FINAL 04 - Antihistamines and Related Antiallergic and Antiulcer Agents

Question 1

__________ has a β-imidazolylethylamine moiety

Answer 1

Histamine

Question 2

__________ is synthesized from L-histidine by histidine decarboxylase

Answer 2

Histamine

Question 3

Histamine exerts its diverse biologic effects through __________ types of receptors

Answer 3

Four

Question 4

The term __________ historically has referred to drugs that block the actions of histamine at H1-receptors rather than other histamine receptor subtypes

Answer 4

Antihistamine

Question 5

The first antihistamine to be discovered

Answer 5

Piperoxan

Question 6

2 types of H1 antihistamines (FS)

Answer 6

1st generation (Classical antihistamines), 2nd generation (Non-sedating antihistamines)

Question 7

Has a diarylalkylamine framework (Types of H1 antihistamines)

Answer 7

1st generation (Classical antihistamines)

Question 8

Includes aminoalkyl ethers, ethylenediamines, piperazines, propylamines, phenothiazines, and dibenzocycloheptenes (Types of H1 antihistamines)

Answer 8

1st generation (Classical antihistamines)

Question 9

Derivatives of several 1st generation agents (Types of H1 antihistamines)

Answer 9

2nd generation (Non-sedating antihistamines)

Question 10

Have been modified to be more specific in pharmacologic action and limited in their tissue distribution or accumulation profiles (Types of H1 antihistamines)

Answer 10

2nd generation (Non-sedating antihistamines)

Question 11

__________ is aryl, including phenyl, substituted phenyl, and heteroaryl groups such as 2-pyridyl (SAR of H1 antagonists) (Structural requirements)

Answer 11

Ar

Question 12

__________ is a second aryl or arylmethyl group (SAR of H1 antagonists) (Structural requirements)

Answer 12

Ar’

Question 13

__________ is a connecting atom of O, C, or N (SAR of H1 antagonists) (Structural requirements)

Answer 13

X

Question 14

__________ represents a carbon chain, usually ethyl (SAR of H1 antagonists) (Structural requirements)

Answer 14

(CH2)n

Question 15

__________ represents a basic, terminal amine function (SAR of H1 antagonists) (Structural requirements)

Answer 15

NRR’

Question 16

__________ substitution pattern is present in both the 1st and 2nd generation antihistamines and is essentially a significant H1-receptor affinity (SAR of H1 antagonists)

Answer 16

Diaryl

Question 17

The two aromatic systems may be linked, as in the __________ antihistamines (phenothiazines, dibenzocycloheptanes, and heptenes) (SAR of H1 antagonists)

Answer 17

Tricyclic

Question 18

__________ may be part of a heterocyclic structure (SAR of H1 antagonists)

Answer 18

Amine

Question 19

The __________ have been used extensively for the symptomatic treatment of allergic rhinitis, chronic idiopathic urticaria, and several other histamine-related diseases (Types of H1 antihistamines)

Answer 19

1st generation (Classical antihistamines)

Question 20

Many of the ___________ antihistamines readily penetrate the BBB because of their lipophilicity (Types of H1 antihistamines)

Answer 20

1st generation (Classical antihistamines)

Question 21

The __________ agents also tend to achieve and maintain higher levels in the brain, resulting in CNS-based pharmacologic actions (Types of H1 antihistamines)

Answer 21

1st generation (Classical antihistamines)

Question 22

Blockade of central __________ receptors causes sedation, decreased cognitive and psychomotor performance, increased appetite, and weight gain

Answer 22

H1

Question 23

Several 1st generation antihistamines, particularly the __________ and __________, have antiemetic actions, thus may be useful in the treatment of nausea and vomiting and for vertigo and motion sickness (PA)

Answer 23

Phenothiazines, Aminoalkyl ethers

Question 24

Are characterized by the presence of a CHO connecting moiety and a 2 or 3-carbon atom chain as the linking moiety (Classes of 1st generation antihistamines)

Answer 24

Aminoalkyl ethers (Ethanolamines)

Question 25

Prototype of aminoalkyl ethers (Ethanolamines)

