Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ocular Pharm > Antihistaminics > Flashcards

Antihistaminics Flashcards

1
Q

____ is a common mediator of itching

A

histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does histamine induce

A
  1. vascular permeablity: running nose, watery eyes, swollen lids, papillae
  2. induces vasodilation: redness, headache, hypotension, reflex tachycardia
  3. causes smooth muscle contraction: bronchoconstriction
  4. stimulates sensory nerves: pain and itching and sneezing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens as a result of ag binding to Ab?

A

degranulation; histamine gets released.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the most common sites of ocular allergy

A
  1. conjunctiva
  2. cornea
  3. lids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the different types of ocular allergies

A
  1. acute conjunctivitis
  2. atopic conjunctivitis (pt is predisposed to dev allergic conjunctivits bc of hyper allergenic state due to asthma or skin condition)
  3. contact dermatitis: physical contact of chemical on surface
  4. seasonal conjunctivitis
  5. perennial conjunctivitis: year round; high degree of hypersensitivity
  6. GPC: associated with hard contacts & upper lid
  7. Vernal conjunctivitis; severe reaction; cornea is also involved
  8. Urticaria (hives)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is innate immune response

A

a non specific generic acute response that lacks immunologic memory and acts near entry points of infection or injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the two different types of innate immune response? Describe them

A
  1. Humoral: Blood based; Non classical complement cascade. Release of cytokines by first responder immune cells.
  2. Cell mediated: Phagocytes ingest foreign proteins, fungi, pathogens,e tc and secrete cytokines to recruit monocytes and neutrophils.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the adaptive immune response and the two different types

A

It is an acquired specific response that requires prior exposure to the antigen and features both specificity and memory.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the two different types of adaptive immune response

A
  1. Humoral: Exposed APC’s stimulate T cells to mature into helper T cells which cause B cells to transform into Ab producing plasma cells.
  2. Cell mediated: Exposed APC’s stimulate T cells to mature into helper T cells which facilitate sensitization of killer T cells.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the key cells in innate and adaptive immune response?

A

Innate: Killer T cells and macrophages
Adaptive: Cloned memory B and T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the response time for innate & adaptive immune response

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the different types of antigens

A
  1. Environmental: Animal dander, ragweed, pollen, dust, insect stings.
  2. Biological: bacteria, viruses, fungi, parasites
  3. chemical: Vaccines, drugs, proteins, carbs, metals, food additives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the different types of hypersensitivity response

A

(ACID)

  1. Type 1: Allergy
  2. Type 2: Cytotoxic/Ab Mediated
  3. Type 3: Immune complex
  4. Type 4: Delayed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What falls under type I hypersensitivity response?

A

It is IgE based; asthma, latex, bee sting, anaphylaxis, angiodema, urticaria, food allergies, rhinitis, atopic dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What falls under type IV hypersensitivity response?

A

Cd4/CD8 (cell mediated) T cell based reactions leading to macrophage activation/lysis resulting in cytokine mediated inflammation.
Conjunctivitis medicamentosa, contact dermatitis, chronic graft rejection, type 1 diabetes, MS, PPD test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the type I hypersensitivity rxn

A

B cell gets in contact with foreign antigen and clones B cells which takes 3-6 days for this reaction to occur. Once they have generated Ab’s they are passed on to mast cells and basophils. mast cell are in tissue , basophils are in blood. The secondary reaction involves re exposure with the ag. Calcium enters and you get degranulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when does immediate type 1 hypersensitivity occur

A

5-30 min after re exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What makes up mast cells/basophils?

A
  1. prostaglandins
  2. leukotrienes
  3. platelet activating factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the mediator of tissue mast cells and basophils

A

phospholipase A2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Type IV delayed hypersensitivity is ___ cell based and _____ independent..it is NOT responsive to antihistamines, It takes 2-3 days for development and involves re-exposure (memory) response

A

T; Ab;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some ocular allergy therapies

A
  1. Topical decongestants
  2. Topical antihistamines
  3. topical mast cell stabilizers
  4. topical combo drugs
  5. oral antihistamines
  6. topical Nsaids/steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what do cold compresses do

A

cause vessels to shrink/constrict they act like decongestants and reduce redness and swelling. (less leaky vessels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Decongestants are ____ agents and include _____ and tetrahydrozoline which are OTC imidazolines

A

adrenergic; naphazoline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are combo actions of decongestants

A

Reduce vascular absorption:

  1. reduces sytemic toxicity
  2. reduces sytemic metabolism/drug clearance
  3. sustains local effect of applied drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are decongestant indications

A

allergy induces hyperemia and injection
(Phenylephrine is not used in allergy therapy due to its predilection to produce rebound congestion and with chronic use, conjunctival medicamentosa .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are adverse effects of decongestants

A
  1. blur, epithelial erosions, rebound congestion, upper lid retraction
  2. mydriasis
  3. elevated IOP
  4. Reduced IOP
27
Q

which decongestant causes mydriasis and elevated IOP

A

naphazoline

28
Q

which decongestant causes a reduction in IOP

A

tetrahydrozoline

29
Q

H1 and H2 antihisaminics are ______ _____

A

inverse agonists; they cause the reversal of constitutive receptor activity.

