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pharmacy Antihistamine
n/a
110
Medical
Professional
12/23/2012

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Term
Common Cold
Definition
Caused by viral infection
Term
Common cold virus
Definition
invades mucosa of upper respiratory tract causing URI
Term
Cold Symptoms
Definition
sore throat, coughing, upset stomach
Term
Cold symptoms
Definition
fluid drips down the pharynx into the esophagus and lower respiratory tract
Term
Inflammatory
Definition
IGE, histamine, serotonin, Chemotaxis
Term
nasal congestion treatment
Definition
Alpha 1 agonist: pseudoepherine and phenyleprine
Term
Combined treatment of common cold
Definition
antihistamine, nasal decongestants, antitussives, expectorants
Term
antihistamine
Definition
Stops nasal drips
Term
Early stage of common cold
Definition
give antihistamine
Term
Late stage of common cold
Definition
give antihistamine + nasal decongestant
Term
Treatment of common cold
Definition
SYMPTOMATIC ONLY, not curative, does not eliminate causative pathogen
Term
how to tell if it is a viral infection not bacterial?
Definition
dry nonproductive cough
Term
how to tell if bacterial infection causing common cold?
Definition
mucous production and congestion
Term
What are antihistamines?
Definition
directly compete with histamine for specific receptor sites
Term
What are the two histamine receptors?
Definition
H1 and H2
Term
H1 recepts are found in...
Definition
skin, smooth muscle of bronchioles, capillaries
Term
H2 receptors are found in
Definition
ONLY IN GI in stomach, associated with gastric acid secretion
Term
What is the triple response?
Definition
REDNESS, ITCHINESS, and EDEMA
Term
H2 blockers or H2 agonists?
Definition
used to reduce gastric acid in peptic ulcer disease
Term
h2 drug that is an enzyme inhibitor?
Definition
cimetidine ( tagamet), need to increase levels of another drug if giving cimetdine
Term
Antihistamines act of what type of receptors?
Definition
H1
Term
Effects of antihistamine
Definition
anticholinergic, sedative, antihistamine
Term
MOA of antihistamine
Definition
block action of histamine at receptor
compete with histamine for unoccupied receptors
CANNOT PUSH HISTAMINE OFF if already bound
Term
Antihistamines prevent...
Definition
vasodilation
increased GI secretion ( acid)
increased capillary permeability
Term
If you know allergy season is approaching you should load up on antihistamines because
Definition
antihistamines will bind to all the histamine receptors creating a lesser histamine reaction in the future
Term
Effective in prevention not reversing the effects of allergies and should be given early in treatment
Definition
Antihistamines
Term
histamine cardiovascular effects
Definition
dilation and increased permeability ...which allows shit to leak into tissues
Term
antihistamine cardiovascular effects
Definition
prevent dilation and decrease permeability
Term
Histamine smooth muscle (exocrine gland) effects
Definition
stimulate salivary, gastric , lacrimal, and bronchial secretions
Term
antihistamine smooth muscle effects
Definition
DRYING UP PERSON: prevent salivary, gastric, lacrimal, and bronchial secretions
Term
Cromalin
Definition
prevents degranulation of mast cells before histamine release.
gets less reaction
Term
histamine immune effects
Definition
mast cells release histamine and other substances, resulting in allergic reactions
Term
antihistamine immune effects
Definition
binds to histamine receptors, preventing histamine from causing a response
Term
Antihistamine skin effects
Definition
block capillary permeability, wheal and flare formation, and itching
Term
antihistamine anticholinergic effect
Definition
DRYING EFFECT: reduced nasal, salivary, and lacrimal gland
Term
antihistamine sedative effects
Definition
CAUSE DROWSINESS- CROSSES BBB
Term
Antihistamine is used for
Definition
nasal allergies
seasonal and perennial allergic rhinitis
allergic reactions
motion sickness
sleep disorders
Term
Terbinfafine/ lamisil allergy
Definition
give benadryl to reverse rxn or injection for severe rxn
Term
What is first line therapy for anaphylaxis?
