Antihistamines

Question 1

effects of histamine

Answer 1

• vasodilation: H1 and H2
• increased capillary permeability: H1
• increased GI and pulmonary secretions: H2

Question 2

differentiate between acute and chronic urticaria

Answer 2

• acute: < 6 weeks
• chronic: > 6 weeks

Question 3

list clinical indications to use antihistamines

Answer 3

• allergic conditions: rhinitis, dermatitis
• hypersensitivity rxn to drugs
• anaphylaxis
• urticaria
• motion sickness
• vertigo
• insomnia

Question 4

chlorpheniramine

Answer 4

• H1 blocker
• first generation

Question 5

Dimenhydrinate

Answer 5

• H1 blocker
• first generation

Question 6

Promethazine

Answer 6

• H1 blocker
• first generation

Question 7

Meclizine

Answer 7

• Antivert
• H1 blocker
• first generation

Question 8

hydroxyzine

Answer 8

• H1 blocker
• first generation
• extreme sedation

Question 9

Loratadine

Answer 9

• claritin
• non-sedating H-1 blocker
• 2nd generation

Question 10

Cetirizine

Answer 10

• non-sedating H-1 blocker
• 2nd generation

Question 11

Fexofenadine

Answer 11

• allegra
• non-sedating H-1 blocker
• 2nd generation

Question 12

famotidine

Answer 12

• pepcid
• H2 blocker

Question 13

ranitidine

Answer 13

• zantac
• H2 blocker

Question 14

azelastine (astelin, astepro)

Answer 14

• nasal spray antihistamine

Question 15

azelastine (optivar)

Answer 15

• antihistamine eye drops

Question 16

Ketotifen

Answer 16

• antihistamine eye drops
• mast cell stabilizer

Question 17

Naphazoline

Answer 17

• antihistamine eye drops

Question 18

Olopatadine

Answer 18

• antihistamine eye drops
• mast cell stabilizer

Question 19

H1 1st generation block cholinergic receptors. what are the side effects

Answer 19

• Red and a beet -> flushing
• dry as a bone -> dry mouth, constipation
• blind as a bat -> mydriasis
• mad as a hatter -> delirium
• hot as a hare -> hyperthermia

Question 20

what is the most sedating of the H1 second generation

Answer 20

• cetirizine (zyrtec)

Question 21

first line for male with allergies with BPH

Answer 21

• nasal steriod
  
  • avoid decongestants and antihistamine

Question 22

can patient with glaucoma take antihistamines

Answer 22

• risk of increasing intraocular pressure is present with decongestants, antihistamines, and steriods (nasal steroids)
• speak to ophthalmologist to determine plan

Question 23

pt presents with BPH and viral gastroenteritis with significant nausea and vomiting. which antinausea med would you avoid

Answer 23

• phenergan (promethazine)
  
  • blocks
    
    • DA
    • muscarinic
    • histamine

Question 24

patient with narrow angle glaucoma presents with vertigo. what medication would you want to avoid

Answer 24

• Meclizine (antivert)

Question 25

option for antihistamine to help with sleep

Answer 25

• hydroxyzine (atarax)

Question 26

DOC antihistamine for pregnant/breast feeding patients

Answer 26

• Loratadine
  
  • minimally excreted in breast milk
• cetirizine is second choice

Question 27

What can be beneficial as adjuct tx for urticaria

Answer 27

• H2 blockers
  
  • ranitidine

Question 28

DOC anaphylaxis

Answer 28

• epinephrine

Question 29

define anaphylaxis

Answer 29

• severe allergic rxn that affects more than one body part at the same time
  
  • respiratory
  • skin and mucosa
  • GI
  • cardiac