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318 CH. 69:
Antihistamines
| Question | Answer |
|---|---|
| What are the H1 receptors responsible for? | Vasodilation, increase capillary permeability, bronchoconstriction, on sensory nerves -> itching/pain and secretion of mucous |
| What are teh H2 receptors responsible for? | Secretion of acid in the stomach |
| what are the 2 primary uses for antihistamines? | allergic disorders and Peptic ulcer disease |
| What are the s/s of anaphylactic shock? | swollen tongue, edema of glottis -> airway constriction, hypotension, bronchoconstriction |
| What is the treatment for anaphylactic shock? | Epi. Antihistamnines are not used because histamine has little to do with anaphylactic shock and therefore is only of little help |
| Histamine is present in almost all tissues, but mostly in what organs? | skin, lungs, GI tract. |
| there are 2 major groups of the H1 antagonist what are they and what are their defining differences? | Firstgeneration (Sedating) and second generation (non-sedating) |
| what is the mechanism of action for H1 antagonists? | bind SELECTIVELY to H1 receptors to block them. can bind to muscarinic receptors leading to anticholinergic response |
| What are the CNS effects of H1 antagonists? | At THERAPEUTIC DOSE: first generation can cause CNS depression (second generation not so much). OVERDOSE: CNS excitation (seizures) |
| What might a child experience when taking H1 antagonists (first generation)? | many children experience a paradoxical effect (opposite) |
| what are H1 antagonists used for? | mild allergies, motion sicness, Insomnia |
| what are the side effects of H1 antagonists? | Drowsiness (paradoxical effect = hyperexcitability), dizziness, lethargy/fatigue, confusion, coordination problems, n/v/d/c/loss of appetite = COMMON!!! anticholinergic, dysrhythmias |
| what should you avoid if you are taking an H1 antagonist? | CNS depressants |
| when is it MOST important to avoid H1 antagonists (Benadryl) during pregnancy? | during the 3rd trimester because the fetus is susceptible to CNS depression |
| should you be on an H1 antagonist during breast feeding? | no |
| what are the s/s of acute toxicity of H1 antagonists? | anticholinergic effects. (in children, CNS excitation is the prominent s/s) |
| what is used to treat acute toxicity of H1 antagonist (Benadryl) | activated charcoal, Cathartic[laxative] NO ANATIDOTE |
| What is H1 antagonist, first generation example? | Benadryl |
| What are the second generation H1 antagonist drugs? | Allegra, Zyrtec and Claritin |
| What are second generation H1 antagonists used for? | Allergic rhinitis |
| which are more expensive, First or second generation H1 antagonists? | second. |
| What is Allegra used for? | seasonal allergic rhinitis, chronic idiopathic urticaria |
| what is Zyrtec used for? | seasonal allergic rhinitis, chronic idiopathic urticaria (same as Allegra) |
| Which of the second generation H1 antagonists are best in Efficacy and safety? | Allegra |
| how is allegra administered? | oral |
| how is Zyrtec administered? | oral |
| does food affect Zyrtec? | yes. Delays absorption |
| What are teh side effects of Zyrtec? | Drowsiness, fatigue, dry mouth/nose/throat |
| what are the side effects of Claritin? | headache, mild drowsiness |
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