Answer 25

Diphenhydramine

Question 26

Are characterized by the presence of a nitrogen-connecting atom (X) and a 2-carbon atom chain as the linking moiety (Classes of 1st generation antihistamines)

Answer 26

Ethylenediamines

Question 27

The connecting moiety (X) is a CHN group, and the carbon chain, terminal amine functionality, and the nitrogen atom of the connecting group are all part of a piperazine moiety (Classes of 1st generation antihistamines)

Answer 27

Piperazines (Cyclizines)

Question 28

Are characterized structurally by an sp3 or sp2 carbon-connecting atom with a carbon chain of two additional carbons (Classes of 1st generation antihistamines)

Answer 28

Propylamines (Monoaminopropyl or alkylamine derivatives)

Question 29

Propylamines with a saturated carbon-connecting moiety are commonly referred to as the ___________

Answer 29

Pheniramines

Question 30

Propylamines with unsaturated connecting moiety include the ___________ derivatives and the __________ analogs (SC)

Answer 30

Simple open-chain alkene, Cyclic alkene

Question 31

Bridging entity is sulfur; contains a 2 or 3-carbon branched alkyl chain between the ring system and terminal nitrogen atom (Classes of 1st generation antihistamines)

Answer 31

Phenothiazines

Question 32

Has lower sedation potential and reducing binding affinities for nontarget proteins (Types of H1 antihistamines)

Answer 32

2nd generation (Non-sedating antihistamines)

Question 33

Are derivatives of the 1st generation antihistamines (Types of H1 antihistamines)

Answer 33

2nd generation (Non-sedating antihistamines)

Question 34

Do not accumulate in the CNS because of their hydrophilicity (Types of H1 antihistamines)

Answer 34

2nd generation (Non-sedating antihistamines)

Question 35

The first two 2nd generation H1 antihistamines, ___________ and __________, were found to be even more cardiotoxic than the 1st generation agents (AT)

Answer 35

Astemizole, Terfenadine

Question 36

___________ are stabilizers involved in the inhibition of histamine release

Answer 36

Mast cell stabilizers

Question 37

Obtain from the plant Ammi visnaga; led to the development of bis(chromones) as compounds that stabilize mast cells and inhibit the release of histamine (Mast cell stabilizers)

Answer 37

Khellin

Question 38

Khellin is a mast cell stabilizer obtained from the plant ___________

Answer 38

Ammi visnaga

Question 39

Are novel antihistaminic compounds with dual mechanisms of action including H1 receptor antihistaminic action and mast cell stabilization

Answer 39

Dual-acting antihistamines

Question 40

First clinically effective and relatively safe member of this therapeutic class (H2 antagonists)

Answer 40

Cimetidine

Question 41

Is short-acting, causes gynecomastia, and inhibits CYP isozymes and renal tubular secretion, resulting in clinically significant drug interactions (H2 antagonists)

Answer 41

Cimetidine

Question 42

The drug interaction potential and several adverse effects of cimetidine appear to be directly related to the presence of the ___________ group

Answer 42

Imidazole

Question 43

Replacement of the imidazole ring in H2 antagonists with a ____________ or a ____________ heterocycle with a basic ring substituent not only enhances both potency and selectivity of H2 antagonism, but also reduces cytochrome and renal secretory drug interactions (FT)

Answer 43

Furan, Thiazole

Question 44

H2 antagonist with furan ring

Answer 44

Ranitidine

Question 45

2 H2 antagonists with a thiazole ring (FN)

Answer 45

Famotidine, Nizatidine

Question 46

2 H2-antagonists with a basic ring substituent (GD)

Answer 46

Guanidine, Dimethylaminomethyl

Question 47

Irreversibly inhibits the H+/K+/ATPase pump (Antiulcer therapies)

Answer 47

Proton pump inhibitors

Question 48

Are composed of pyridylmethyl benzimidazole sulfides (Antiulcer therapies)

Answer 48

Proton pump inhibitors

Question 49

An aluminum hydroxide complex of the octasulfate ester of sucrose (Antiulcer therapies)

Answer 49

Sucralfate

Question 50

A semisynthetic derivative of PGE1; exhibits both antisecretory and cytoprotectant effects that is characteristic of the natural prostaglandins (Antiulcer therapies)

Answer 50

Misoprostol