lec 1 Anti histamines and anti cough medications

Question 1

clinical pharmacology of histamine:

Answer 1

-provocative test of bronchial hyperractivity
-Shouldnt give to patients with asthma

Question 2

Physiologic histamine antagonists:

Answer 2

-epinephrine:
-have smooth muscle action opposite to histamine
-used in anaphylaxis injections

Question 3

Release inhibitors of histamine:

Answer 3

-Cromolyn and nedocromil
-used to treat asthma

beta 2 adrenoreceptor agonist also reduce histamine release.

Question 3

H1- receptor mediates:

Answer 3

H1 receptors mediate :
-allergic rhinitis
-urticaria
-bronchoconstriction
-asthma
-anaphylaxis
-conjunctivitis (IPAT)

Question 4

Chemistry and pharmacodynamics of H1 receptor antagonists:

Answer 4

-first generation is most likely to block autonomic receptors
-2nd generation are less distributed in CNS

Question 5

Effects of antihistamine on cholinergic receptors:

Answer 5

-Dry mouth
-urinary retention
-sinus tachycardia (affect SA node)

diphenhydramine and promethazine

Question 6

Effect of A-H on adrenergic receptors:

Answer 6

-hypotension
-dizziness
-reflex tachycardia

by promethazine

Question 7

effect of A-H on serotonin receptors:

Answer 7

Increased appetite

by cyproheptadine

Question 8

All antihistamine effects on H1 receptors:

Answer 8

-decreased allergic reactions
-decreased neurotransmission in CNS
-decreased cognitive and psychomotor reflex
-increased sedation and appetite

Question 9

3 important drugs

Answer 9

Diphenhydramine:
-first gen
-produces sedation
-treats motion sickness

Loratidine and desloratidine:
-second generation
-nonsedating
-given for rhinitis

Cetrizine and levocitrizine:
-2nd gen
-causes sedation
-treats urticaria and allergies

Question 10

which 2 second generation drugs are used that cause less drowsiness:

Answer 10

-fexofenadine
-Loratidine

Question 11

Allergic and inflammatory condition treatment:

Answer 11

-oral antihistamines used for rhinitis and urticaria

-Ophtalamic antihistamines like:
azelastine, olopatidine, kitotifen
treat allergic conjunctivitis

-diphenhydramine to treat atopic dermatitis—- sedative

H1 blockers arent the main treatments for bronchial asthma

Question 12

Motion sickness and nausea treatment:

Answer 12

-taken along with scopalamine antimuscarinic agent.
-taken before symptoms

-cyclizine
-diphenhydramine- sedative
-hydroxyzine-sedative
-meclizine
-promethazine-sedative

Question 13

Non sedative first gen:

Answer 13

-cyclizine
-meclizine

Question 14

Insomnia treatment:

Answer 14

-2nd gen have no insomia management

First gen:
Diphenhydramine and doxylamine

Question 15

Adverse effects of first generation:

Answer 15

vertigo
drowsiness
dry mouth
increased appetite
urinary retention
tachycardia
hypotension

Question 16

Treat the underlying cause of cough:

Answer 16

1)Asthma and sputum cough- ICS inhaled corticosteroids
2) Non-asthmatic cough- anticholinergic therapy
3) sinusitis- antibiotics, nasal decongestants, intra nasal steroids

Question 16

1)Opiates

Answer 16

-Codeine-postviral cough
-Morphine and methadone: for bronchial carcinoma

Question 17

2) Dextromethorphan

Answer 17

-N-methyl-D-aspartate receptor antagonist
-poorly effective
-can cause hallucinations can be abusive

Question 18

miscallaneous medications:

Answer 18

1)Guanifesein - aid secretion of sputum
2)Benzonatate: supress cough action
adv effects: dizziness, numbness of the tounge mouth and throat.