Question | Answer |
Difference between 1st and 2nd generation H1 blockers | The first-generation antihistamines have sedative and antiemetic effects, so they are occasionally used to produce sedation and treat nausea and vomitting. The second generation drugs lack antiemetic activity and none of them causes substantial sedation. |
Which ones can be used as an antiemetic (for nausea/vomiting) | the first-generation antihistamines: promethanzine |
Which drugs can cause drowsiness? Which ones normally don’t | diphehydramine, hydroxyzine, promethazine, meclizine |
Prostaglandin drugs for the eyes: treat open-angle glaucoma | latanoprost |
First prostaglandin drug indicated for the treatment of glaucoma | latanoprost: topically as eyedrops |
Lataloprost adverse effects | alter the color of the iris can cause a permanent eye color change by increasing the amount of melanin in melanocytes |
Intranasal antihistamines | azelastine |
azelastine - indication | Treatment of symptoms of allergic rhinitis: sneezing, nasal |
azelastine - Adverse effects: | nasal irritation, dizziness, fatigue, headache, , dry mouth, and weight gain |
ophthalmic antihistamines | Olopatadine (Patanol), Ketotifen (Zaditor) |
Olopatadine (Patanol)indications: | eyedrop formulation: temporary relief of the signs and symptoms of seasonal allergic conjunctivis |
Olopatadine (Patanol)adverse effects: | transient stinging and burning |
Ketotifen classification | mast cell stabilizer, noncompetitive H1 antagonist |
ketotifen indications | temporary prevention of itching of the eye caused by allergic conjunctivitis |
First generation drugs | • diphenhydramine (Benadryl)
• promethazine (Phenergan)
• meclizine (Antivert)
• dimenhydrinate (Dramamine)
• hydroxyzine HCl (Atarax) pamoate
• chlorpheniramine (Chlor-Trimeton) |
Second Generation | • loratadine (Claritin)
• cetirizine (Zyrtec)
• fexofenadine (Allegra)
• desloratadine (Clarinex)
• levocetirizine (Xyzal) |
Intranasal Antihistamine | azelastine (Astelin, Astepro) |
Ophthalmic Antihistamines | • Olopatadine (Patanol)
• Ketotifen (Zaditor) |
Histamine H1 receptor Antagonists | First generation
;Second Generation
;Ophthalmic Antihistamines
;Intranasal Antihistamine |
Serotonergic Drugs (5-HT) | Serotonin Antagonists
;Serotonin Agonists |
Serotonin Agonists | buspirone (Buspar)
sumatriptan (Imitrex) |
Serotonin Antagonists | • clozapine (Clozaril)
• cyproheptadine (Periactin)
• ondansetron (Zofran) |
Prostaglandin Drugs | • alprostodil (Caverject, Muse)
• misoprostol (Cytotec)
• latanoprost (Xalatan)
• bimatoprost (Lumigan, Latisse)
• travoprost (Travatan) |
Endothelin-1 antagonists | • bosenten (Tracleer)
• ambrisentan (Letairis) |
First generation antihistamines indications | treat nausea and vomiting, prevent motion sickness (travel by plane, boat), treat vertigo |
meclizine, dimenhydrinate | treat motion sickness or vertigo |
promethazine | relieve nausea and vomiting |
second gen drugs | treatment of allergies |
cetirizine | more likely to cause some sedation than fexofenadine or loratadine |
first-gen adverse effects | sedation, produce excitement in children and infants |
diphenhydramine, promethazine | highest anticholinergic activity => adverse eff: dry mouth, blurred vision, tachycardia, urinary retention, and other atropine-like side effects |
buspirone (BuSpar) | Indications: anxiety & depression |
sumatriptan (Imitrex) | Indications: Migraine |
cyproheptadine (Periactin) | Indications: urticaria, pruritis, carcinoid syndrome |
ondansetron (Zofran) | Indications: Chemo/postop related N & V |
ondansetron (Zofran) | Adverse effects: HA, constipation, fatigue |
alprostadil | Indications: maintain patency of patent ductus arteriosus, ED |
misoprostol (Cytotec) | Indication: prevent NSAID-induced ulcers |
misoprostol (Cytotec) | Adverse effects: Category X, stimulate uterine contractions |
bosentan (Tracleer)
ambrisentan (Letairis) | Indications: pulmonary arterial hypertension |
bosentan (Tracleer)
ambrisentan (Letairis) | Adverse effects: Category X, liver enzymes |