Pharmacotherapy of the Upper Airway

Question 1

Antihistamines are primarily used in ___________.

Answer 1

allergic rhinitis

Question 2

Physiologically, decongestants are ___________.

Answer 2

vasoconstrictors

Question 3

Decongestants are primarily used to treat _________.

Answer 3

allergic rhinitis and viral colds

Question 4

The cough reflex is controlled by ___________.

Answer 4

the vagus nerve

Question 5

What are the vascular effects of histamine?

Answer 5

Vasodilation, hypotension, reflex increase in heart rate, and increased permeability

Question 6

What are the GI effects of histamine?

Answer 6

Contraction and secretion of gastric acid

Question 7

Histamine stimulates _________ in the lungs.

Answer 7

bronchoconstriction

Question 8

On the neurons, histamine stimulates __________.

Answer 8

itching

Question 9

Excessive histamine release is treated with __________.

Answer 9

epinephrine

Question 10

________ is the non-drowsy alternative to dramamine.

Answer 10

Meclizine

Question 11

Histamine receptors come in two types: H1 and H2. Most are H1, but which two receptors are H2?

Answer 11

Cardiac (which is vasodilatory) and the acid-secreting GI receptors

Question 12

First-generation antihistamines bind to ________, while second-generation antihistamines are __________.

Answer 12

both H1 and non-H1 receptors; H1 selective

Question 13

How are second-generation antihistamines non-drowsy?

Answer 13

They are more selective for H1 and they don’t penetrate the blood-brain barrier as well.

Question 14

What four symptoms occur from blocking muscarinic receptors?

Answer 14

Can’t see (blurred vision)
Can’t pee (urinary retention)
Can’t shit (constipation)
Can’t spit (dry mouth)

Question 15

Overuse of antihistamines is not associated with rebound _________.

Answer 15

congestion

Question 16

Mast cell histamine receptors have a ________ role in viral cold infections.

Answer 16

minor

Question 17

Topical decongestants stimulate ________, leading to vasoconstriction in the nasopharynx.

Answer 17

alpha-1 receptors (adrenergic)

Question 18

Name two topical decongestants.

Answer 18

Oxymetazoline (Afrin) and phenylephrine

Question 19

What are two common oral decongestants?

Answer 19

Pseudophedrine and phenylephrine

Question 20

What would be a physiologic antagonist of histamine in the lungs?

Answer 20

Epinephrine
Albuterol
Anything that stimulates ß2 receptors

Question 21

What generation antihistamines are used for motion sickness, and why?

Answer 21

First, because they block H1 and muscarinic receptors

Question 22

What would you give to a nauseated pregnant woman?

Answer 22

First-generation anti-histamine

Question 23

Anti-histamines can have paradoxical excitation in _________.

Answer 23

children

Question 24

CNS depression is mediated by the _________ effect of anti-histamines.

Answer 24

anticholinergic

Question 25

Overuse of decongestants can lead to _________.

Answer 25

rebound congestion

Question 26

Dextromethorphan is a ___________.

Answer 26

cough suppressant

Question 27

NSAIDs are effective for coughs that _________.

Answer 27

arise from inflammation due to viral infections

Question 28

Anti-histamines are metabolized __________.

Answer 28

hepatically

Question 29

First-generation anti-histamines, particularly promethazine, can have _________ as a side effect.

Answer 29

postural hypotension

Question 30

Guaifenesin is an ____________.

Answer 30

expectorant