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Pharmacology > Allergic Rhinitis Treatments H1-Receptor Antagonists & Decongestants > Flashcards

Allergic Rhinitis Treatments H1-Receptor Antagonists & Decongestants Flashcards

1
Q

Histamine (H1)-Receptor Antagonists

MOA

A

competitive anatagonist of histamine
binds to H1 receptos without activation
prevents histamine binding and action

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2
Q

Do Histamine (H1)-Receptor Antagonists do better at preventing or reversing histamine action?

A

preventing, much more effective, work best as prophylactic

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3
Q

How do Histamine (H1)-Receptor Antagonists accomplish the reversal of symptoms

A

anticholinergic properties, causes drying of mucous membranes

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4
Q

are 1st generation or 2nd generation Histamine (H1)-Receptor Antagonists more effective

A

1st generation

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5
Q

Diphenhydramine

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
1st Generation H1-Receptor Antagonists
15 to 30 minutes until action 
6-8 hours duration 
\+++ sedative effect 
\+++ anticholinergic effect
B pregnancy category

Common brand name Benadryl

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6
Q

Chlorpheniramine

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
1st Generation H1-Receptor Antagonists
15 to 30 minutes until action 
4-6 hours duration 
\+ sedative effect 
\++ anticholinergic effect
B pregnancy category

Best recommended out of 1st Generation H1-Receptor Antagonists for pregnancy

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7
Q

Hydroxyzine

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
1st Generation H1-Receptor Antagonists
15 to 30 minutes until action 
4-6 hours duration 
\++ sedative effect 
\+ anticholinergic effect
C pregnancy category
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8
Q

Promethazine

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
1st Generation H1-Receptor Antagonists
15 to 30 minutes until action 
4-6 hours duration 
\+++ sedative effect 
\+++ anticholinergic effect
C pregnancy category
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9
Q

Loratadine (Claritin)

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
2nd Generation H1-Receptor Antagonists
1-3 hour until action 
>24 hours duration 
0 sedative effect 
0 anticholinergic effect
B pregnancy category
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10
Q

Desloratadine

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
2nd Generation H1-Receptor Antagonists
<1 hour until action 
24 hours duration 
0 sedative effect 
0 anticholinergic effect
C pregnancy category
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11
Q

Cetirizine (Zyrtec)

  • generation
  • onset
  • duration
  • relative sedative effect
  • relative anticholinergic effect
  • pregnancy category
A 
2nd Generation H1-Receptor Antagonists
40 to 60 min until action 
greater or equal to 24 hours duration 
\+ sedative effect 
0 anticholinergic effect
B pregnancy category
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12
Q

Histamine (H1)-Receptor Antagonists contraindications

A

hypersensitivity to formulation

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13
Q

Histamine (H1)-Receptor Antagonists adverse reactions

A

anticholinergic effects (xersotomia, constipation, urinary retention), CNS depression (dizziness, sedation), paradoxial excitement

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14
Q

Histamine (H1)-Receptor Antagonists drug interactions

A

anticholingeric agents – increase side effects

CNS depressants – increase side effect

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15
Q

Histamine (H1)-Receptor Antagonists monitoring

A

monitor OTC use and side effects

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16
Q

Histamine (H1)-Receptor Antagonists intranasal

A

Azelastine, Olopatadine

17
Q

Histamine (H1)-Receptor Antagonists topical

A

Diphenhydramine

18
Q

Histamine (H1)-Receptor Antagonists ophthalmic

A

Azelastine, Ketotifien, Olopatadine

19
Q

Decongestants MOA

A

stimulates alpha adrenergic receptors to produce vasoconstriction
also pseudoephedrine stimulates beta adrenergic receptors causes bronchial relaxation and increases heart rate and contractility

20
Q

Decongestants topical agents vs oral agents

A

topical decongestants are immediately effective, oral agents tend to last longer and have more systemic side effects

21
Q

overuse of topical decongestants can cause

A

rebound congestion

22
Q

Phenylephrine

A

intranasal decongestant spray requiring 2-3 sprays every 4 hours

oral decongestant every 4 hours

23
Q

Trahydrozoline

A

intranasal/ ophthalmic decongestant

Intranasal decongestant: 3-4 sprays every 3-4 hours
ophthalmic decongestant: 1-2 drops 2-4 times per day

24
Q

Naphazoline

A

intranasal/ ophthalmic decongestant

Intranasal decongestant: 1-2 sprays every 6 hours
ophthalmic decongestant: 1-2 drops every 6 hours

25
Q

Oxymetazoline

A

intranasal/ ophthalmic decongestant

Intranasal decongestant: 2-3 sprays every 12 hours
ophthalmic decongestant: 1-2 drops every 6 hours

26
Q

Pseudoephedrine

A

oral decongestant available in both immediate and extended release forms available

27
Q

what is a common drug used by amateur chemists to produce methamphetamine

A

Pseudoephedrine, an oral decongestant

28
Q

Decongestants contraindications

A

hypersensitivity

MAOI use within 14 days

29
Q

Why should those taking an MAOI (within the past 14 days) not use decongestants

A

use increases the risk of hypertension (associated with adverse effect decongestants)

30
Q

Decongestants Drug interactions

A

When used with sympathomimetics, adverse events of decongestants are enhances

When used with SNRIs (venlafaxine), you may enhance tachycardic effects of decongestants

31
Q

Decongestant Adverse Events

A

Hypertension, tachycardia, rebound congestion

32
Q

Describe the rebound congestion experienced with decongestant use

A

after 3 to 5 days of nasal formula decongestant use patients can experience increased congestion that will not respond to decongestants for some time

33
Q

what should be monitored with decongestants use

A

heart rate and blood pressure

also monitor OTC use

Pharmacology (9 decks)

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