Antihistamines, Decongestants, Anitussives and Expectorant Flashcards
1st gen. antihistamines Rapid onset and short duration highly lipophilic Diphenhydramine q6-8h No decongestant PM
2nd gen. antihistamines slow onset and long duration less lipophilic Cetirizine, Fexofenadine, Desloratadine AM
DOC for allergic rhinitis
2nd gen. antihistamines
Antihistamines SEs and CIs DIs.
drowsiness, nervousness, paradoxical excitability and difficulty sleeping
CI: pregnancy, lactating, glaucoma, prostatic hypertrophy, kidney and liver disease
Example of antitussive and expectorant and CIs
Dextromethorphan- antitussive
Guaifenesin- expectorant
CIs chronic, persitent cough, pts w lung disease and pregnant, lactating
Decongestants: Pseudoephedrine, Phenylephrine are more effective but CIs
CIs: ♥️ dis. HTN, thyroid dis, diabetes, glaucoma, prostatic hypertrophy, pts taking antidepressants, pregnant and lactating
Topical Decongestants SE
SEs ate mainly local and >3-5 days causes rebound congestion
DOC for motion sickness and for pilots navigators
Diphenhydramine, dimenhydrinate - m s
Meclizine- nav. due to long t1/2
Phenyl and Pseudo with MAOi causes?
HTN crisis
Dextromethorphan concurrent use with what drugs causes what syndrome?
MAOis, SSRIs, TCAs
causes serotonin syndrome
Mild and High fever signs and symptoms
Mild: chills. dehydration, HS, loss of appetite, n&v
High: convulsions (febrile seizures) -children, confusion and delirium for adults
Neurological damage at body temp. >41.7C
Acute inflamm of mucous membrane of the nose usually accompa the common cold and symptoms
Allergic rhinitis (Hay fever) runny nose pruritus of eye ear throat, sneezing cough no fever no sore throat, watery eyes fatigue
Seasonal and perennial allergy.
Seasonal- begins in spring, ends in fall
Perennial- caused by allergens present year-round, house dust mites animal dander cockroaches and indoor molds
Allergens pollens molds mites stimulate release of what chemical mediators:
Histamine, Leukotriene LTC3 LTD4 LTE4
Prostaglandins D2, Kinins
Two types of virus causes Influenza
Influenza A- most common and severe
B- superficial epithelium of the airway tract
Flu vaccine CIs
Influenza season Oct-April (winter)
Immunization season Oct-Nov
Less than 6 mo age
Allergies to eggs
person w flu symptoms
DOC for acute sinusitis
Amoxi
If allergic: TMP/SMX
Viral and bacterial pharyngitis causes and tx.
V: Epstein-bar infection, Influenza, common cold, measles, vericella
B: Beta hemolytic streptococcus during winter or early spring
tx: Pen V
if allergic: Eryth base-adults estolate-children
Non and narcotic antitussives
Non: Dextro, Diphenhydramine
narcotic: Codeine, Hydrocodone
Mechanism of Gauifenesin (extract of tar)
Inc. ciliary action, fluid from resp. tract viscous, facilitate mucus removal, high doses cause emesis
Ammonium chloride mechanism
Irritant of stomach, causes reflex inc. in airway mucus secretions, high doses cause acidosis in pts w renal failure
Topical and nasal decongestants and another term for rebound nasal decongestion
Top: Oxymetazoline, Xylo
rhinitis medicamentosa usually occurs 5-10 days of tx
Nasal: Phenylephrine, propylhexedrine
Systemic decongestants and SEs
Pseudo, Epi, Phenyl, Phenylpropamine
CIs MAOis, HTN, ♥️ dis, hyperthyroidism, diabetes, glaucoma, BPH
SEs CNS stimulation insomia, HE, irritation, tachy or palpitation, affects BP and blood sugar
