respiratory unit A

Question 1

1st generation antihistamines

Answer 1

Benadryl (diphenhydramine)

Phenergan (promethazine)

Question 2

Indications for Benadryl

Answer 2

Flu, cold, allergy symptoms
Insomnia, anxiety
Anaphylaxis
Motion sickness
Parkinsonism
Pruritis

Question 3

MOA of Benadryl

Answer 3

Competes with histamine for receptor sites on effector cells. Blocks both histaminic and muscarinic receptors

Question 4

BBW for promethazine

Answer 4

Serious behavioral and other adverse effects in children less than 2.

Question 5

2nd generation antihistamines

Answer 5

Zyrtec (cetirizine)
Allegra (fexofenadine)
Loratadine (Claritin)

Question 6

MOA of 2nd generation antihistamines

Zyrtec, Allegra, Claritin

Answer 6

H1RA - blocks histamine receptors more peripherally. Large molecules with low lipid solubility so they cannot cross the BBB. Little affinity to H1 receptors in the brain.

Question 7

MOA of oral decongestants

Answer 7

Activate alpha-1 adrenergic receptors leading to vasoconstriction of nasal blood vessels.

Question 8

oral decongestant

Answer 8

Sudafed (pseudoephedrine)

Phenyleprine (Neo-synephrine)

Question 9

Nasal decongestants

Answer 9

Afrin (Oxymetazoline)

Question 10

MOA of nasal decongestants

Afrin

Answer 10

Stimulates smooth muscle alpha adrenergic receptors producing vasoconstriction

Question 11

opioid antitussives

Answer 11

Codeine

hydrocodone

Question 12

MOA of opioid antitussives

Answer 12

Act in the CNS to elevate cough threshold

Question 13

Nonopioid antitussives

Answer 13

dextromethorphan (Robitussin, Delsym)
Diphenhydramine (Benadryl)
Benzonatate (Tessalon)

Question 14

MOA of dextromethorphan

Answer 14

Blocks receptors for N-methyl-D-aspartate (NMDA) in the brain and spinal cord.

Question 15

How does benzonatate (Tessalon) work?

Answer 15

Suppresses cough by decreasing the sensitivity of respiratory tract stretch receptors.

Question 16

Prolongs QT interval

Answer 16

Allegra (fexofenadine)

Question 17

Intranasal antihistamines

Answer 17

Azelastine (Astelin)

Question 18

MOA of intranasal antihistamines

Astelin

Answer 18

Compete with H1-receptor sites and inhibit the release of histamine and other mediators involved in allergic response

Question 19

Leukotrine modifiers

Answer 19

montelukast (Singulair)

Zafirlukast (Accolate)

Question 20

BBW for leukotrine modifiers

Answer 20

Agitation, depression, hallucinations, insomnia, tremor, dream abnormalities, irritability

Question 21

Can be used in children 6 months of age and older for allergic rhinitis

Answer 21

Singulair

Question 22

Approved for asthma in children 12 months and older

Answer 22

Singulair

Question 23

Nasal corticosteroids

Answer 23

Fluticasone (Flonase)

Question 24

How long does it take for intranasal corticosteroids to be effective?

Answer 24

5 days - give oral antihistamine for first 5 days