Antihistamines and Antileukotrienes

Question 1

What is the one airway, one disease concept?

Answer 1

Allergic Rhinitis and Asthma are seemingly separate disorders but are actually manifestations of the same disease expressed to a greater or lesser extent

Question 2

Time for peak in symptoms in Allergic rhinitis (AR)

Answer 2

1 hour after provocation

Question 3

When do symptoms of AR and AS usually resolve?

Answer 3

12-24 hours

Question 4

Predominant mediator types: early phase

Answer 4

Cysteinyl leukotrienes, Histamine

Question 5

Predominant mediator types: late phase

Answer 5

Cysteinyl leukotrienes, Cytokines

Question 6

two important pathways of inflammation in asthma

Answer 6

Cysteinyl leukotrienes and steroid-sensitive mediators

Question 7

Three actions of Cysteinyl Leukotrienes

Answer 7

1. activation and recruitment of inflammatory cells 2. increased vascular permeability leading to edema 3. increased mucus secretion

Question 8

Triple responses of Lewis

Answer 8

Wheal, flare, flush

Question 9

MOA of H1 antihistamines

Answer 9

do not antagonize the binding of histamine; bind to different sites on the receptor to produce the opposite effect

Question 10

All of the available H1 receptor antagonists are (reversible/irreversible), (competitive, non-competitive)

Answer 10

reversible, competitive

Question 11

What H1 blocker has anti-parkinsonism effects?

Answer 11

Diphenhydramine

Question 12

What h1 blocker has alpha-receptor blocking effects?

Answer 12

promethazine

Question 13

What H1 blocker has Serotonin-blocking actions?

Answer 13

Cyproheptadine

Question 14

Most 2nd gen and some 1st gen last for _____ hours.

Answer 14

24

Question 15

Elimination of antihistamines

Answer 15

Renal

Question 16

antihistamines have significant cardiac toxicity when taken in combination with:

Answer 16

ketoconazole, itraconazole, erythromycin, grapefruit

Question 17

MOA of zileuton

Answer 17

Inhibitors of leukotriene synthesis: inhibition of 5 -lipoxygenase

Question 18

MOA of monteleukast

Answer 18

Inhibitors of leukotriene (LTD4) binding

Question 19

What is the Churg-Strauss syndrome?

Answer 19

systemic vasculitis accompanied by worsening asthma, pulmonary infiltrates and eosinophilia

Question 20

T or F. Antileukotrienes are less effective than intranasal corticosteroids

Answer 20

T

Question 21

Example of 1st gen Ethanolamines

Answer 21

diphenhydramine, dimenhydrinate

Question 22

Example of 1st gen Alkylamines

Answer 22

chlorphenamine

Question 23

Example of 1st gen Ethylenediamines

Answer 23

pyrilamine

Question 24

Example of 1st gen Piperazines

Answer 24

hydroxyzine

Question 25

Example of 1st gen Phenothiazines

Answer 25

promethazine