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Pharma 1 Flashcards

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1
Q

From where is histamine produced and where is it stored

A

mast cells

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2
Q

from what amino acid is histamine produced from and from what enzyme

A

histidine

histidine decarboxylase enzyme

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3
Q

when histamine binds to H1 receptor what does it do

A 
bronchoconstriction 
vascular dilation and increased permeability 
increased in nasal and bronchial mucus
positive inotropic , cramps and diarrhea
itching
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4
Q

when histamine binds to H2 receptor what does it do

A

on parietal cells
HCL production
positive inotropic and chronotropic

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5
Q

ant histamines are more effective in preventing symptoms than reversing them

A

true

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6
Q

main effect of antihistamine

A

decrease allergic rxn
decrease pruritis, sneezing and rhinorrhea
decrease neurotransmission in CNS (sedation and impaired cognitive )

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7
Q

what are the other effects of antihistamine unrelated to H1 block

A

anti cholinergic / antimuscarinic
anti serotenergic
anti alpha adrenergic

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8
Q

antichollinergic like and effect

A

diphenhydramine and promethazine

cant see cant pee cant shit cant spit and tachycardia

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9
Q

antiserotenergic like and effect

A

cyproheptadine

weight gain and increased appetite

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10
Q

anti alpha adrenergic like and effect

A

promethazine

reflex tachycardia and hypotension

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11
Q

what are the indications for the use of antihistamines

A

relief common cold symptoms
motion sickness
insomnia
allergic conditions

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12
Q

what is DOC for motion sickness

A

scopalamine ( antimuscarinic)

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13
Q

what can be used for motion sickness other than DOC

A

H1 blockers
Diphenhydramine
Dimenhydrinate
Cycloxine , meclizine and promethazine

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14
Q

are motion sickness drugs effective if symptoms already present

A

no

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15
Q

H1 blocker inhibits nausea and vomiting mediated by

A

chemoreceptor and vestibular pathway

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16
Q

what does an antiemetic block

A

H1 and M1

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17
Q

Meclizine indications

A

motion sickness and vertigo associated with vestibular disorders

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18
Q

only first generation anti histamines can be used for insomnia ( 2nd generation cant be used)

A

true cuz they have sedative property

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19
Q

what does diphenhydramine do in children

A

paradoxical hyperactivity

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20
Q

are H1 blockers medication of choice for insomnia

A

no

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21
Q

characteristics and examples of first generation anti histamine

A 
cheap 
OTC 
Dirty drugs 
Cross bbb leading to sedation 
Chlorpheniramine and diphenhydramine
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22
Q

characteristics and examples of second generation anti histamine

A

carboxylated so became polar and cannot cross BBB
improved speciificity
s/e headache
Fexofenadine , loratadine and desloratadine

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23
Q

what are the drug interactions of anti histamine

A

cant be used with other CNS depressants or alcohol
cant be used with MAOI
cant be used with choline esterase inhibitors

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24
Q

do oral anti histamine have a fast onset of action

A

yes

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25
are oral anti histamine useful in management of allergic rhinitis symp
yes
26
which generation is used for allergic rhinitis
second generation
27
are ophthalmic and nasal antihistamine delivery devices available
yes
28
what is a topical intranasal anti histamine
olopatadine and azelastine
29
when is the combination of anti histamine and decongestant useful
congestion feature of rhinitis patients have no response incomplete control of symptoms
30
what are alternatives for oral anti histamine
``` intranasal corticosteriod short acting alpha adrenergic agonist intranasal cromolyn leukotriene receptor antagonist intranasal ipratropium ```
31
example of intranasal corticosteriod
fluticasone
32
what is the most effective drug to treat allergic rhinitis
fluticasone ( intranasal corticosteriod)
33
onset of action of intranasal corticosteriod and what is smth it improves that anti histamine alone cant
3-36 hours | nasal congestion
34
example of short acting alpha adrenergic agonist ( nasal decongestant) and what does it do
phenylephrine | constrict arteriole in nasal mucosa and reduce airway resistance ( bronchodilation)
35
example of longer acting alpha adrenergic agonist
oxymetazoline
36
what are the formulations of adrenergic agonists available
intranasal and oral
37
why rhinitis medicamentosa happens and to which drug
intranasal formulation of short acting alpha adrenergic agonist used for more than 3 days leading to rebound nasal congestion
38
how does intranasal cromolyn work
mast cell stabilizer
39
to optimize therapeutic effect of intranasal cromyln dosing should begin before how many weeks prior to allergen exposure
1-2 weeks
40
what is rebound congestion called
rhinitis medicamentosa
41
what is the inferior to other treatments
leukotriene receptor antagonist
42
is leukotriene receptor antagonist a reasonable option to be used with patients that have asthma
yes
43
what drug relieves rhinorrhea but not sneezing or nasal congestion
intranasal ipratropium
44
before treating cough the identification of the cause is important so treat underlying cause
true
45
management of cough includes
treat underlying cause | cough suppressant
46
what are the antitussive drugs
codeine dextromethorphan guaifenesin benzonatate
47
characteristic of codeine
naturally occuring opiate decreases cough center sensitivity in CNS cause constipation decrease mucousal secretion
48
characteristics of dextromethorphan
synthetic of morphine decrease cough center sensitivity in CNS OTC
49
when is dextromethorphan not effective
cough due to asthma , smoking and emphysema
50
why do we prefer dextromethorphan over codeine
its equally effective but less S/E and less addictive potential
51
what drug is a recreational drug and what does it mean
dextromethorphan | hallucinations and euphoria
52
dont give dextromethorphan to child less than
4
53
serious life threatening s/e could happen when taking dextromethorphan if
MAOI didnt clear out of body ( 14 days to clear)
54
what drug is an expectorant
guaifenesin
55
guaifenesin has two formulations single ingredient or in combination with codeine or dextromethrophan
true
56
what does guaifenesin does
thins mucus and lubricates RS tract
57
what does benzonatate suppress
cough reflex in peripheral
58
what is MOA of benzonatate
anesthetizes stretch receptors
59
what are adverse effects of benzonatate
numbness of tongue mouth throat dizziness chocking
60
when benzonatate s/e appear should you eat
no
61
benzonatate should be taken at specific doses not need of basis and dont double missed doses
true
62
benzonatate shouldnt be given for child less than
10
63
what is the age of child benzonatate and dextromethorphan shouldnt be given to
10 | 4

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