Antihistamines, Decongestants, Anitussives and Expectorant

Question 1

1st gen. antihistamines 
Rapid onset and short duration
highly lipophilic
Diphenhydramine q6-8h
No decongestant
PM

Answer 1

2nd gen. antihistamines 
slow onset and long duration
less lipophilic 
Cetirizine, Fexofenadine, Desloratadine 
AM

Question 2

DOC for allergic rhinitis

Answer 2

2nd gen. antihistamines

Question 3

Antihistamines SEs and CIs DIs.

Answer 3

drowsiness, nervousness, paradoxical excitability and difficulty sleeping
CI: pregnancy, lactating, glaucoma, prostatic hypertrophy, kidney and liver disease

Question 4

Example of antitussive and expectorant and CIs

Answer 4

Dextromethorphan- antitussive
Guaifenesin- expectorant
CIs chronic, persitent cough, pts w lung disease and pregnant, lactating

Question 5

Decongestants: Pseudoephedrine, Phenylephrine are more effective but CIs

Answer 5

CIs: ♥️ dis. HTN, thyroid dis, diabetes, glaucoma, prostatic hypertrophy, pts taking antidepressants, pregnant and lactating

Question 6

Topical Decongestants SE

Answer 6

SEs ate mainly local and >3-5 days causes rebound congestion

Question 7

DOC for motion sickness and for pilots navigators

Answer 7

Diphenhydramine, dimenhydrinate - m s

Meclizine- nav. due to long t1/2

Question 8

Phenyl and Pseudo with MAOi causes?

Answer 8

HTN crisis

Question 9

Dextromethorphan concurrent use with what drugs causes what syndrome?

Answer 9

MAOis, SSRIs, TCAs

causes serotonin syndrome

Question 10

Mild and High fever signs and symptoms

Answer 10

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

Question 11

Acute inflamm of mucous membrane of the nose usually accompa the common cold and symptoms

Answer 11

Allergic rhinitis (Hay fever)
runny nose pruritus of eye ear throat, sneezing cough no fever no sore throat, watery eyes fatigue

Question 12

Seasonal and perennial allergy.

Answer 12

Seasonal- begins in spring, ends in fall

Perennial- caused by allergens present year-round, house dust mites animal dander cockroaches and indoor molds

Question 13

Allergens pollens molds mites stimulate release of what chemical mediators:

Answer 13

Histamine, Leukotriene LTC3 LTD4 LTE4

Prostaglandins D2, Kinins

Question 14

Two types of virus causes Influenza

Answer 14

Influenza A- most common and severe

B- superficial epithelium of the airway tract

Question 15

Flu vaccine CIs
Influenza season Oct-April (winter)
Immunization season Oct-Nov

Answer 15

Less than 6 mo age
Allergies to eggs
person w flu symptoms

Question 16

DOC for acute sinusitis

Answer 16

Amoxi

If allergic: TMP/SMX

Question 17

Viral and bacterial pharyngitis causes and tx.

Answer 17

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

Question 18

Non and narcotic antitussives

Answer 18

Non: Dextro, Diphenhydramine
narcotic: Codeine, Hydrocodone

Question 19

Mechanism of Gauifenesin (extract of tar)

Answer 19

Inc. ciliary action, fluid from resp. tract viscous, facilitate mucus removal, high doses cause emesis

Question 20

Ammonium chloride mechanism

Answer 20

Irritant of stomach, causes reflex inc. in airway mucus secretions, high doses cause acidosis in pts w renal failure

Question 21

Topical and nasal decongestants and another term for rebound nasal decongestion

Answer 21

Top: Oxymetazoline, Xylo
rhinitis medicamentosa usually occurs 5-10 days of tx
Nasal: Phenylephrine, propylhexedrine

Question 22

Systemic decongestants and SEs

Answer 22

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