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Pharmacology (TCMC) > Drugs For Allergic Reactions II > Flashcards

Drugs For Allergic Reactions II Flashcards

0
Q

Decongestants

A

Phenylephrine

Pseudoephedrine

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1
Q

Glucocorticoids for allergic reactions

A

Fluticasone

Prednisone

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2
Q

Anticholinergics

A

Ipratropium

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3
Q

Drugs for anaphylaxis

A

Epinephrine

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4
Q

Glucocorticoids MOA

A

Influences protein synthesis
Annexins are synthesized; annexins inhibit PLA2 thus inhibiting the breakdown of phospholipids to arachidonic acid: this inhibits synthesis of prostaglandins & leukotrienes
Reduce # of eosinophils, basophils, mast cells in the the nasal mucosa & epithelium
Inhibit directly mediators from mast cells & basophils
Reduce mucosa edema & vasodilation
Decrease exudation
Reduce sensitivity of irritant receptors (decreased itching & sneezing)
Effective in blocking the late phase reaction which is due to migration & infiltration of inflammatory cells (eosinophils, basophils, others) caused by chemotactic factors
Onset of action takes hours
Corticosteroids are the most effective drugs available for prevention & relief of allergic rhinitis symptoms

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5
Q

Fluticasone administration

A

Intranasal

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6
Q

Fluticasone adverse effects

A

Dryness & irritation or burning of the nasal mucosa
Sore throat
Epistaxis
Headache

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7
Q

Prednisone adverse effects

A

Glucocorticoids have effects on virtually every organ in body
Systemic administration can cause numerous, at times serious side effects (reserve use for severe allergic reactions)
Significant effects include:
Suppression of HPA axis
Growth suppression
Osteoporosis
Increased intraocular pressure & cataracts
The lowest dose that prevent & control symptoms should be used for all routes

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8
Q

Prednisone administration

A

Oral

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9
Q

Decongestants MOA

A

Act as vasoconstrictors In the nasal mucosa- stimulate alpha-1 adrenergic receptors on venous sinusoids
Relieves congestion only (not effective against sneezing, itching or discharge)

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10
Q

Pseudoephedrine administration

A

Oral

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11
Q

Phenylephrine administration

A

Intranasal

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12
Q

Pseudoephedrine adverse effects

A

CNS excitation (insomnia, excitability, headache, nervousness)
Cardiovascular stimulation (palpitations, tachycardia, hypertension)
GI (nausea, vomiting)
Urinary retention

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13
Q

Phenylephrine adverse effects

A

Rebound vasodilation & congestion intranasal (rhinitis medicamentosa) when used for long periods
Nasal irritation

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14
Q

Pseudoephedrine contraindications

A 
Patients w/ coronary artery disease or hypertension (alpha-1 receptor mediated vasoconstriction can worsen)
Enlarged prostate (alpha-1 receptor activation compresses the urethra & decreases bladder emptying)
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15
Q

Ipratropium MOA

A

Anticholinergic
Muscarinic receptor antagonist- blocks nasal discharge (reduces nasal secretions)
Does not relieve sneezing, itching or nasal congestion

16
Q

Ipratropium administration

A

Intranasally

17
Q

Ipratropium adverse effects

A

Dry nose & mouth
Pharyngeal irritation
Urinary retention
Increased intraocular pressure (with inadvertent instillation in the eye)

18
Q

Ipratropium contraindications

A 
Glaucoma (blocking muscarinic receptors in the eye can increase intraocular pressure) 
Prostatic hypertrophy (blocking muscarinic receptors in the bladder leads to urinary retention)
19
Q

Epinephrine MOA

A

Treatment of choice for anaphylaxis
Alpha-1 adrenergic receptor agonist causing vasoconstriction increasing systemic vascular resistance & blood pressure
Beta-adrenergic receptor agonist causing bronchodilation & increases cardiac rate contractility
Inhibits release of mediators from mast cells & basophils

20
Q

Epinephrine administration

A

Aqueous epinephrine administered intramuscularly (thigh) or subcutaneously every 5 min. as necessary- should be used to control symptoms & increase blood pressure
Fatalities during anaphylaxis usually result from delayed administration of epinephrine & from severe respiratory complications, cardiovascular complications or both

21
Q

Epinephrine contraindications

A

No contraindications to administration in anaphylaxis

22
Q

Allergic rhinitis treatment

A

For mild to moderate allergic rhinitis especially for seasonal or intermittent symptoms an oral (or intranasal) second-generation H1-antihistamine would be appropriate
For moderate to severe allergic rhinitis an intranasal corticosteroid is more likely to be effective

23
Q

Allergic conjuctivitis treatment

A

Any second-generation oral H1-antihistamine or topical ophthalmic H1-antihistamine/mast cell stabilizer would be appropriate

24
Q

Atopic dermatitis treatment

A

Topical corticosteroid creams & ointments remain the first line choices for pharmacotherapy

Pharmacology (TCMC) (6 decks)

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