Exam 2: AntiHistamines (+separate lecture), Antifungals, and AntiVirals

Question 1

What are the two cells that produce Histamine?

Answer 1

Basophils and Mast Cells

Question 2

Histamine- General Dilation = H_ receptor…Facial Dilation = H__ receptor

Answer 2

Gen= H1… facial H2

Question 3

Respiratory tract = H__ receptors, ________ papillary smooth muscle.

Answer 3

H1…constricts

Question 4

For the most part the GI tract is H__ receptors, except for the Illium = H__.

Answer 4

H2….illium=H1

Question 5

Glandular System = H__ receptors

Answer 5

H1

Question 6

What are the Lewis triple responses? They are mediated by H__ receptors.

Answer 6

Redness, Flare, Swelling… H1

Question 7

Dermal, mostly by H__.

Answer 7

H1

Question 8

Which type of antihistamine blocker? Clinical Uses: Allergic rhinitis

Answer 8

H1

Question 9

Which type of anti histamine blocker? CNS

Answer 9

H1

Question 10

Which histamine blocker? Mechanism of action = competitive blockage of H__ receptors (GI tract), Reduces intracellular concentration of cAMP, Protein kinase (in parietal cells) that drives the H+/K+-ATPase pump is shut down, Inhibits basal and nocturnal gastric acid secretion (evoked by histamine)

Answer 10

H2

Question 11

Whichi Receptor blocker?Clinical uses:

Answer 11

H2

Question 12

Adverse Effects of AntiHistamines (3)

Answer 12

Drowsiness, xerostomia, and dry mucous membranes

Question 13

Benedryl is an ______amine.

Answer 13

EthanolAmine

Question 14

_______ AND ______ need to be in the dental office emergency kit, it helps with anaphylaxis (along with Epi).

Answer 14

Benadryl…Chlor-TriMetOn

Question 15

Zyrtec’s main side effect

Answer 15

Sedation

Question 16

_______ and ______ are non drowsy anti-histamines.

Answer 16

Claritin and Allegra

Question 17

What happens if we add H1 and H2 blockers together?

Answer 17

all CARDIOVASCULAR effects of histamine are blocked!

Question 18

What is an example of an H2 blocker?

Answer 18

Zantac

Question 19

H__ blockers dont cure the whole problem of peptic ulcers, because they don’t kill H Pylori, but they DO stop acid production.

Answer 19

H2..Zantac

Question 20

Are the H2 side effects a big deal?

Answer 20

No, minor-headache, coinfusion, GYNACOMASTIA, impotense

Question 21

Which H2 blocker is the safest? Which has the most adverse effects?

Answer 21

safe=ranitidine (Zantec), adverse=ci-met-idine (Tagamet)

Question 22

What is the Mast cell stabilizing drug?

Answer 22

cro-mo-lyn (Gastrocrom)

Question 23

Angular Cheilitis- what type of infection?

Answer 23

fungal

Question 24

______ anti-fungals = chronic, extensive mucocutaneous candidiasis…..vs….________ anti-fungals = local candidiasis

Answer 24

systemic…topical

Question 25

Which anti-fungal delivery system is preferred? Along those lines—______ = sweetened vaginal preps with cocoa butter • Caution in patients with diabetes(contain sugar)……_______ = lozenge-type delivery

Answer 25

Topical…..Troches…..Pastilles

Question 26

What is the most popular Anti-fungal drug? What’s its mech?

Answer 26

NY-Statin (Mycostatin)…binds to Sterols in fungal cell wall

Question 27

Is there good or poor complacence for anti-fungals?

Answer 27

poor

Question 28

What anti-fungal can we use when NYStatin is not effective?

Answer 28

Clot-Rim-Az-ole

Question 29

______ anti-fungals are SYSTEMIC anti-fungals. TRY TO AVOID for these 3 reasons!

Answer 29

Azole…Resistance, Interactions, Hepatotoxic

Question 30

What is a popular Parenteral anti-fungal, given to HIV patients?

Answer 30

AMPHO-tericin

Question 31

For angular cheilitits, consider adding a ______ to the anti-fungal. For example _______ and _______.

Answer 31

steroid…NyStatin and TriAmCinOlone (you’ve been on that one!)

Question 32

WHEN IS THE OPTIMAL TIME TO TAKE AN ANTIVIRAL?

Answer 32

Prodromal stage-very FIRST signs of upcoming outbreak!

Question 33

A Primary viral infection is ________ whereas ______ is a recurrent infection.

Answer 33

Primary-gingivostomatitis…herpes labialis

Question 34

Viral infection treatment is primarily ________.

Answer 34

pallative

Question 35

Viral lesions are highly ________ and can last for about ___ days.

Answer 35

contagious….10 days

Question 36

Drug considerations for Anti-Viral: ________ are ineffective for treatment of viral herpes lesions…..Systemic ________ are CONTRAINDICATED for use during viral illnesses

Answer 36

Antibiotics….corticosteroids (VIRUS-NO, FUNGUS-YES)

Question 37

_______, ______, ______ can all initiate viral lesions

Answer 37

Sunlight, stress, trauma can all initiate lesions

Question 38

All drugs for recurrent Herpes Simplex outbreaks end in “_____”

Answer 38

“vir”

Question 39

What Anti-Viral am I? Inhibits viral DNA polymerase preferentially, inhibiting viral replication….Drug is incorporated into viral DNA…Available systemically and topically….Immunocompromised patients….Systemic: recurrent mucosal and cutaneous herpes simplex infections…. Topical: herpes labialis, mucocutaneous infections

Answer 39

Acyclovir

Question 40

What are the 4 dose forms of Acyclovir?

Answer 40

Oral, Cream, Suspension, Injection

Question 41

What are the 2 main side effects of Anti-Virals?

Answer 41

Bone marrow suppression and therefore blood dyscrasias