URI Pharm

Question 1

histamine

Answer 1

substance involved in nerve transmission, capillary dilation, smooth muscle contraction, gastric acid secretion, and HR control

Question 2

what is H1?

Answer 2

receptors which mediate smooth muscle contraction and capillary dilation –> target for traditional allergy meds

Question 3

what is H2?

Answer 3

mediation heart rate and gastric acid secretion

Question 4

what can release of excessive histamines result in?

Answer 4

anaphylaxis and severe allergic symptoms

Question 5

H2 blockers

Answer 5

–cimetidine, rantidine, famotidine, nizatidine
–act on GI system
–GERD treatment most common

Question 6

H1 blockers

Answer 6

–can be sedating and non-sedating
–usually treat nasal allergies, seasonal allergies, sneezing, runny nose
–palliative, not curative

Question 7

MOA of H1 blockers

Answer 7

bind to H1 receptors and block histamine release

Question 8

contraindications of H1 blockers

Answer 8

–closed angle glaucoma
–cardiac disease
–kidney disease
–HTN
–bronchial asthma
–COPD
–PUD
–seizures
–BPH
–pregnancy

Question 9

example of sedating histamines

Answer 9

diphenhydramine

Question 10

indications for sedating antihistamines

Answer 10

–mild allergic reactions
–motion sickness
–insomnia

Question 11

routes for sedating antihistamines

Answer 11

PO or IV

Question 12

NSG implications for sedating antihistamines

Answer 12

–monitor closely for dizziness when ambulating
–monitor for urinary retention
–constipation

Question 13

sedating antihistamine warning

Answer 13

avoid driving and activities requiring mental alertness

Question 14

examples of non-sedating antihistamines

Answer 14

–loratidine
–fexofenadine
–cetirizine

Question 15

indications for non-sedating antihistamines

Answer 15

–allergic rhinitis
–chronic idiopathic urticaria

Question 16

side effects for non-sedating antihistamines

Answer 16

–fewer SE
–less drowsiness and fatigue

Question 17

route for non-sedating antihistamines

Answer 17

PO

Question 18

examples of sympathomimetics

Answer 18

–phenylephrine
–pseudophedrine

Question 19

indications for sympathomimetics

Answer 19

–reduce nasal congestion
–allergic rhinitis
–sinusitis
–common cold

Question 20

MOA of sympathomimetics

Answer 20

–mimics action of SNS
–activates alpha1-adrenergic receptors = vasoconstriction of blood vessels, causing nasal turbinates to shrink and opens nasal passages

Question 21

side effects of sympathomimetics

Answer 21

–all r/t CNS stimulation
–agitation
–insomnia
–anxiety
–tachycardia
–heart palpitations

Question 22

patient education for sympathomimetics

Answer 22

–do not use for more than 4 days = rebound nasal congestion if abruptly stopped

Question 23

specifics of pseudophendrine

Answer 23

–potential for abuse
–meth
–OTC, but behind the counter
–purchasing limits per person

Question 24

examples of antitussives

Answer 24

–dextromethorphan
–codeine
–benzonatate

Question 25

indication for antitussives

Answer 25

cough suppressant

Question 26

MOA for antitussives

Answer 26

directly suppresses the cough reflex in the brain

Question 27

routes for antitussives

Answer 27

--PO --syrups/sprays/lozenges

Question 28

side effects for antitussives

Answer 28

CNS depressant --do not take with other CNS depressants

Question 29

example of expectorant

Answer 29

guaifenesin

Question 30

indication for expectorants

Answer 30

decrease mucus in colds, bronchitis, etc.

Question 31

MOA for expectorants

Answer 31

reduction in surface tension of secretion helping to thin mucus, making it easier to expectorate

Question 32

side effects of expectorants

Answer 32

few, mild GI distress

Question 33

specifics for expectorants

Answer 33

--encourage fluid to help thin secretions as well --be careful in patients with chronic cough/asthma

Question 34

example of mucolytics

Answer 34

acetylcysteine

Question 35

indication for mucolytics

Answer 35

bronchopulmonary disease, CF

Question 36

MOA for mucolytics

Answer 36

decreases viscosity of mucus, making it easier to cough

Question 37

side effects for mucolytics

Answer 37

--bronchospasm may occur --smells terrible

Question 38

specifics for mucolytics

Answer 38

--monitor lung sounds closely --given via nebulizer or through trach