Definition
epinephrine, NOT antihistamine
Term
histamine- mediated disorders
Definition
allergic rhinitis, anaphylaxis, angioneurotic edema, drug fevers, insect bite rxns, uticaria
Term
what to give is sneezing and running nose?
Definition
antihistamine
Term
Derivatives of antihistamine
Definition
can be used for nausea and vomiting bc of antiemetic effects
Term
Antihistamine side effects
Definition
anticholinergic or antimuscarinic : DRYING EFFECT
dry mouth - decreased salivation
difficulty urinating
constipation
Term
What are the two types of antihistamines?
Definition
traditional and nonsedating/ peripherally acting
Term
Tradiational antihistamines
Definition
older
work peripherally AND centrally
anticholinergic effects - more effective than nonsedating agents
Term
traditional antihistamine drugs
Definition
Diphenhydramine ( benadryl)
Clorpheniramine( chlor- trimethon)
Term
Ethanolamine derivatives drugs
Definition
diphenhydramine ( benadryl) - Drowsiness
dimenhydrinate
Term
Piperazine derivatives drugs
Definition
Hydroxizine -
cyclizine
meclozine
Term
Hydroxizine does what?
Definition
reduce anxiety , itching, redness, and discomfort
Term
What do you prescribe to patients with anxiety neurosis that leads to itching, redness and discomfort?
Definition
hydoxizine
Term
cyclizine and meclozine
Definition
motion sickness causes less drowsiness
Term
Alkylamine derivative drugs
Definition
phenothiazines
ciproheptadine
Term
phenothiazides
Definition
antiemetic- nausea/vomiting
Term
What do you gives kids who have problems eating bc feeling nausea?
Definition
ciproheptadine
Term
What are second generation drugs?
Definition
Piperidine derivatives = NONSEDATING
Term
What antihistamine drugs are nonsedative and second generation?
Definition
piperidine derivative / terfenadine
Term
terfenadine
Definition
piperidine derivative and nonsedating
Term
You can get arrythmias if you take erythromycin with this drug
Definition
terfenadine/ nonsedating/ piperidine derivative
Term
nonsedative/ peripherally acting antihistamines
Definition
eliminate sedation
works periphrally to block histamine actions
fewer CNS effects
longer duration of action ( increased compliance)
Term
Nonsedating/ peripherally acting antihistamine drugs
Definition
fexofenadine ( allegra)
loratidine ( Claritin)
DONT CROSS BBB + LONGER ACTING
Term
antihistamines are contradindicated for
Definition
Acute asthma attacks and lower respiratory diseases
Term
antihistamines are contradindicated for
Definition
Glaucoma- increased intraocular pressure even more
PUD- will make worst if not hit H2 receptor
BPH- can get urinary block
Term
What should pts on antihistamines not do?
Definition
driving or operating heavy machinery because it causes drowsiness
Term
What are the primary causes of nasal decongestion?
Definition
allergies and upper respiratory infections( common cold)
Term
Nasal congestion definition
Definition
excessive nasal secretions and inflamed and swollen nasal mucosa
Term
What are the two types of decongestants used?
Definition
Adrenergics
corticosteroids
Term
What is the classic decongestant if difficulty breathing
Definition
phenylephrine ( alpha 1 agonist caused vasoconstriction)
Term
Oral decongestants
Definition
delayed onset
no rebound congestion
exclusivesly adrenergics
Term
what are examples of oral decongestants?
