Drugs

Question 1

First generation antihistamines

Answer 1

• Diphenhydramine (Benadryl)
• Chlorpheniramine
• Clemastine
• Promethazine
• Hydroxyzine

Question 2

First generation antihistamine effects

Answer 2

Antihistaminic activity; antiemetic (anti-nausea) activity

1st generation agents are lipophilic and can cross BBB:
- sedative effects
- anticholinergic activities (dry mouth, throat, nasal area)

Side effects:
sedation, anticholergic, GI (nausea/vomiting, appetite inducer)

Question 3

Second generation antihistamines

Answer 3

• Cetirizine (Zyrtec)
• Levocetirizine (Xyal)
• Azelastine (Azstelin nasal spray)
• Fexofenadine (Allegra)
• Loratadine (Claritin)
• Desloratadine (Clarinex)

Question 4

Second generation antihistamine effects

Answer 4

Antihistaminic activity

Lipophobic, cannot cross BBB:
+/- sedative effects, +/- anticholinergic activity

Side effects:
- GI nausea, vomiting
- appetite inducer

Question 5

H1 antagonist used for sedation purposes

Answer 5

Diphenhydramine (Benadryl)

Question 6

H1 antagonists used for motion sickness

Answer 6

Dimenhydrinate (Dramamine), Meclizine (Antivert)

Question 7

Short-acting glucocorticoids

Answer 7

Cortisone, Hydrocortisone
- 8-12hr biological half-life
- Least anti-inflammatory
- Most sodium retaining potency

Question 8

Intermediate-acting glucocorticoids

Answer 8

Prednisone, Triamcinolone, Methylprednisolone
- 12-36hr biological half-life (2-4hr plasma half-life)
- medium anti-inflammatory potency
- 0 sodium retaining potency (except for Prednisone, which has 1)

Question 9

Long-acting glucocorticoids

Answer 9

Dexamethasone, Betamethasone
- 36-72hr biological half-life
- Most anti-inflammatory
- 0 sodium retention potency

Question 10

Glucocorticoid adverse effects

Answer 10

• Drug-induced adrenal insufficiency: after taking steroids chronically, adrenal glands no longer produce cortisol
• Fluid retention, hypertension
• Immunosuppression
• Peptic ulcers
• Lymphocytopenia, neutrophilia, eosinophilia, monocytopenia
• Behavioral: insomnia, nervousness, anxiety, psychosis, mood changes
• Decreased wound healing, osteoporosis
• Hyperlipidemia, hyperglycemia
• Cataracts

Question 11

Keratolytics

Answer 11

Salicylic acid, podophyllum resin, fluorouracil
- agents that exfoliate outer layer of skin, causing shedding
- used to treat corns, warts, acne