Respiratory Drugs: Anti-Histamines Flashcards
This patient has to avoid a lot of negative food and drug interactions when prescribed this medication.
What medication have this drug interaction?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Hypersensitivity is an allergy. The allergen attaches to _________ that are located on target cells in the host tissue.
H1 receptors
This medication can be given Sub Q for local reaction after a medication has infiltrated and it will make that go away.
Diphenhydramine/Benadryl 1st and 2nd Generation
Less drowsiness
What medication have this therapeutic effect?
Fexofenadine / Allegra - 2nd Generation Antihistamine
Histamine contributes to the inflammatory response by causing inflammation this results in what three physiological changes?
Vasodilation which causes increased blood flow to the affected area.
Increased vascular permeability which causes edema.
Constriction of bronchial smooth muscle which decreases lumen of airway.
Drowsiness (Caution - No Driving)
Many anti-cholinergic side effects > Inhibits Salivation Lacrimation Urination and Defecation (SLUD).
What medication has these side effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
What is the therapeutic classification of Fexofenadine / Allegra ?
2nd Generation Antihistamine
Increased CNS depression with other CNS depressants
What medication have this drug interaction?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Study Tip: CNS Depressants
Ex. Alcohol, Narcotics, and Barbiturates
These increase vasodilation, vascular permeability, and bronchoconstriction.
What inflammatory modulator has this effect in the body?
Prostaglandins
Study Tip: This inflammatory mediator is derived from a chemical called arachidonic acid. Also increases platelet aggregation (clotting), and inhibition of gastric acid secretion (constipation). Also stimulates pain.
Give IM in large muscle (Not given in the deltoid. Where is it administered?)
What medication have these nursing interventions?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Vastus Lateralus
Used to treat seasonal allergies
What medication have this therapeutic effect?
Fexofenadine / Allegra - 2nd Generation Antihistamine
Most important activator of the inflammatory response?
Mast Cells
Pros: Can decrease nasal itching.
Cons: Common in many OTC cold medications can be bad for patients with a respiratory infection.
What medication has these side effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Study Tip: This medication is bad for patients with a respiratory infection because you want the patient to be able to clear the secretions from the airway. Can prevent the patient from getting better.
_______ medications inhibit the inflammatory response.
Antihistamine
Fewer anti-cholinergic side effects. Longer halflife. Can be taken once a day.
What medication has these side effects?
Diphenhydramine/Benadryl - 2nd Generation Antihistamine
Zyrtec
What is the generic name of this 2nd Generation Antihistamine medication?
Saterazine
Less anticholinergic effects
What medication have this therapeutic effect?
Fexofenadine / Allegra - 2nd Generation Antihistamine
_________ that are located in the skin regulate vascular permeability. They do not have cell to cell contact but it modulates the behavior of the cells (Eosinophils, Neutrophils, Basophils, T-cells, and Langerhans cells) because they release the modulators into the blood stream.
Mast cells
Prevention and Treatment of Allergic rhinitis (Irritation of the Nose) and Nasal Itching
What medication have these therapeutic effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Avoid driving (NO FORKLIFTS) when taking this medication Avoid alcohol when taking this medication After taking medication use sugarless candy for dry mouth (to increase salivation) What medication have these nursing interventions?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Study Tip: These are examples of patient education.
PSNS Antagonist.
Causes dry mouth and decreases GI (constipation and urinary retention), Eye (no tears), and Oral secretions.
What medication has these side effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Study Tip: This medication is an Anticholinergic medication
Mast cells degranulate during the inflammatory response releasing the powerful inflammatory modulators __________, _____________, and ______________.
histamines
leukotrienes
prostaglandins
What physiological effects do the inflammatory modulators released from mast cells have in the body?
Vasodilation, Increased vessel permeability, Constriction of bronchial smooth muscle
Study Tip: These effects create less room for airflow which is important for patients in respiratory distress or with respiratory disease.
Non-sedating
Does not affect PSNS.
What medication has these side effects?
Diphenhydramine/Benadryl - 2nd Generation Antihistamine
What are both the generic and trade name of two of the antihistamines a nurse needs to know?
Diphenhydramine (Benedryl)
Fexofenadine (Allegra)
Antitussive
Pre-medication for blood infusions and chemotherapy in case of a bad reaction.
What medication have these therapeutic effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
This causes dilation of blood vessels, increased secretion of acid by the stomach, smooth muscle constriction (e.g., in the bronchi), and mucus production, tissue swelling, and itching (during allergic reactions).
What inflammatory modulator has this effect in the body?
Histamine
Study Tip: The release of histamine from mast cells is a major component of type I hypersensitivity reactions, including asthma.
What is the generic name for the medication Benardyl?
