3. Rest Flashcards
antihistamine
Old & sedating
List
Promethazine BD/ TDS
Alimemazine (very sedating)
Chlorphenamine
Hydroxyzine (QT prolonged)
Ketotifen
Clemastine
Cyproheptasine
Antihistamine
New & non sedating
List
Acrivastine Bilastine Mizolastine Cetirizine Levocetizirine Loratidine Fexofenadine
ALL P exempt fexofenadine
Antihistamine
Old ie: promethazine
SE
dry mouth Blurred vision Constipation Urinary retention Headache
Antihistamine
New non sedating
Ie fexofenadine
SE
Dizziness; drowsiness; headache; nausea
Antihistamine
Indication:
Allergic rhinitis. Allergic conjunctivitis. Allergic dermatological reaction(s) Sinusitis. Urticaria. Angioedema. Atopic dermatitis. Bronchitis.
Antihistamine
Runny nose good idea?
No better to give nasal decongestant
Antihistamine
Caution! Avoid in these conditions
4
Pregnancy and breastfeeding
Acute porphyrias
Benign prostatic hyperplasia
Angle closure glaucoma
Which AH ( sedating or non sedating) can cause
Hepatic coma in pts with severe liver impairment
Sedating! AVOID!!!
non sedating AH can only be given if absolutely necessary
Antihistamine
Hydroxyzine
MHRA warning
High risk of QT prolongation
And
Torsade de pointes
Used short term only 100mg OD MAX
AVOID IN ELDERLY
Desensitising vaccines should be avoided in
Pregnancy Asthmatics Children younger than 5 ACE Pts taking BB ( due to adrenaline shot)
Beta blockers and
Adrenaline
Beta blockers, also known as beta-adrenergic blocking agents, are medications that reduce your blood pressure. Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. Beta blockers cause your heart to beat more slowly and with less force, which lowers blood pressure
Patients on nonselective beta-blockers should generally not receive a systemic dose of epinephrine if they are not already in anaphylaxis; an acute hypertensive reaction is likely to occur. If they do have anaphylaxis, the epinephrine will not be harmful, but it probably will not work. It would be prudent to avoid all beta-blockers in patients who are at risk of anaphylaxis, including those receiving immunotherapy or those who carry epinephrine for self-injection. The beta-blocker may increase the risk of anaphylaxis and may also inhibit the therapeutic effect of epinephrine in treating anaphylaxis.
MAJOR CI
IN ASTHMA & COPD
Never give this …..? to those patients
Beta blockers!!!!
Alternative :
IV salbutamol Or Aminophylline & Inhaled ipratropium
Laryngeal oedema
MEDICAL EMERGENCY 🆘
Tx
Adrenaline O2 (intubation in severe cases)
Antihistamine
Corticosteroids
Sputum viscosity
Mucolytics
List
What do they do
Carbocisteine
Erdosteine
A mucolytic helps you cough up phlegm. It works by making your phlegm less thick and sticky.
Mucolytics
Carbocisteine
CI in which conditions
Active peptic ulcer
