Antihistamines (Lauren🌭)

Question 1

Most of the effects of the allergic response are due to the (H1/H2) receptor

Answer 1

H1

Question 2

What do H1 receptors in the BRAIN do?

Answer 2

Wakefulness

Appetite control

Question 3

What is the main difference between first generation and second generation antihistamines?

Answer 3

First generation enters the brain and makes you very sleepy

Question 4

Which receptors are blocked by first generation antihistamines?

Answer 4

H1

Muscarinic

Question 5

The side effects we see from first generation antihistamines come from the (H1 block/muscarinic block)

Answer 5

Muscarinic block

Question 6

Other than sedation, what other side effects do we see from first generation antihistamines?

Answer 6

Dry eyes,

Dry mouth etc

Basically your typical anticholinergic effects (due to the muscarinic blockade**)

Question 7

Dimenhydrinate (Dramamine) is an anticholinergic that is used for motion sickness.
This is because of the _____________

Answer 7

Muscarinic blockade

Question 8

Would you use H1 antagonists for someone having an acute asthma attack?

Answer 8

No

Question 9

Which H1 blocker can be used for motion sickness and as an antiemetic

Answer 9

Promethazine (Phergan)

Antiemetic due to it blocking D2

Question 10

Do second generation H1 blockers have any anticholinergic effects?

Answer 10

NO

Question 11

Do second generation antihistamines work for motion sickness?

Answer 11

NO

Question 12

Which second generation antihistamines are excreted by the kidney and would be great for patients with liver disease or are on multiple drugs?

Answer 12

Cetirizine (Zyrtec)*****

Levocetirizine (Xyzal)

Acrivastine

Question 13

How are most second generation antihistamines metabolized?

Answer 13

CYP450s in liver

Question 14

Cetirizine (Zyrtec) would be a bad choice if someone had a shitty (kidney/liver)

Answer 14

Kidney

Question 15

An overdose on first generation antihistamines would look a lot like an overdose on ___________

Answer 15

Atropine

ANTICHOLINERGIC

Question 16

What are the 3 drugs that inhibit the release of histamine, and what is the difference between them?

Answer 16

Cromolyn- inhibits histamine release

Azelastine (Optivar) -inhibits histamine release and ALSO blocks receptors

Cetirizine- ~may~ have some effect on inhibiting histamine release

Question 17

Which second generation H1 blocker may also inhibit histamine release?

Answer 17

Cetirizine (Zyrtec)

Question 18

A lady wants an allergy med that wont make her sleepy. Her GFR is 12. Which would be a better choice:
A.) Loratadine (Claritin)

B.) Cetirizine (Zyrtec)

Answer 18

A.) Loratadine

Not excreted by Kidney

Question 19

(First/Second) generation h1 blockers gave anticholinergic effects

Answer 19

First

Question 20

Name all of the first generation H1 antagonists that are SUPER sedating

Answer 20

Diphenhydramine (Benadryl)***

Dimenhydrinate (Dramamine)***

Promethazine (Phenergan)***

Hydroxyzine (Atarax, Vistaril)

Doxylamine (Unisome)

(Bolded ones are ***)

Question 21

Look at a list of moderately sedating first generation H1 blockers that probably are not on this test

Answer 21

Brompehiramine maleate (Bromamine, Dimetane)

Chlorpheniramine maleate (Chlor-Trimeton)

Clemastine (Tavist)

Cyclizine (Merezine)

Meclizine (Bonine)

Question 22

Name all of the second generation H1 antagonists

Answer 22

Loratadine (Claritin)***

Cetirizine (Zyrtec)***

Fexofenadine (Allegra)***

Desloratadine (Clarinex)

Levocetirizine (Xyzal)

Acrivistine/Pseudoephedrine (Semprex)

The ones with *** were bolded in handout