30
Q

what are the different histamine receptors

A

H1, H2, H3, and H4

31
Q

this is a classic histamine receptor that is involved in immediate hypersensitivity reaction

A

H1

32
Q

this receptor promotes gastric acid production, immune cell activation

A

H2

33
Q

this receptor is involved in pre synaptic feedback inhibition

A

H3

34
Q

this receptor is involved in immune modulation, inflammation and nociception roles

A

H4

35
Q

What is the dosing for antihistamines

A

QD, BID, and QID

36
Q

What are broader ophthalmic indications for the use of antihistamines

A
  1. allergic conjunctivitis
  2. myokymia
  3. allergic rhinitis
  4. intraoperative anti miotic
37
Q

____ is a 2nd generation antihistamine. It is category B and dosed 4 x a day. Paed use is 3 YOA

A

Emadine

38
Q

What are serious adverse reactions of emadine

A

keratitis, corneal infiltrates

39
Q

what are common adverse reactions of emadine

A
  1. headache
  2. abnormal dreams
  3. bitter taste
  4. blurred, dry eyes
  5. foreign body sensation
  6. hyperemia, pruritus, lacrimation
40
Q

What is the antihistamine that has the brand name called Vasocon -A that is combined with naphazoline?

A

Antazoline

41
Q

What is similar between the topical OTC antihistamines + decongestants besides 1?

A

They all have the antihistamine Pheniramine and the decongestant naphazoline and are all dosed 4 x a day, category C and paed use is 6 YOA and all first generation antihistamines.

42
Q

What are adverse reactions of topical antihistamines + decongestants?

A

mydriasis, anisocoria, medicamentosa,s reactive hyperemia, lacrimation/dry eye, irritation, pain, photophobia, IOP fluctuation, conjunctival vasoconstriction, headache

43
Q

what are drug interactions involved with topical antihistamines + decongstants

A

MAOI, and EtOH

44
Q

what are contraindications of topical AH + Decongestants

A

Hypersensitivity, CVD, DM, narrow anterior chamber angles, precautionary use with dry eye

45
Q

What are mast cell stabilizers

A

oral agents that are believed to block Ca++ influx that stimulates degranulation; this effects not only mast cells but other immune cells. You take it before symptoms .

46
Q

What is the clinical use of mast cell stabilizers

A

halt type 1 hypersensitivity reaction!

47
Q

Which topical mast cell stabilizer is the fastest acting?

A

Alocril (brand name)/Nedocromil (generic name); Paed use is 3 YOA and is dosed 2 x a day (bid) instead of qid (4)

48
Q

What are adverse effects of mast cell stabilizers

A
  1. burn/sting
  2. headache
  3. dry eye
49
Q

which topical mast cell stabilizer is the least likely to provoke a problem?

A

Nedocromil

50
Q

Which topical antihistamine + MCS combo is the only OTC product?

A

Ketotifen/Zaditor; Ped use is 3 YOA and is dosed bid

51
Q

Which MCS + antihistamine combo is 2 YOA for ped use?

A

bepotastine, alcaftadine, and olopatadine

52
Q

what are adverse reactions of topical antihistamine + MCS combos

A

sting, burn, FBS, dry eye, itch, H/A, flu-like syndrome, rhinitis, taste changes, URI associated with Elestat

53
Q

What are differences/advantages between oral vs topical allergy therapy

A

Topical: required dosing may be more frequent that oral therapy.

Oral: Better for deeper ocular involvement
Better for moderate to severe eyelid edema & conjunctival chemosis

54
Q

Which receptor is indicated for GERD, gastric ulcer

A

H2 receptor antagonists

55
Q

What are oral formulations of Anti H2 antihistamines

A
  1. Tagamet - Cimetidine
  2. Pepcid - Famotidine
  3. Axid - Nizatidine
  4. Zantac - Ranitidine
56
Q

What is common between all first generation oral antihistaminics

A

they make you drowsy.

57
Q

Which oral antihistamine is mildly sedating? moderately sedating? strongly sedating?

A
  1. chlorpheniramine
  2. clemastine
  3. diphenhydramine (bendaryl) and promethazine
58
Q

what are first gen drug interactions for oral antihistamine’s

A
  1. potassium supplements
  2. codeine & opioids
  3. anticholinergics
59
Q

what are first generation contraindications for oral antihistamines

A
  1. peptic ulcer
  2. prostatic hypertrophy
  3. bladder obstruction
  4. Angle closure glaucoma
60
Q

What are the 2nd generation oral antihistaminics

A
  1. allegra - fexofenadine
  2. claritin - loratadine
  3. clarinex - desloratadine
  4. zyrtec - cetirizine
61
Q

what are ancillary allergy therapies

A
  1. NSAIDS

2. steroids

62
Q

which NSAID is used to treat seasonal allergic conjunctivitis

A

acular

63
Q

which steroid is safe for long term therapy of SAC and VKC

A

lotemax

Ocular Pharm (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions