Pharm Test 3 Antihistaminics/respiratory Drugs

Front 1

Histamine is formed from what

Back 1

histidine

occurs primarily bound to heparin in mast cells and basophils

Front 2

mast cells are important initiators of what

Back 2

allergic reactions

Front 3

mast cells promote what kind of response and how

Back 3

inflammatory response by providing mediators which initiate chemotaxis of leukocytes

Front 4

where do mast cells highly occur

Back 4

lung
GI tract
skin

Front 5

basophils are primarily found where

Back 5

the blood

Front 6

what are the factors involved in histamine release

Back 6

mast cells respond to injury by increasing blood flow
histamine is release from mast cells by antigen antibody interactions

Front 7

what are the 2 receptors for histamine

Back 7

H1
H2

Front 8

activation of H1 receptors causes what

Back 8

vasodialation increased capillary permeability, nerve ending stimulation, and bronchiolar and intestinal constriction

Front 9

H2 receptors are most important for what

Back 9

gastric acid secretion

they also mediate some cardiac and CNS actions of histamine and contribute to vasodialation

Front 10

the dominant actions of histamine are on ?

Back 10

blood vessels
other smooth muscles
afferent nerve endings (H1 receptors)
secretion of gastric acid and pepsin (H2)

Front 11

what is the triple response

Back 11

red spot (vasodialation)
wheal (fluid leakage causing edema)
flare (diffuse redness due to nerve stimulation)

itching and pain usually accompany this as well

Front 12

what does histamine constrict

Back 12

nonvascular smooth muscle including bronchioles, gut, and urinary bladder

Front 13

the allergic response to the release of histamines ranges from what to what

Back 13

hives--> anaphylactic shock

Front 14

antihistamines that are H1 receptor antagonists are used to treat primarily

Back 14

allergic reactions other than anaphylaxis

Front 15

antihistamines come from ___ chemical classes and are (specific/non specific) in structure and (small/large)

Back 15

7
non specific
large

Front 16

antihistamines antagonize all the components of the ______ ______

Back 16

triple response

Front 17

what is the triple response again

Back 17

vasodilation
increased capillary permeability
stimulation of nerve endings

Front 18

what are the 6 antihistamine H1 receptor antagonists drugs

Back 18

diphenhydramine
promethazine
chlorpheniramine
loratadine
fexofenadine
meclizine

Front 19

H2 receptor antagonists are used for what

Back 19

ulcer therapy
esophageal reflux
hypersecretory states

Front 20

what are the 4 H2 receptor antagonists drugs

Back 20

cimetidine
ranitidine
famotidine
nizatidine

Front 21

what does H1 do

Back 21

allergic response

Front 22

what does H2 do

Back 22

gastrointestinal: release of acid and pepsin

Front 23

what do H1 and H2 have in common

Back 23

both cause vasodilation

Front 24

Promethazine
- what kind of drug
- MOA
- whats it used for

Back 24

- antihistamentic
- H1 receptor antagonist
- used as antiemetic to decrease throwing up like to chemo treatment

Front 25

Diphenhydramine
- what kind of drug
- MOA
- what else is it known as

Back 25

- antihistamentic
- H1 receptor antagonist
- benadryl

Front 26

Chlorpheniramine
- what kind of drug
- MOA

Back 26

- antihistamentic
- H1 receptor antagonist

Front 27

which three H1 receptor antagonists (H1 blockers) produce a lot of sedation

Back 27

Diphenhydramine
Promethazine
Chlorpheniramine
- get into brain
- good for allergic responses

Front 28

Loratadine
- kind of drug
- MOA
- what are they good for

Back 28

- antihistamentic
- H1 receptor antagonist
- allergic responses

Front 29

Fexofenadine
- Kind of drug
- MOA
- what are they good for

Back 29

- antihistamentic
- H1 receptor antagonist
- allergic responses

Front 30

which 2 H1 receptor antagonists can be used by prescription only

Back 30

Loratadine
Fexofenadine
- don't cross blood brain barrier readily

Front 31

Meclizine
- kind of drug
- MOA
- what is it good for

Back 31

- antihistamentic
- H1 receptor antagonist
- motion sickness

Front 32

what are H2 receptor antagonists beneficial for

Back 32

gut
GI tract
- decrease secretion of acid and pepsid into tract

Front 33

what do H2 receptor antagonists treat

Back 33

peptic ulcers
reflux disease

Front 34

Cimetidine
- kind of drug
- MOA
- what does it treat
- other info

Back 34

- antihistamentic
- H2 receptor antagonist
- treats ulcers and reflux
- has untoward effects. duration isn't long so have to take more doses

