What is the efficacy of NSAIDs compared to aspirin?

NSAIDs have similar efficacy in reducing pain and inflammation but impact blood coagulation less than aspirin.

How do NSAIDs work at the nociceptor level?

NSAIDs inhibit pain mediators at the nociceptor level.

What is the role of COX-1 and COX-2 enzymes in pain perception?

COX-1 and COX-2 enzymes secrete prostaglandins that are responsible for pain perception.

What is the mechanism of action for LABA in combination inhalers?

LABA relaxes muscles around the airway to improve breathing.

What is the role of anticholinergics in combination inhalers?

Anticholinergics cause bronchodilation via parasympathetic nervous system stimulation.

What is the purpose of corticosteroids in combination inhalers?

Corticosteroids reduce inflammation within the airway.

What are the common examples of monoclonal antibodies mentioned?

Examples include Omalizumab, Reslizumab, Dupilumab, and Mepolizumab.

What is the significance of the A delta and C fibers in pain transmission?

A delta fibers transmit sharp, well-defined pain rapidly, while C fibers transmit dull, poorly localized pain more slowly.

What is the role of COX inhibitors in pain relief?

They inhibit the COX enzyme responsible for forming prostaglandins, reducing inflammation and pain.

What is a COX-2 inhibitor and give an example?

A COX-2 inhibitor, such as celecoxib, specifically blocks the COX-2 enzyme to provide targeted pain relief.

How do centrally acting drugs alleviate pain?

They exert effects directly within the brain and spinal cord, bypassing nociceptors and blocking pain reception.

What mechanism do centrally acting drugs use to block pain?

They inhibit the reuptake of norepinephrine and serotonin in spinal neurons.

What are potent opioid agonists and give examples?

Potent opioid agonists, such as fentanyl, morphine, and hydromorphone, treat severe pain by interacting with mu and kappa receptors.

What effects does mu receptor activation have?

Mu receptor activation provides analgesia, euphoria, respiratory depression, physical dependence, and sedative effects.

What are less potent opioid agonists and their function?

Less potent agonists, like codeine and oxycodone, manage moderate pain by activating opioid receptors in the brain.

How do mixed agonist and antagonist opioids work?

They stimulate opioid receptors for analgesia while blocking or having no effect on the other receptor not activated.

What is the function of opioid antagonists?

Opioid antagonists, such as naloxone and naltrexone, block the action of opioid agonists at mu and kappa receptors.

How do opioid antagonists reverse opioid intoxication?

They prevent opioids from binding to receptors, reversing effects like respiratory distress and sedation.

What types of pain can anti-seizure medications relieve?

They can relieve diabetic neuropathy, post-herpetic neuralgia, and trigeminal neuralgia.

What is the role of serotonin and serotonin-norepinephrine reuptake inhibitors in pain management?

They are used for neuropathic pain and post-herpetic neuralgia pain.

What is the purpose of benzodiazepines in pain management?

They relax skeletal muscle in muscle spasms and reduce anxiety in terminal dyspnea.

What type of pain do bisphosphonates address?

They are used for cancer-related bone pain.

What conditions can alpha agonists treat?

They can treat neuropathic pain, post-thoracotomy pain, chronic low back pain, reflex sympathetic dystrophy, and post-spinal surgery pain.

What is the effect of corticosteroids in pain management?

They reduce swelling and pain in the CNS, cancer, spinal cord compression, and post-spinal surgery.

What type of pain do tricyclic antidepressants help alleviate?

They are effective for neuropathic pain.

What is the first-line drug for migraines after NSAIDs?

Triptans, such as sumatriptan, are the first-line drug for aborting migraines.

What are ergot alkaloids used for?

They are used if migraines are unresponsive to triptans and interact with adrenergic, dopaminergic, and serotonergic receptors.

What are CGRP receptor blockers used for?

They are used for medication-resistant chronic migraines.