Autacoid Drugs Flashcards
Histamine H1 receptor antagonists (group) - MoA
Contain an alkylamine group that resembles the side chain of histamine and permits them to bind to the H1 receptor and act as competitive receptor antagonists, and block most of the effects of histamine on vascular smooth muscles and nerves and thereby prevent or counteract allergic reactions
Histamine H1 receptor antagonists (group) - Clinical use
Allergic reactions (all are equally active for this), but differ markedly in their sedative, antiemetic and anticholinergic properties.
Histamine H1 receptor antagonists (group) - Interactions
Extensively metabolized by cytochrome P450.
1st generation antihistamines
Chlorpheniramine Clemastine Dimenhydrinate Diphenhydramine Hydroxyzine Meclizine Promethazine Doxepin Doxylamine with vitamin B6
1st generation antihistamines - MoA
Block cholinergic muscarinic receptors
1st generation antihistamines - Clinical use
Used to produce sedation
Treat: Nausea, vomiting, vertigo.
Prevention of motion sickness.
1st generation antihistamines - Administration and Contraindication (Caution)
Administered oral or parenteral
Caution for treatment of children
1st generation antihistamines - Adverse effects
Sedation Children and infants: cause excitement Dry mouth Blurred vision Tachycardia Urinary retention Hallucinations
Chlorpheniramine - Clinical use
Allergic reactions to pollen, mold, and other environmental allergens
Dimenhydrinate, Meclizine - Clinical use
Vertigo
Prevent motion sickness
Diphenhydramine, Hydroxyzine, Promethazine - Clinical use
Induce sleep, pre-op sedation.
Distress from severe pruritus
Doxepin - Clinical use
Antidepressant and anxiolytic effects
Insomnia treatment (low doses)
Induce sleep, preoperative sedation
Distress from severe pruritus
Doxylamine - Clinical use
With vitamin B6 for morning sickness in pregnant women
Which 1st generation antihistamines must be cautiously used against heavy machinery in patients taking the drug
Diphenhydramine
Hydroxyzine
Promethazine
Doxepin
2nd generation antihistamines + administration
Cetirizine Fexofenadine Loratadine Desloratadine Astemizole (Removed from market) Terfenadine (Removed from market)
Oral or parenteral
2nd generation antihistamines - Clinical use
Cause little or no sedation and are preferred for the treatment of allergic reactions
Lack antiemetic activity
Does 2nd generation antihistamines cross BBB?
No
Which 2nd generation antihistamine can cause some sedation?
Cetrizine
Intranasal antihistamine
Azelastine
Azelastine - Clinical use
Allergic rhinitis
Azelastine - Interaction and Contraindication (Caution)
Metabolized by cytochrome P450 enzymes to active metabolite, desmethylazelastine.
Caution against heavy machinery in patients taking the drug
Azelastine - Adverse effects
Rare: Dizziness Drowsiness Headache Fatigue Nasal irritation Dry mouth Weight gain
Ophthalmic antihistamines
Levocabastine
Epinastine
Olopatadine
Ketotifen
Ophthalmic antihistamines - Clinical use
Temporary relief of symptoms of conjunctivitis
Levocabastine, Epinastine, Olopatadine - MoA
Selective H1 antagonist
Ketotifen - MoA
Selective, noncompetitive H1 antagonist and mast cell stabilizer
Levocabastine, Epinastine, Olopatadine - Clinical use
Seasonal allergic conjunctivitis
Ketotifen - Clinical use
Prevention of itching of the eye in allergic conjunctivitis
Ophthalmic antihistamines - Adverse effects
Transient stinging & burning of eyes
Serotonin agonists
Buspirone Sumatriptan Triptans Ergot drugs Cisapride (Removed from market) Tegaserod (Removed from market) Lorcaserin Flibanserin
Which serotonin agonist is a partial agonist?
Buspirone
Buspirone - MoA
Acts at 5-HT1A receptor
Buspirone - Clinical use
Anxiety
Depression
Sumatriptan (Triptans), Ergot drugs - MoA
Acts at 5-HT1D/1B receptor
Sumatriptan (Triptans), Ergot drugs - Clinical use
Migraine headaches