Block V- Pulm Allergy Drugs

Question 1

What drugs all block degranulation and mediator release of Histamine?

Answer 1

• Isoproterenol
• Theophylline
• Epinepherine
• Cetizine
• Cromolyn

Question 2

What is an accurate index of endogenous histamine levels?

Answer 2

N-methylhistamine in urine

Question 3

Which histamine receptors are located post synaptically

Answer 3

H1 and H2

Question 4

which histamine receptors are located presynaptically?

Answer 4

H3

Question 5

where are all histamine receptors found?

Answer 5

the brain

Question 6

which histamine receptors are found in the periphery?

Answer 6

H1 and H2

Question 7

Where are H1 receptors?

Answer 7

Smooth muscle

endothelium

Question 8

Where are H2 receptors?

Answer 8

gastric mucosa
cardiac muscle
vascular smooth muscle

Question 9

where are H3 receptors?

Answer 9

presynaptic

Question 10

Where are H4 receptors?

Answer 10

blood cells in bone marrow and circulation

-mediate chemotaxis of eosinophils and mast cells

Question 11

What are the three types of drugs to block histamine actions?

Answer 11

• physiological antagonists
• release inhibitors
• Receptor antagonists

Question 12

What are the clinical indications for H1 antagonists?

Answer 12

• allergic rhinitis
• utricaria
• motional sickness
• “cold pills”
• sleep aids

Question 13

What are contraindications of H1 antagonist?

Answer 13

children under 4

Question 14

What are contraindications of Fexofenadine (Allegra)

Answer 14

• Glaucoma
• urinary retention
• MAO inhibitors

Question 15

What are contraindications of Loratadine? (claratine)

Answer 15

• pregnancy

- lactation

Question 16

What is one of the most potent anti-histamines?

Answer 16

Doxepin (Sinequan)

-anti depressent

Question 17

What are adverse effects of H1 blockers?

Answer 17

anorexia
N/V
constipation
diarrhea
epigastric distress
decreased alertness
impaired ability to concentrate
drowsiness
muscular weakness 
Blood dyscrasias

Question 18

What are signs of H1 blocker overdose?

Answer 18

antichoinergic effects
-dry mouth, palpitations, chest tightness, urinary retention, visual disturbances, convulsions, hallucinations, respiratory depression, fever, hypotension, mydriasis

Question 19

what are contraindications of Diphenhydramine?

Answer 19

-patients with asthma and COPD because of the anticholinergic actions

Question 20

How do you treat mild anaphylaxis reactions?

Answer 20

epinephrine

• apply a tourniquet to the injection site and inject epi into the site to reduce systemic absorption of the antigen
• oral antihistamine for 24 hour

Question 21

How do you treat severe anaphylaxis reactions?

Answer 21

• diphenhydramine IV and epinephrine
• then long acting epi
• oral antihistamine for 24 hours

Question 22

How do you treat the most severe anaphylaxis reactions?

Answer 22

• IV fluids
• Epi slowly
• antihistamines

Question 23

Which antihistamines cross the BBB?

Answer 23

Fexfenadine
Loratidine
Citirizine

Question 24

Which antihistamines are OTC?

Answer 24

Diphenhydramine

Chlorpheniramine

Question 25

how are HI antagonists eliminated?

Answer 25

hepatic elimination

Question 26

Which are the first generation H1R antagonist?

Answer 26

• Diphenhydramine

- Chlorpheniramine

Question 27

Which drug is preferred for motion sickness?

Answer 27

-Dimenhydrinate

Question 28

Which are the second generation H1R antagonists?

Answer 28

• Fexofenadine
• Loratindine
• Citrizine