Pharmacology Overview for Exam Preparation

Caffeine blocks phosphodiesterase (PDE) enzymes, which normally degrade cyclic AMP (cAMP).
Increased cAMP levels can lead to increased heart rate and potential arrhythmias.
Roflumilast: Another PDE4 inhibitor primarily used in patients with Chronic Obstructive Pulmonary Disease (COPD).

Anticholinergics (also known as antimuscarinics) are used to manage asthma; they block the action of acetylcholine and relax bronchial smooth muscles.
Examples include Ipratropium, Moxitropium, Tiotropium.
Anticholinergic agents are classified into long-acting and short-acting:
- Long-acting agents provide relief for at least 12 hours by blocking muscarinic receptors.
- Short-acting agents are used for acute cases, such as short-acting beta-2 agonists (SABAs).

GINA (Global Initiative for Asthma) guidelines provide recommendations for asthma management.
Long-acting bronchodilators are preferred for their extended effect on asthma control compared to short-acting agents.

Corticosteroids (e.g., prednisone, hydrocortisone) are used for their anti-inflammatory properties.
They can be administered orally or through inhalation; proper inhalation technique is crucial for aerosol delivery.
Inhaled corticosteroids (ICS) are effective for long-term control of asthma symptoms.
Common ICS: Beclomethasone, Budesonide, Fluticasone (often combined with long-acting beta agonists).

Montelukast and Zafirlukast are used particularly in children.
These medications help to prevent asthma exacerbations but are not designed for immediate relief.

Drugs like Cromolyn sodium and Nedocromil can be utilized, particularly in children, for allergy-induced asthma.

Omalizumab (an IgE monoclonal antibody) works to target IgE and alters the response to allergens, used for patients with severe asthma.

Management of asthma may include the use of short-acting beta agonists for acute attacks and ICS for long-term control.
Combination therapies may include ICS along with long-acting beta agonists for various stages of asthma severity.

Prokinetics (like metoclopramide) assist in improving gastric motility.
Laxatives: Classified as bulk-forming, osmotic, stimulant, and stool softeners.
Anti diarrheals: Medications like loperamide and bismuth compounds work by reducing gastrointestinal motility.

Medications include ondansetron (5-HT3 serotonin antagonist) and promethazine (caution with CNS effects).

Gastric acid secretion is influenced by histamine (H2 receptors), acetylcholine, and gastrin.
H2 blockers and PPIs are common medications used to manage conditions such as GERD and peptic ulcers.

Treatment includes 5-ASA compounds (e.g., mesalamine) for mild cases, with corticosteroids for moderate to severe cases.
Tumor necrosis factor antagonists (like Infliximab) are for moderate to severe cases of Crohn's or ulcerative colitis.

Activation of the coagulation cascade involves platelets and various factors leading to fibrin formation.
Anticoagulants like heparin work by targeting antithrombin, whereas antiplatelets like aspirin inhibit platelet aggregation.
Thrombolytics, such as alteplase, are used to break down existing clots.

Insulin regulates glucose levels by facilitating cellular absorption of glucose.
Various insulins include rapid-acting, short-acting, and long-acting forms, each with distinct pharmacokinetics.
GLP-1 agonists and DPP-4 inhibitors are new therapies that enhance insulin sensitivity and secretion.

Statins are primarily used for lowering LDL cholesterol levels, with dietary measures (omega-3 fatty acids) also significant for lipid management.
It's important to monitor and manage side effects, including the risk of muscle damage (rhabdomyolysis) with statins.

Treatment approaches vary based on the type of anemia (iron-deficiency vs macrocytic).
Iron supplementation can be via oral or parenteral routes, while specific vitamins (like B12 and folic acid) may be necessary depending on the deficiency.