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23 Cards in this Set
- Front
- Back
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Chlorpheniramine (chlor-trimeton)
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Clinical use: *3rd line therapy of allergic rhinitis *Not as effective as INGC
Mechanism of action: *3 effects --> Antihistamine, sedative, anticholinergic *Shifts equilibrium from active to inactive form of H1 receptor causes ↓ H1 receptor activity *↓ vascular permeability, pruritis, bronchial smooth muscle contraction, mucosal drying Adverse Reaction: *Lipid soluble --> cross BBB-->CNS depression --> caution while driving *anticholinergic effects --> dry mouth, urinary retention, worsening of narrow angle glaucoma, confusion Contraindication:*Acute asthma *↑mortality in <2yo |
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Diphenhydramine
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Clinical use: *3rd line therapy of allergic rhinitis *Not as effective as INGC
Mechanism of action: *3 effects --> Antihistamine, sedative, anticholinergic *Shifts equilibrium from active to inactive form of H1 receptor causes ↓ H1 receptor activity *↓ vascular permeability, pruritis, bronchial smooth muscle contraction, mucosal drying Adverse Reaction: *Lipid soluble --> cross BBB-->CNS depression --> caution while driving *anticholinergic effects --> dry mouth, urinary retention, worsening of narrow angle glaucoma, confusion Contraindication:*Acute asthma *↑mortality in <2yo |
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Clemastine fumarate
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Clinical use: *3rd line therapy of allergic rhinitis *Not as effective as INGC
Mechanism of action: *3 effects --> Antihistamine, sedative, anticholinergic *Shifts equilibrium from active to inactive form of H1 receptor causes ↓ H1 receptor activity *↓ vascular permeability, pruritis, bronchial smooth muscle contraction, mucosal drying Adverse Reaction: *Lipid soluble --> cross BBB-->CNS depression --> caution while driving *anticholinergic effects --> dry mouth, urinary retention, worsening of narrow angle glaucoma, confusion Contraindication:*Acute asthma *↑mortality in <2yo |
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Cyproheptadine
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Clinical use: *3rd line therapy of allergic rhinitis *Not as effective as INGC
Mechanism of action: *3 effects --> Antihistamine, sedative, anticholinergic *Shifts equilibrium from active to inactive form of H1 receptor causes ↓ H1 receptor activity *↓ vascular permeability, pruritis, bronchial smooth muscle contraction, mucosal drying Adverse Reaction: *Lipid soluble --> cross BBB-->CNS depression --> caution while driving *anticholinergic effects --> dry mouth, urinary retention, worsening of narrow angle glaucoma, confusion Contraindication:*Acute asthma *↑mortality in <2yo |
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Cetirizine
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2nd generation antihistimine
Indication: *2nd line therapy for allergic rhinitis *mild or intermittent symptoms *Not as effective as INGC Mechanism of action: *Selective peripheral H1-receptor competitive antagonist *Anti-inflammatory --> ↓ mast cell mediators release, ↓down regulation of adhesion molecule expression, ↓ IL-4 and IL-13 production Adverse reaction: *more sedating than other 2nd generation Contraindication:*caution w/ liver/renal impairment |
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Loratadine (claritin)
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2nd generation antihistimine
Indication: *2nd line therapy for allergic rhinitis *mild or intermittent symptoms *Not as effective as INGC Mechanism of action: *Selective peripheral H1-receptor competitive antagonist *Anti-inflammatory --> ↓ mast cell mediators release, ↓down regulation of adhesion molecule expression, ↓ IL-4 and IL-13 production Adverse reaction: *dry mouth Contraindication:*caution w/ liver/renal impairment |
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Desloratadine
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2nd generation antihistimine
Indication: *2nd line therapy for allergic rhinitis *mild or intermittent symptoms *Not as effective as INGC Mechanism of action: *Selective peripheral H1-receptor competitive antagonist *Anti-inflammatory --> ↓ mast cell mediators release, ↓down regulation of adhesion molecule expression, ↓ IL-4 and IL-13 production Adverse reaction: Contraindication: |
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Fexofenadine (allegra)
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2nd generation antihistimine
Indication: *2nd line therapy for allergic rhinitis *mild or intermittent symptoms *Not as effective as INGC Mechanism of action: *Selective peripheral H1-receptor competitive antagonist *Anti-inflammatory --> ↓ mast cell mediators release, ↓down regulation of adhesion molecule expression, ↓ IL-4 and IL-13 production Adverse reaction: Contraindication: |
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Azelastine (astelin)
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2nd generation antihistimine
Indication: *2nd line therapy for allergic rhinitis *mild or intermittent symptoms *Not as effective as INGC Mechanism of action: *Selective peripheral H1-receptor competitive antagonist *Anti-inflammatory --> ↓ mast cell mediators release, ↓down regulation of adhesion molecule expression, ↓ IL-4 and IL-13 production Adverse reaction: *bitter taste Contraindication: |
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Beclomethasone (beconase)
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Indication: *1st line therapy for nasal congestion, allergic rhinitis
