Antihistamines

Question 1

3 effects of histamine…

Answer 1

vasodilation
capillary permeability
GI/Pulm secretion

Question 2

6 common sedating 1st gen H1 blockers…

Answer 2

diphenhydramine
chlorpheniramine
dimenhydrinate
promethazine
meclizine
hydroxyzine

Question 3

3 common non sedating 2nd Gen H1 blockers

Answer 3

laratadine
cetirizine
fexofenadine

Question 4

2 common H2 blockers

Answer 4

ranitidine

famotidine

Question 5

2 nasal spray antihistamines

Answer 5

azelastine

azelastine + fluticasone

Question 6

Which antihistamine eye drops are antihistamine + mast cell stabilizer?

Answer 6

ketotifen

olopatadine

Question 7

2 AH only eye drops

Answer 7

azelastine

naphazoline

Question 8

Antihistamine SE mnemonic

Answer 8

hot as a hare
red as a beet
dry as a bone
blind as a bat
mad as a hatter

Question 9

2 approved antihistamines for airline pilots…

Answer 9

loratadine

fexofenadine

Question 10

approved AHs for pilots can be used only after…

Answer 10

trial w/o SEs

Question 11

how long must a pilot be grounded if they are using a non-approved AH?

Answer 11

5x the half-life

60 hours for benadryl

Question 12

avoid _____ antihistamines in BPH due to risk of______

Answer 12

avoid 1st gen H1 blockers

urinary retention

Question 13

1st line tx for allergic rhinitis w. concomitant BPH…

Answer 13

nasal steroids

Question 14

What three classes commonly used in allergies can increase IOP?

Answer 14

decongestants
antihistamines
steroids

Question 15

Which type of glaucoma has a lower risk of increased IOP with antihistamine use?

Answer 15

open angle

Question 16

Can patients with BPH/Glaucoma with the below conditions be given an antihistamine?

gastroenteritis
labrynthitis
motion sickness
insomnia

Answer 16

no… same reasons as allergic conditions

Question 17

which antihistamines be useful for in scabies tx and why?

Answer 17

hydroxyzine, diphenhydramine

sleep aid

Question 18

What is an important hx question for hives?

Answer 18

acute or chronic ( > 6 wks)

Question 19

Chronic urticaria is linked to ________ and responds well to ________

Answer 19

autoimmune link

2nd gen antihistamines (non-sedating)

Question 20

3 tx options for poison ivy…

Answer 20

topical steroids
2nd gen H1 blocker
+/- PO steroid

Question 21

Tx of new onset urticaria a/w drug allergy….

Answer 21

2nd gen H1 blocker

+/- IM and systemic steroids, IM AH

+/- H2 blockers

Question 22

Meds for anaphylaxis…

Answer 22

Epi 1st line

diphenhydramine (H1 blocker) + dexamethasone + famotidine (H2 blocker)

Question 23

Which class of AH is shorter acting and crosses BBB?

Answer 23

1st gen H1 blocker

Question 24

4 high-risk antihistamine populations…

Answer 24

BPH
Glaucoma
extremes of age
high risk occupation