Cold and Allergy medications Flashcards
What cold medication is used to limit the symptoms of nasal congestion?
- Pseudoephedrine (sudafed)
What is the MOA of Sudafed?
It’s a non-specific alpha and beta adrenergic receptor agonist
What are side effects of sudafed?
1.
what receptors does the sympathetic nervous system act on?
adrenergic receptors – alpha & beta
What are the main effects of sympathetic system?
- fight or flight response
- tachycardia
- bronchodilation
- mydriasis (pupil dilation)
- decrease secretions (dry)
Pneumonic: My Bro Dilates Too Damn Fuckn Fast
what are 2 unique ocular side effects of sudafed?
- diplopia
- blurred vision
List the steps in histamine release?
- IgE antibodies bind to Fc receptors on the surface of mast cells & basophils, making them IgE-sensitized mast cells.
- Exposure to allergen leads mast cell degranulation, which is release of histamine, platelet activating factor, leukotrienes, kinins.
What are the types of histamine receptors? Where are each located?
- H1 receptor –> located in smooth muscle of bronchi, BV, intestines.
- H2 receptor –> located in gastric parietal cells, heart, pulmonary BV & cells of the immune system.
Activation of H1 receptors causes what?
- itching
- vasodilation
- increased vascular permability
- contraction of smooth muscle in GI tract
Activation of H2 receptors causes what?
- itching
- vasodilation
- m,mucous discharge
- gastric secretion
what is the primary histamine receptor in the eye? What does it cause to the eye?
- H1
- itching, tearing, chemosis of the conj & eyelids, hypermia of conj BV, papillary rxn.
What is the MOA of H1 antihistamines?
Block interaction between histamine and the histamine receptor (H1).
Difference between 1st and 2nd generation antihistamines?
1st gen –> easily enter the brain thus causes CNS issues. 2nd gen do not.
* Main CNS issue is sedation.
List 4 first gen systemic antihistamines drugs.
- diphenhydramine (benadryl)
- chlorpheniramine
- brompheniramine
- promethazine
what are the SE of 1st gen systemic antihistamines?
- sedation
- dizziness
- insomia
- anticholinergic effects (mydriasis, dry eyes & mouth, tachycardia)
what are the clinical indications for 1st gen systemic antihistamine?
- allergic skin rxns (hives, contact dermatitis)
- motion sickness (prophylactic)
Specific Ocular Side effects to promethazine?
- corneal epithelial keratopathy
- corneal endothelial pigmentation
- lenticular changes
- pigmentary retinopathy
what is the only H1 topical antihistamine available?
- Emedastine
List 3 2nd gen systemic H1 antihistamine.
- loratadine (claritin)
- fexofenadine (allegra)
- cetirizine (zyrtec)
what are the clinical indications for 2nd gen systemic H1 antihistamines?
- allergic rhinitis
- chronic urticara (hives)
what are SE of 2nd gen systemic H1 antihistamines?
- less CNS effects
- less adrenergic effects
what is a unique SE of ceterizine?
oculogyric crisis (abnormal EOM contractions)
MOA for topical mast cell stabalizers work?
- act on exposed mast cells & inhibit their degranulation by preventing calcium influx upon re-exposure to the antigen –> not as effective in acute allergic symptoms
How long does it take a mast cell stablizers to work?
- takes a couple of days to weeks
What are some clincal indications for topical mast cell stabilizers?
- chronic allergic conjunctivitis
- vernal conjunctivitis
- atopic keratoconjunctivitis
List 4 topical mast cell stabilizers.
- cromolyn sodium
- lodoxamine
- pemirolast
- nedocromil
What are the benefits of topical mast cell-antihistamine combinations?
- good for acute and long term managment of allergic conjunctivitis.
List 6 topical mast cell-antihistamine combination drops. what is the penumonic for it?
- bepptastine (Bepreve)
- epinastine (Elestat)
- ketotifen (Zaditor)
- olopatadine 10% (Patanol)
- azelastine (Optivar)
- olopatadine 20% (Pataday)
Pneumonic: BEZPOP