Diphenhydramine
Drowsiness Dizziness Fatigue Nausea / Vomiting Dry mouth Anti-SLUD effects Excitation in children What medication have these side effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
The pathophysiological process by which the immune system destroys, dilutes, or walls off injurious agents and injured tissue occurs when the immune system is activated. Small blood vessels dilate and become permeable. This increases blood flow and permits exudation of plasma and leukocytes. The cells arriving from the blood include monocytes, neutrophils, basophils, and lymphocytes; those of local origin include endothelial cells, mast cells, tissue fibroblasts, and macrophages. Other mediators of inflammation include cytokines, interleukins, and neuropathies.
What inflammatory modulator is responsible for cell-mediated immunity?
Mast Cells
Mast Cells activate inflammatory response after contact with allergen they become activated, they degranulate and they release _________.
histamine
What therapeutic classification of medications are used on the receptors in the lungs to neutralize histamine mediated release of inflammatory mediators and can be used to treat an allergic response?
H1 inhibitors
H1 stabilizers
Study Tip: H1-Histamine Receptor in the Lungs
Histamine is the most potent of the _____________ mediated hypersensitivity.
Immunoglobulin-E
Secreted in response to inflammation or tissue injury. They are powerful bronchoconstrictors and vasodilators and mediate the adverse vascular and bronchial effects of systemic anaphylaxis. What inflammatory modulator has this effect in the body?
Leukotrienes
Study Tip: They have been implicated in the development of the inflammatory responses in asthma, psoriasis, rheumatoid arthritis, and inflammatory bowel disease.
Antihistamines are used to treat ________ because they inhibit histamines actions in the body. Histamine release of inflammatory mediators. Can treat or prevent this response.
Treats allergic reactions.
Allegra
What is the generic name of this 2nd Generation Antihistamine medication?
Fexofenadine
What therapeutic classification of medications are used on the receptors are in the GI system and commonly located in the stomach?
H2 inhibitors
H2 stabilizers
Prevention of motion sickness
Commonly seen in OTC Sleep aids
What medication have these therapeutic effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
1st Generation Antihistamines have more _______ than 2nd Generation Antihistamines.
Side effects
When giving Benardyl PO: administer with food to decrease GI upset
What medication have these nursing interventions?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
________ are located in loose connective tissue and they are very close to blood vessels. They are activated in the inflammatory response after physical injury or in response to chemical agents like toxins like snake, and bee venom. This is just your immune system at work. They release granular contents into into the extracellular matrix and synthesize other chemicals. Once the contents have been released it’s too late to do anything. There are meds that stabilize and prevent them from ever releasing the chemical modulators.
Mast cells
What is the therapeutic classification of Diphenhydramine/Benadryl?
1st or 2nd Generation Histamine blocker (H1 blocker) And 1st or 2nd Generation Antihistamine And 1st Generation: Anti-Cholinergic
Study Tip: Used for the prevention of a histamine response.
PO: onset 15-45 min
IM: onset 15-30 min
IV: Onset immediate
What medication have these pharmacodynamics?
Which route would you give for an acute allergic reaction?
Diphenhydramine/Benadryl 1st and 2nd Generation
Route: IV due to immediate onset to open the airway if the patient is presenting with anaphylaxis.
Which of the following is true regarding a second-generation antihistamine?
- Leads to urine retention
- May cause blood dyscrasias (malformations)
- Cause little or no drowsiness
- Is contraindicated in narrow-angle glaucoma
- Cause little or no drowsiness.
Study Tip: First Generation antihistamines lead to urine retention, may cause blood dyscrasias (malformations), and is contraindicated in narrow-angle glaucoma.
Claritin
What is the generic name of this 2nd Generation Antihistamine medication?
Loratadine
H2 blockers decrease gastric secretions.
Route chosen depends on the patients symptoms. This is not used in anaphylaxis. They will use epinephrine because it is more powerful.
What medication have these therapeutic effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Give three examples of CNS depressants?
Ex. Alcohol, Narcotics, and Barbiturates
Take with water or milk, NOT juice.
What medication has this nursing intervention?
Fexofenadine / Allegra - 2nd Generation Antihistamine
Nonsteroidal anti-inflammatory or NSAIDS block the production of __________.
prostaglandins
What is the generic name for the medication Allegra?
Fexofenadine
Thrombocytopenia
What medication have this adverse effects?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Study Tip: Thrombocytopenia is defined as NOT ENOUGH PLATELETS. Puts patient at high risk for bleeding. Monitor Platelet Level.
Avoid using this medication with MAOIs (Monoamine Oxidase Inhibitor)
What medication have this drug interaction?
Diphenhydramine/Benadryl - 1st Generation Antihistamine
Study Tip: This medication is given to people with mental health problems.
What labs would you monitor in a patient that is on Diphenhydramine/Benadryl the 1st Generation Antihistamine?
Monitor Platelet Level.
Could run a CBC.
Monitoring for signs of Thrombocytopenia which is an adverse reaction to this medication. Thrombocytopenia is defined as NOT ENOUGH PLATELETS. Patient at high risk for bleeding.
