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Spr24 Pharm II > H1/H2/PPI (Ex1) > Flashcards

H1/H2/PPI (Ex1) Flashcards

1
Q

Histamine released from

A

Endogenous
-From basophils and mast cells

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2
Q

Histamine significant effects (2)

A

-Contraction of Airway Smooth muscle
-Secretion of stomach acid

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3
Q

Significant drugs that release histamine (5)

A

Morphine
Mivacurium
Atracurium
Succinylcholine
Protamine

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4
Q

H1 receptor effects (3)

A

-Hyperalgesia
-Inflammatory pain
-Allergic rhino-conjunctivitis symptoms

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5
Q

H2 receptor effects (2)

A

-Elevates cAMP (B1-like stimulation)
-Increase acid volume

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6
Q

Histamine inflammatory effects (H1 and H2) (5)

A

Hypotension
Capillary permeability
Flushing
Prostacyclin release
Tachycardia

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7
Q

H1 receptor antagonist side effects (4)

A

Blurred vision
Urinary retention
Dry mouth
Drowsiness (1st gen)

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8
Q

First gen H1 antagonist drugs (2)

A

Diphenhydramine (Benadryl)
Promethazine (Phenergan)

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9
Q

Second gen H1 antagonists (2)

A

Cetirizine (Zyrtec)
Loratadine (Claritin)

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10
Q

Diphenhydramine trade name

A

Benadryl

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11
Q

Benadryl main uses (3)

A

-Antipuritic
-Pre-treatment for allergies (IVP dye)
-Anaphylactic indications

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12
Q

Benadryl E 1/2 time

A

7-12 hrs

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13
Q

Benadryl benefit in eye surgery

A

Inhibition of oculo-emetic reflex

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14
Q

Benadryl dose

A

25-50 mg IV

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15
Q

Phenergan main use

A

Rescue anti-emetic

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16
Q

Phenergan E 1/2 time

A

9-16 hrs

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17
Q

Phenergan black box warnings (2)

A

-Respiratory arrest in children under 2
-Necrosis from infiltration

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18
Q

Phenergan dose

A

12.5-25 mg IV

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19
Q

Phenergan onset

A

5 minutes

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20
Q

H2 antagonist main uses (2)

A

-Decrease gastric acid volume (release)
-Decrease acidity of gastric acid

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21
Q

H2 antagonist side effects (4)

A

HA/confusion
Diarrhea
Sk-muscle pain
Bradycardia

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22
Q

Downside to prolonged decreased acidity

A

Overgrowth of bacteria in stomach acid

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23
Q

H2 antagonist drugs (3)

A

(-tidine)
-Cimetidine (Tagamet)
-Ranitidine (Zantac)
-Famotidine (Pepcid)

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24
Q

Cimetidine trade name

A

Tagamet

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25
Tagamet metabolism
CYP450 Cleared in urine
26
Tagamet drug interaction effect
Strongly inhibits CYP450 => inhibits metabolism of other drugs
27
Tagamet adverse effects (3)
Bradycardia Hypotension Impotence
28
Tagamet dose
150-300 mg IV 1/2 dose in renal impairment
29
Ranitidine trade name
Zantac
30
Zantac metabolism
Hepatic metabolism, renal clearance
31
Zantac effect on hepatic enzymes
No significant interaction
32
Zantac dose
50 mg diluted 20 cc over 2 min 1/2 dose for renal impairment
33
Famotidine trade name
Pepcid
34
Pepcid metabolism
Hepatic metabolism, renal clearance
35
Pepcid effects on hepatic enzymes
No interference with p450s
36
Pepcid E 1/2 time
2.5-4 hours
37
Pepcid potency
Most potency in H2 antagonists
38
Pepcid dose
20 mg IV 1/2 dose for renal impairment
39
PPI MOA
Irreversibly bind and inhibit proton pumps
40
PPI onset
Up to 5 days
41
PPI Main uses
Controlling gastric acidity and volume -better for chronic/longer treatment
42
PPI drug interactions (2)
-Inhibits warfarin metabolism -Blocks enzyme that activates Plavix
43
PPI drugs (4)
(-prazole) -Omeprazole (Prilosec) -Pantoprazole (protonix) -Lansoprazole (Prevacid) -Dexlansoprazole (dexilent)
44
Omeprazole trade name
Prilosec
45
Prilosec metabolism
Metabolized by CYPs
46
Prilosec dose
40 mg in 100cc over 30 min (Or PO > 3 hrs prior)
47
Prilosec side effects (6)
HA agitation Confusion Abd pain N/V Flatulence
48
Pantoprazole trade name
Protonix
49
Protonix metabolism
CYP enzymes
50
Protonix E 1/2 time (comp)
Longer than prilosec
51
Protonix dose
40 mg in 100cc over 2-15 min
52
Particulate antacid based with
Aluminum or magnesium
53
Non-particulate antacids based with
Sodium, carbonate, citrate, bicarbonate
54
Antacid MOA
Neutralize acid
55
Antacid drug
Sodium Citrate (bicitra)
56
Long term acid neutralization problems (2)
Leads to inhibited breakdown of food And acid rebound
57
Long term Magnesium antacid use
Neurologic and neuromuscular impairment
58
Sodium based antacid considerations
Increased sodium load in hypertensive and cardiac impaired pts
59
Sodium citrate trade name
Bicitra
60
Base + acid =
Salt, CO2, and H2O
61
Bicitra use
Protect against aspiration acid damage, not aspiration
62
Bicitra onset and duration
Immediate onset Lose effect 30-60 min
63
Bicitra dose
15-30 mL PO

Spr24 Pharm II (32 decks)

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