1. How does endothelin-1 work?
    • Physiologic
    • Increases intracellular Ca2+ in smooth muscle tissue of blood vessels -> contraction -> vasoconstriction.
  2. How does Bosentan work?
    • Competitive non-selective antagonist of endothelin-1 at ET-A and ET-B receptors
    • Decreased pulmonary vascular resistance.
  3. Name two ET-A blockers?
    • Sitaxentan
    • Ambrisentan: low liver toxicity, high potency.
  4. Where are prostacyclins synthesized, where and how do they act?
    • Synthesized in endothelial cells
    • Act on smooth muscle cells through G-protein, increase protein kinases -> vasodilation.
  5. What do prostacyclin analogs have in their name?
  6. What is the ending of PDE 5 selective inhibitors, how do they work?
    • -afil
    • inhibit degradation of cGMP -> vasodilation.
  7. What is Inomax, how are systemic effects prevented?
    • Inhaled nitric oxide
    • Rapid binding to hemoglobin.
  8. What is Dornase Alfa, what is it used for?
    • Recombinant human DNase (rhDNase)
    • Enzyme selectively cleaves DNA
    • Inhalable, used in CF, reduces viscosity in lungs
    • Improved clearance of secretions.
  9. What is the MOA of N-Acetyl-Cysteine (NAC)?
    Rate limiting step in glutathione (GSH) synthesis - provides precursor so increases GSH (antioxidant).
  10. What is NAC used for?
    Acetominophen overdose, decreases amount of toxic NAPQI.
  11. What three factors does the viscosity of mucus depend on?
    • Concentration of mucoproteins
    • Presence of di-sulfide bonds
    • DNA.
  12. Mucolytics usually contain one of which two compounds?
    • Acetylcysteine
    • Ambroxol.
  13. What is the MOA of ambroxol?
    • Stimulates synthesis and release of surfactant by type 2 pneumocytes
    • Also has local anaesthetic effect.
  14. What is almitrine, how does it work?
    • Respiratory stimulant
    • Agonist at peripheral chemoreceptor
    • Increase PaO2 and decrease PaCO2.
  15. What do surfactant analogs have in their name?
Card Set
pulmonary pharm