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Chapter 189 - Antihistamines Flashcards

1
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

_____ antihistamines are _____ agonists that reversibly bind and stabilize the inactive form of the histamine receptor, thereby favoring the inactive state.

A

Both H1 and H2 antihistamines are inverse agonists that reversibly bind and stabilize the inactive form of the histamine receptor, thereby favoring the inactive state.

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2
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

_____ agents are relatively lipophilic, which enhances penetration of the blood–brain barrier and leads to sedation.

A

First-generation H1 agents are relatively lipophilic, which enhances penetration of the blood–brain barrier and leads to sedation.

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3
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

_____ antihistamines may interact with other drugs metabolized by the hepatic cytochrome P450 system leading to drug–drug interactions.

A

First-generation H1 antihistamines may interact with other drugs metabolized by the hepatic cytochrome P450 system leading to drug–drug interactions.

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4
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

_____ antihistamines have poor penetration of the blood–brain barrier and thus are less sedating.

A

Second-generation H1 antihistamines have poor penetration of the blood–brain barrier and thus are less sedating.

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5
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

_____ antihistamines bind selectively to peripheral H1 receptors and have fewer CNS effects.

A

Second-generation H1 antihistamines bind selectively to peripheral H1 receptors and have fewer CNS effects.

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6
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

_____ antihistamines require less hepatic metabolism and thus are less likely to interact with other medications.

A

Second-generation H1 antihistamines require less hepatic metabolism and thus are less likely to interact with other medications.

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7
Q

TABLE 189-1
Basic Pharmacology of Antihistamines

Fill in the blanks

There is no evidence of _____ or _____ to first-generation or second-generation antihistamines.

A

There is no evidence of tolerance or tachyphylaxis to first-generation or second-generation antihistamines.

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8
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Acute urticaria

A

H1 Antihistamines

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9
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Chronic idiopathic urticarial

A

H1 Antihistamines

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10
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Physical urticarias and dermatographism

A

H1 Antihistamines

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11
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Pruritus associated with histamine release

A

H1 Antihistamines

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12
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Symptoms of mastocytosis

A

H1 Antihistamines

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13
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Acute allergic reactions

A

H2 Antihistamines

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14
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Chronic urticaria (as a second-line agent)

A

H2 Antihistamines

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15
Q

TABLE 189-2 vs TABLE 189-6
Indications for Treatment with H1 Antihistamines vs Dermatologic Indications for Treatment with H2 Antihistamines

Systemic symptoms associated with mastocytosis (especially GI related)

A

H2 Antihistamines

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16
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Chlorpheniramine

A

Hepatic impairment

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17
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Cyproheptadine

A

Hepatic impairment

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18
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Diphenhydramine

A

Hepatic impairment

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19
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Hydroxyzine

A

Hepatic impairment

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20
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Tripelennamine

A

Hepatic impairment

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21
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Acrivastine

A

Renal impairment

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22
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Azelastine

A

Renal and hepatic impairment

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23
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Cetirizine

A

Renal and hepatic impairment

24
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Desloratadine

A

Renal and hepatic impairment

25
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Ebastine

A

Renal impairment

26
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Fexofenadine

A

Renal impairment

27
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Levocetirizine

A

Renal and hepatic impairment

28
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Loratadine

A

Renal and hepatic impairment

29
Q

TABLE 189-3
Dosing Regimens for H1 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Mizolastine

A

Hepatic impairment

30
Q

TABLE 189-7
Dosing Regimens for H2 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Cimetidine

A

Renal or hepatic impairment

31
Q

TABLE 189-7
Dosing Regimens for H2 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Ranitidine

A

Renal impairment

32
Q

TABLE 189-7
Dosing Regimens for H2 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Famotidine

A

Renal impairment

33
Q

TABLE 189-7
Dosing Regimens for H2 Antihistamines

CONDITIONS REQUIRING
DOSAGE ADJUSTMENT
Hepatic vs Renal vs Both

Nizatidine

A

Renal impairment

34
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Chlorpheniramine

A

1st gen H1

35
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Cyproheptadine

A

1st gen H1

36
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Diphenhydramine

A

1st gen H1

37
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Hydroxyzine

A

1st gen H1

38
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Tripelennamine

A

1st gen H1

39
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Acrivastine

A

2nd gen H1

40
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Azelastine

A

2nd gen H1

41
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Cetirizine

A

2nd gen H1

42
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Desloratadine

A

2nd gen H1

43
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Ebastine

A

2nd gen H1

44
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Fexofenadine

A

2nd gen H1

45
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Levocetirizine

A

2nd gen H1

46
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Loratadine

A

2nd gen H1

47
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Mizolastine

A

2nd gen H1

48
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Cimetidine

49
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Famotidine

50
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Ranitidine

51
Q

TABLE 189-3 vs TABLE 189-7
Dosing Regimens for H1 Antihistamines vs Dosing Regimens for H2 Antihistamines

1st gen H1 vs 2nd gen H1 vs H2

Nizatidine

52
Q

TABLE 189-4
Factors for Risk-to-Benefit Assessment of
First-generation H1 Antihistamine Therapy

Risk vs Contraindication

History of cardiac arrhythmias, particularly ventricular arrhythmias

53
Q

TABLE 189-4
Factors for Risk-to-Benefit Assessment of
First-generation H1 Antihistamine Therapy

Risk vs Contraindication

First trimester of pregnancy

54
Q

TABLE 189-4
Factors for Risk-to-Benefit Assessment of
First-generation H1 Antihistamine Therapy

Risk vs Contraindication

Prostatic hypertrophy

55
Q

TABLE 189-4
Factors for Risk-to-Benefit Assessment of
First-generation H1 Antihistamine Therapy

Risk vs Contraindication

Narrow-angle glaucoma

A

Contraindication

56
Q

TABLE 189-4
Factors for Risk-to-Benefit Assessment of
First-generation H1 Antihistamine Therapy

Risk vs Contraindication

Concomitant use of monoamine oxidase inhibitors

A

Contraindication

Fitzpatrick Tables (77 decks)

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