Mechanism of action: *Derivatives of hydrocortisone *Binds intracellular glucocorticoid receptor --> enters cell nucleus and binds to response elements located on Anti-inflammatory genes --> mRNA transcription for anti-inflammatory proteins --> ↓ neutron phil chemotasis, ↓intracellular edema, ↓ mast cell late phase reaction --> ↓histamine and ↓leukotriene --> Anti-inflammation Adverse reaction:*Nasal mucosal drying, burning, irritiation, epistaxis, rare nasal septal perforation *no significant mucosal atrophy or hypothalamic-pituitary adrenal suppression *Overall quite safe |
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FLunisolide (naserel)
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Indication: *1st line therapy for nasal congestion, allergic rhinitis
Mechanism of action: *Derivatives of hydrocortisone *Binds intracellular glucocorticoid receptor --> enters cell nucleus and binds to response elements located on Anti-inflammatory genes --> mRNA transcription for anti-inflammatory proteins --> ↓ neutron phil chemotasis, ↓intracellular edema, ↓ mast cell late phase reaction --> ↓histamine and ↓leukotriene --> Anti-inflammation Adverse reaction:*Nasal mucosal drying, burning, irritiation, epistaxis, rare nasal septal perforation *no significant mucosal atrophy or hypothalamic-pituitary adrenal suppression *Overall quite safe |
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Fluticasone (flonase)
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Indication: *1st line therapy for nasal congestion, allergic rhinitis
Mechanism of action: *Derivatives of hydrocortisone *Binds intracellular glucocorticoid receptor --> enters cell nucleus and binds to response elements located on Anti-inflammatory genes --> mRNA transcription for anti-inflammatory proteins --> ↓ neutron phil chemotasis, ↓intracellular edema, ↓ mast cell late phase reaction --> ↓histamine and ↓leukotriene --> Anti-inflammation Adverse reaction:*Nasal mucosal drying, burning, irritiation, epistaxis, rare nasal septal perforation *no significant mucosal atrophy or hypothalamic-pituitary adrenal suppression *Overall quite safe |
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mometasone furoate (nasonex)
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Indication: *1st line therapy for nasal congestion, allergic rhinitis
Mechanism of action: *Derivatives of hydrocortisone *Binds intracellular glucocorticoid receptor --> enters cell nucleus and binds to response elements located on Anti-inflammatory genes --> mRNA transcription for anti-inflammatory proteins --> ↓ neutron phil chemotasis, ↓intracellular edema, ↓ mast cell late phase reaction --> ↓histamine and ↓leukotriene --> Anti-inflammation Adverse reaction:*Nasal mucosal drying, burning, irritiation, epistaxis, rare nasal septal perforation *no significant mucosal atrophy or hypothalamic-pituitary adrenal suppression *Overall quite safe |
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Montelukast (singlair)
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Leukotriene receptor antagonists
Indication:*Allergic rhinitis *similar effectiveness to 2nd generation anthistamines *not as effective as INGC Mechanism of action: *antifinlammatory, competitive antagonist of Cys-LT1 Adverse reaction:*eosinophilia *Vasculitis (Churg-strauss) |
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Ipratroprium (atrovent)
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Anticholinergics
Indication:*2nd or 3rd line treatment for allergic rhinitis *Vasomotor rhinitis Mechanism of action:*non-selective muscarinic receptor blocker *Acetylcholine release is ↑ and overcomes block on smooth muscle receptors (M3) Adverser reaction:*Nasal drying *epistaxis *Headaches |
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Cromolyn Sodium
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Mast cell stabilizer
Indication:*Episodic allergen exposure *less effective than INGC or 2nd generation antihistamines Mechanism of action:*↓ mast cells degranulation --> ↓ histamine release Adverse reaction:*Bad taste *nasal irritation *Symptoms worsen if stopped abruptly |
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Oxymetazoline (Afrin, Vicks)
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Nasal Decongestants
Indication:Nasal congestion Mechanism of action:*Selective alpha 1 agonist --> vasoconstriction Adverse reaction:*Hypertension *bradycardia *angina *rebound congestion if used more than 3 days Contraindication:*hypertension *History of Ventricular tachycardia *MAOI |
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Phenylephrine Pseudonephrine
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Nasal Decongestants
Indication: Mechanism of action:*alpha and mild beta agonist Adverse reaction:*Hypertension *bradycardia *angina *rebound congestion if used more than 3 days Contraindication:*hypertension *History of Ventricular tachycardia *MAOI |
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Mineral Oil
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Ceruminolytics
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Docusate Sodium
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Ceruminolytics
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Acetic Acid
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Topical ear acidifying solution
Indication:*Otitis externa Mechanism of action:*acidifies ear canal --> exerts astringent, bactericidal and fungicidal effects Adverse Reaction:*burning *Stinging *irritation Contraindication:*perforated tympanic membrane |
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Dexamethasone
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Topical steroids
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Hydrocortisone
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Topical steroids
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