Definition
phenylephrine and pseudoephedrine
Term
Topical nasal decongestants
Definition
adrenergic and steroids
prompt onset
potent
Term
important thing to know about topical nasal decongestants
Definition
CAUSES REBOUND CONGESTION
Term
topical nasal decongestant- Adrenergics
Definition
epherine ( vicks)
oxymetazoline (afrin)
naphazoline ( privine)
phenylephrine ( neo synephrine)
Term
topical nasal decongestants- intranasal steroids
Definition
beclomethasone diproprionate ( beconase, vancenase)
flunisolide ( nasalide)
Term
MOA of nasal decongestant adrenergics
Definition
constrict small blood vessels which shrink tissues to allow better draining of nasal secretions in the swollen mucous membranes
Term
MOA of nasal decongestants - intranasal steroids
Definition
anti-inflammatory
turns off immune system cell response to decrease inflammation
Term
Therapeutic uses of nasal decongestants
Definition
acute/ chronic rhinitis
common cold
sinusitis
hay fever
other allergies
Term
Side effects of nasal decongestant adrenergics
Definition
REBOUND NASAL STUFFINESS, nervousness, insomnia, palpitations, tremors
Term
side effects of nasal decongestant steroids
Definition
DRYNESS
Term
What type of patients should you avoid with nasal decongestants?
Definition
hypertension
palpitations
CNS stimulation
Term
Pts should avoid what with nasal decongestants?
Definition
caffeine- shit will make it worst
Term
What is the cough reflex
Definition
induce coughing and expectoration and is initiated by irritation of sensory receptors in the resp. tract
Term
What are the two basic types of coughs?
Definition
productive and non productive
Term
productive cough
Definition
congested, removes excessive secretions
Term
nonproductive cough
Definition
dry cough
Term
What do antitussives do?
Definition
stop or reduce coughing
Term
What type of cough are antitussives only used for?
Definition
NONPRODUCTIVE
Term
non-opioid drugs are found _______________ and opioid drugs are for ________________
Definition
OTC, and severe coughing
Term
MOA of opioid cough drugs
Definition
direct action on the cough center in the medulla
Term
examples of opioid drugs
Definition
Codeine ( robitussin A-C, deimatane- DC)
hydrocodone
Term
MOA of non-opioid drugs
Definition
numb the stretch receptors in the resp tract and prevent the cough reflex from being stimulated
Term
examples of non-opioid drugs
Definition
Benzonatate
dextromathorphan
Term
Dextromethorphan
Definition
purely cough suppressant
Term
Lozenge
Definition
anesthetic - some form of lidocaine that works as well as non-opioid
Term
antitussives therapeutic uses
Definition
stop the cough reflex when NONPRODUCTIVE
Term
Side effects of benzonatate
Definition
dizziness, headache, sedation
Term
Side effects of dextromathorphan
Definition
dizziness, drowsiness, nausea
Term
Side effects of opioids
Definition
CAUSE THE MOST SEDATION
Term
What should patients not do when on antitussive agent?
Definition
operate heavy machinery and driving
Term
why should you report if a cough lasts more than one week, has fever, and headache?
Definition
bacterial
Term
Expectorants do what?
Definition
breaks up mucus
thin secretions
Term
What are the two MOA of expectorants?
Definition
direct stimulation or reflex stimulation
Term
Direct Stimulation of expectorants
Definition
stimulate secretory glands to increase production of resp tract fluids
Term
Terpin hydrate
Definition
expectorant
Term
Reflex stimulation MOA
Definition
cause irritation of GI tract so that you can
loosen and thinning of resp tract secretions
Term
guaifenesin
Definition
ronitussin - expectorant ( use with a lot of water bc water helps to break up mucus)
Term
ipecac
Definition
expectorant for vomiting
Term
expectorant therapeutic uses
Definition
Common cold
bronchitis
laryngitis
pharyngitis
pertussis
influenza
mesales
Term
Guaifenesin side effects
Definition
Gastric irritation, nausea, vomiting
Term
Terpin hydrate
Definition
gastric upset (elixir has high alcohol content)
Term
Becareful using expectorants in
Definition
Elderly
asthmatics
respiratory insufficiency
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