Week 4 Study Guide.docx

Week 4 Study Guide.docx - Antihistamine 1st Generation...

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Antihistamine 1 st Generation Examples: diphenhydramine, Brompheniramine [Dimetapp, Bromfed], clemastine [Tavist], chlorpheniramine [Chlor-Trimeton], cyroheptadine [Periactin], hydroxyzine [Atarax and Vistaril] MOA: H1 receptor antagonists block the action of histamine as it is released during the inflammatory response to an antigen (normally histamine is histamine is released from mast cells. But it’s blocked [antagonist]) action restores normal airflow to the upper respiratory system Side Effect: sedating side effect Contraindication: narrow angle glaucoma, lower respiratory tract infection (RTI), peptic ulcer disease (PUD), prostate hypertrophy, MAOIs, Lactation (don’t want to dry them up), kids <6 y.o. Cautions: urinary retention, bronchial asthma, hyperthyroidism, Coronary Vascular disease, HTN d/t anticholinergic effects, Pregnancy B&C Interaction: MAOIs, CNS depressants, tricyclics, antimuscarinics (anticholinergics) Education: do not operate heavy machinery, can cause CNS stimulation in young children Of note: Available OTC, inexpensive, caution not to overdose (anti motion sickness, OTC sleep aids) Diphenhydramine Available: IM, IV, vial, amp, syringe Indications: allergic disorders where PO form is impractical or contraindicated, anaphylaxis adjunct (epinephrine), blood or plasma allergic reactions Contraindication: neonates, premature infants, acute asthma Antihistamine 2 nd Generation Examples: cetirizine[Zyrtec], fexofenadine [Allegra], loratadine[Claritin], desloratidine[Clarinex] Indication: seasonal and perennial allergic rhinitis, allergic conjunctivitis, uncomplicated urticaria, angioedema Contraindication: kids < 6 yo Precaution: Pregnancy B & C, Breastfeeding (enters milk), Interaction: certain antifungals and antibiotics [Macrolides Torsades], CNS depressants and other H1 blockers drowsiness Of note: works better if taken a week before the onset of symptoms, Expensive, some now OTC, well-tolerated Azelastine [Astelin] Indication: allergy relief, seasonal allergic rhinitis and vasomotor rhinitis MOA: H1 blocker and inhibitor of histamine release from mast cells (dual action)+ may also interfere with histamine & leukotriene induced bronchospasm Avoid: CNS depressants, ETOH, cimetidine or other H1 blockers Contraindication: kids <12 years Precaution: pregnancy C Adverse: bitter taste, somnolence, HA, nasal irritation, epistaxis, sneezing, rhinitis Of note: expensive (exclusivity) Decongestants Examples: phenylephrine, pseudoephedrine, oxymetazoline, tetrahydrozoline, phenylpropanolamine Indication: decrease nasal congestion d/t common cold, sinusitis, and allergic rhinitis MOA: alpha adrenergic agonists constrict the nasal arterioles, decrease swelling in the nasal membranes (also systemic effect – constrict GI and urinary sphincters, mydriasis and decrease pancreatic beta cell secretion Contraindication: children < 6 years, HTN or CAD, MAOI, BB , TCA use Precaution: pregnancy C, children <12 years
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  • Spring '14
  • LisaA.Cranwell-Bruce

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