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2024 Pharm II > H1/H2/PPI (Ex1) > Flashcards

H1/H2/PPI (Ex1) Flashcards

1
Q

Histamine released from

A

Endogenous
-From basophils and mast cells

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2
Q

Histamine significant effects (2)

A

-Contraction of Airway Smooth muscle
-Secretion of stomach acid

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3
Q

Significant drugs that release histamine (5)

A

Morphine
Mivacurium
Atracurium
Succinylcholine
Protamine

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4
Q

H1 receptor effects (3)

A

-Hyperalgesia
-Inflammatory pain
-Allergic rhino-conjunctivitis symptoms

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5
Q

H2 receptor effects (2)

A

-Elevates cAMP (B1-like stimulation)
-Increase acid volume

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6
Q

Histamine inflammatory effects (H1 and H2) (5)

A

Hypotension
Capillary permeability
Flushing
Prostacyclin release
Tachycardia

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7
Q

H1 receptor antagonist side effects (4)

A

Blurred vision
Urinary retention
Dry mouth
Drowsiness (1st gen)

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8
Q

First gen H1 antagonist drugs (2)

A

Diphenhydramine (Benadryl)
Promethazine (Phenergan)

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9
Q

Second gen H1 antagonists (2)

A

Cetirizine (Zyrtec)
Loratadine (Claritin)

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10
Q

Diphenhydramine trade name

A

Benadryl

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11
Q

Benadryl main uses (3)

A

-Antipuritic
-Pre-treatment for allergies (IVP dye)
-Anaphylactic indications

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12
Q

Benadryl E 1/2 time

A

7-12 hrs

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13
Q

Benadryl benefit in eye surgery

A

Inhibition of oculo-emetic reflex

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14
Q

Benadryl dose

A

25-50 mg IV

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15
Q

Phenergan main use

A

Rescue anti-emetic

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16
Q

Phenergan E 1/2 time

A

9-16 hrs

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17
Q

Phenergan black box warnings (2)

A

-Respiratory arrest in children under 2
-Necrosis from infiltration

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18
Q

Phenergan dose

A

12.5-25 mg IV

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19
Q

Phenergan onset

A

5 minutes

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20
Q

H2 antagonist main uses (2)

A

-Decrease gastric acid volume (release)
-Decrease acidity of gastric acid

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21
Q

H2 antagonist side effects (4)

A

HA/confusion
Diarrhea
Sk-muscle pain
Bradycardia

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22
Q

Downside to prolonged decreased acidity

A

Overgrowth of bacteria in stomach acid

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23
Q

H2 antagonist drugs (3)

A

(-tidine)
-Cimetidine (Tagamet)
-Ranitidine (Zantac)
-Famotidine (Pepcid)

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24
Q

Cimetidine trade name

A

Tagamet

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25
Q

Tagamet metabolism

A

CYP450
Cleared in urine

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26
Q

Tagamet drug interaction effect

A

Strongly inhibits CYP450 => inhibits metabolism of other drugs

27
Q

Tagamet adverse effects (3)

A

Bradycardia
Hypotension
Impotence

28
Q

Tagamet dose

A

150-300 mg IV
1/2 dose in renal impairment

29
Q

Ranitidine trade name

A

Zantac

30
Q

Zantac metabolism

A

Hepatic metabolism, renal clearance

31
Q

Zantac effect on hepatic enzymes

A

No significant interaction

32
Q

Zantac dose

A

50 mg diluted 20 cc over 2 min
1/2 dose for renal impairment

33
Q

Famotidine trade name

A

Pepcid

34
Q

Pepcid metabolism

A

Hepatic metabolism, renal clearance

35
Q

Pepcid effects on hepatic enzymes

A

No interference with p450s

36
Q

Pepcid E 1/2 time

A

2.5-4 hours

37
Q

Pepcid potency

A

Most potency in H2 antagonists

38
Q

Pepcid dose

A

20 mg IV
1/2 dose for renal impairment

39
Q

PPI MOA

A

Irreversibly bind and inhibit proton pumps

40
Q

PPI onset

A

Up to 5 days

41
Q

PPI Main uses

A

Controlling gastric acidity and volume
-better for chronic/longer treatment

42
Q

PPI drug interactions (2)

A

-Inhibits warfarin metabolism
-Blocks enzyme that activates Plavix

43
Q

PPI drugs (4)

A

(-prazole)
-Omeprazole (Prilosec)
-Pantoprazole (protonix)
-Lansoprazole (Prevacid)
-Dexlansoprazole (dexilent)

44
Q

Omeprazole trade name

A

Prilosec

45
Q

Prilosec metabolism

A

Metabolized by CYPs

46
Q

Prilosec dose

A

40 mg in 100cc over 30 min
(Or PO > 3 hrs prior)

47
Q

Prilosec side effects (6)

A

HA
agitation
Confusion
Abd pain
N/V
Flatulence

48
Q

Pantoprazole trade name

A

Protonix

49
Q

Protonix metabolism

A

CYP enzymes

50
Q

Protonix E 1/2 time (comp)

A

Longer than prilosec

51
Q

Protonix dose

A

40 mg in 100cc over 2-15 min

52
Q

Particulate antacid based with

A

Aluminum or magnesium

53
Q

Non-particulate antacids based with

A

Sodium, carbonate, citrate, bicarbonate

54
Q

Antacid MOA

A

Neutralize acid

55
Q

Antacid drug

A

Sodium Citrate (bicitra)

56
Q

Long term acid neutralization problems (2)

A

Leads to inhibited breakdown of food
And acid rebound

57
Q

Long term Magnesium antacid use

A

Neurologic and neuromuscular impairment

58
Q

Sodium based antacid considerations

A

Increased sodium load in hypertensive and cardiac impaired pts

59
Q

Sodium citrate trade name

A

Bicitra

60
Q

Base + acid =

A

Salt, CO2, and H2O

61
Q

Bicitra use

A

Protect against aspiration acid damage, not aspiration

62
Q

Bicitra onset and duration

A

Immediate onset
Lose effect 30-60 min

63
Q

Bicitra dose

A

15-30 mL PO

2024 Pharm II (32 decks)

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