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RS > Pharma 1 > Flashcards

Pharma 1 Flashcards

1
Q

From where is histamine produced and where is it stored

A

mast cells

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2
Q

from what amino acid is histamine produced from and from what enzyme

A

histidine

histidine decarboxylase enzyme

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3
Q

when histamine binds to H1 receptor what does it do

A 
bronchoconstriction 
vascular dilation and increased permeability 
increased in nasal and bronchial mucus
positive inotropic , cramps and diarrhea
itching
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4
Q

when histamine binds to H2 receptor what does it do

A

on parietal cells
HCL production
positive inotropic and chronotropic

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5
Q

ant histamines are more effective in preventing symptoms than reversing them

A

true

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6
Q

main effect of antihistamine

A

decrease allergic rxn
decrease pruritis, sneezing and rhinorrhea
decrease neurotransmission in CNS (sedation and impaired cognitive )

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7
Q

what are the other effects of antihistamine unrelated to H1 block

A

anti cholinergic / antimuscarinic
anti serotenergic
anti alpha adrenergic

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8
Q

antichollinergic like and effect

A

diphenhydramine and promethazine

cant see cant pee cant shit cant spit and tachycardia

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9
Q

antiserotenergic like and effect

A

cyproheptadine

weight gain and increased appetite

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10
Q

anti alpha adrenergic like and effect

A

promethazine

reflex tachycardia and hypotension

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11
Q

what are the indications for the use of antihistamines

A

relief common cold symptoms
motion sickness
insomnia
allergic conditions

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12
Q

what is DOC for motion sickness

A

scopalamine ( antimuscarinic)

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13
Q

what can be used for motion sickness other than DOC

A

H1 blockers
Diphenhydramine
Dimenhydrinate
Cycloxine , meclizine and promethazine

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14
Q

are motion sickness drugs effective if symptoms already present

A

no

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15
Q

H1 blocker inhibits nausea and vomiting mediated by

A

chemoreceptor and vestibular pathway

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16
Q

what does an antiemetic block

A

H1 and M1

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17
Q

Meclizine indications

A

motion sickness and vertigo associated with vestibular disorders

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18
Q

only first generation anti histamines can be used for insomnia ( 2nd generation cant be used)

A

true cuz they have sedative property

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19
Q

what does diphenhydramine do in children

A

paradoxical hyperactivity

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20
Q

are H1 blockers medication of choice for insomnia

A

no

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21
Q

characteristics and examples of first generation anti histamine

A 
cheap 
OTC 
Dirty drugs 
Cross bbb leading to sedation 
Chlorpheniramine and diphenhydramine
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22
Q

characteristics and examples of second generation anti histamine

A

carboxylated so became polar and cannot cross BBB
improved speciificity
s/e headache
Fexofenadine , loratadine and desloratadine

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23
Q

what are the drug interactions of anti histamine

A

cant be used with other CNS depressants or alcohol
cant be used with MAOI
cant be used with choline esterase inhibitors

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24
Q

do oral anti histamine have a fast onset of action

A

yes

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25
Q

are oral anti histamine useful in management of allergic rhinitis symp

A

yes

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26
Q

which generation is used for allergic rhinitis

A

second generation

27
Q

are ophthalmic and nasal antihistamine delivery devices available

A

yes

28
Q

what is a topical intranasal anti histamine

A

olopatadine and azelastine

29
Q

when is the combination of anti histamine and decongestant useful

A

congestion feature of rhinitis
patients have no response
incomplete control of symptoms

30
Q

what are alternatives for oral anti histamine

A 
intranasal corticosteriod 
short acting alpha adrenergic agonist
intranasal cromolyn 
leukotriene receptor antagonist 
intranasal ipratropium
31
Q

example of intranasal corticosteriod

A

fluticasone

32
Q

what is the most effective drug to treat allergic rhinitis

A

fluticasone ( intranasal corticosteriod)

33
Q

onset of action of intranasal corticosteriod and what is smth it improves that anti histamine alone cant

A

3-36 hours

nasal congestion

34
Q

example of short acting alpha adrenergic agonist ( nasal decongestant) and what does it do

A

phenylephrine

constrict arteriole in nasal mucosa and reduce airway resistance ( bronchodilation)

35
Q

example of longer acting alpha adrenergic agonist

A

oxymetazoline

36
Q

what are the formulations of adrenergic agonists available

A

intranasal and oral

37
Q

why rhinitis medicamentosa happens and to which drug

A

intranasal formulation of short acting alpha adrenergic agonist used for more than 3 days leading to rebound nasal congestion

38
Q

how does intranasal cromolyn work

A

mast cell stabilizer

39
Q

to optimize therapeutic effect of intranasal cromyln dosing should begin before how many weeks prior to allergen exposure

A

1-2 weeks

40
Q

what is rebound congestion called

A

rhinitis medicamentosa

41
Q

what is the inferior to other treatments

A

leukotriene receptor antagonist

42
Q

is leukotriene receptor antagonist a reasonable option to be used with patients that have asthma

A

yes

43
Q

what drug relieves rhinorrhea but not sneezing or nasal congestion

A

intranasal ipratropium

44
Q

before treating cough the identification of the cause is important so treat underlying cause

A

true

45
Q

management of cough includes

A

treat underlying cause

cough suppressant

46
Q

what are the antitussive drugs

A

codeine
dextromethorphan
guaifenesin
benzonatate

47
Q

characteristic of codeine

A

naturally occuring opiate
decreases cough center sensitivity in CNS
cause constipation
decrease mucousal secretion

48
Q

characteristics of dextromethorphan

A

synthetic of morphine
decrease cough center sensitivity in CNS
OTC

49
Q

when is dextromethorphan not effective

A

cough due to asthma , smoking and emphysema

50
Q

why do we prefer dextromethorphan over codeine

A

its equally effective but less S/E and less addictive potential

51
Q

what drug is a recreational drug and what does it mean

A

dextromethorphan

hallucinations and euphoria

52
Q

dont give dextromethorphan to child less than

A

4

53
Q

serious life threatening s/e could happen when taking dextromethorphan if

A

MAOI didnt clear out of body ( 14 days to clear)

54
Q

what drug is an expectorant

A

guaifenesin

55
Q

guaifenesin has two formulations single ingredient or in combination with codeine or dextromethrophan

A

true

56
Q

what does guaifenesin does

A

thins mucus and lubricates RS tract

57
Q

what does benzonatate suppress

A

cough reflex in peripheral

58
Q

what is MOA of benzonatate

A

anesthetizes stretch receptors

59
Q

what are adverse effects of benzonatate

A

numbness of tongue mouth throat
dizziness
chocking

60
Q

when benzonatate s/e appear should you eat

A

no

61
Q

benzonatate should be taken at specific doses not need of basis and dont double missed doses

A

true

62
Q

benzonatate shouldnt be given for child less than

A

10

63
Q

what is the age of child benzonatate and dextromethorphan shouldnt be given to

A

10

4

RS (13 decks)

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