Front 35

Rantidine
- kind of drug
- MOA

Back 35

- antihistamentic
- H2 receptor antagonist

Front 36

Famotidine
- kind of drug
- MOA

Back 36

- antihistamentic
- H2 receptor antagonist

Front 37

Nizatidine
- king of drug
- MOA

Back 37

- antihistamentic
- H2 receptor antagonist

Front 38

whats the principal function of the respiratory system

Back 38

exchange oxygen and carbon dioxide

Front 39

what was the most important respiratory disease at the turn of the century

Back 39

tuberculosis

Front 40

how was tuberculosis reduced

Back 40

isoniazid

Front 41

what was the main respiratory disease in the 1930s and how was it controlled

Back 41

pneumococcal pneumonia
- controlled by penicillin

Front 42

what are the top 4 leading causes of death

Back 42

heart disease
cancer
stroke
chronic lower respiratory diseases

Front 43

what is asthma

Back 43

inflammatory disease with associated bronchospasm

Front 44

what are the symptoms of asthma

Back 44

wheezing
breathlessness
cough
mucosal edema
production of mucoid sputum

Front 45

what is the main symptom of asthma in children

Back 45

persistent cough

Front 46

asthma exacerbations are characterized by decreases in what

Back 46

expiratory airflow

Front 47

what are the 2 types of drugs for asthma

Back 47

quick relief medications
long term controllers

Front 48

what are the 3 types of quick relief medications

Back 48

inhaled beta 2 adrenoceptor agonists
anticholinergic
systemic corticosteroids

Front 49

inhaled beta-2 adrenoceptor agonists
- what do they do

Back 49

- relaxation in airways
- quick relief

Front 50

Albuterol
- what kind of drug
- what does it do
- adverse effects (acute/chronic)

Back 50

- inhaled beta 2 adrenoceptor agonist
- relief of acute symptoms. preventative treatment prior to exercise induce asthma
- acute: tremors or shakes b/c it could make too much ACh
- chronic: no impact on chronic airway inflammation

Front 51

cholinergic antagonism
- what do they do

Back 51

- second line drug in treating bronchial asthma but first line in treating COPD

Front 52

Ipratropium
- king of drug
- what does it do
- mechanism
- adverse effects

Back 52

- highly charged anticholingergic
- relief of acute bronchospasm. alternative for patients with intolerance to beta 2 agonists
- bronchodilation by competitive inhibition of muscarinic cholinergic receptors
- dry mouth, increased wheezing
first line for COPD

Front 53

systemic corticosteroids
- what form are they in
- other

Back 53

- pill or shot form
- be in bloodstream for short period of time

Front 54

Prednisone
- kind of drug
- what does it do
- mechanism
- adverse effects

Back 54

- systemic corticosteroids
- for short term burst to gain control, speed recovery and prevent recurrence
- anti-inflammatory by reduce airways hyperresponsiveness. blocks late reaction to allergens
- increased appetite, fluid retention, mood alterations
given if attack is really bad
change your carb and protein metabolism

Front 55

long term controllers
- what do they treat

Back 55

- inflammation of asthma

Front 56

what are the 6 types long term controller drugs

Back 56

inhaled corticosteroids
histamine release inhibitors
leukotriene modifiers oral
long acting inhaled beta 2 adrenoceptor agonists
systemic corticosteroids
methylxanthine (theophylline sustained release)

Front 57

Beclomethasone
- kind of drug
- indication
- mechanism
- adverse effects

Back 57

- inhaled corticosteroids
- long term prevention of symptoms; suppression, control and reversal of inflammation
- same as systemic corticosteroids
- cough, dysphonia, oral thrush

Front 58

Fluticasone
- kind of drug
- indication
- mechanism
- adverse effects

Back 58

- inhaled corticosteroids
- long term prevention of symptoms; suppression, control and reversal of inflammation
- same as systemic corticosteroids
- cough, dysphonia, oral thrush (yeast infection of mouth)
limited to the lungs

Front 59

Cromolyn
- kind of drug
- indications
- mechanism
- adverse effects

Back 59

- histamine release inhibitor (powder)
- long term prevention of symptoms, preventative treatment prior to exposure to exercise or allergen
- stabilize mast cell membranes and inhibit activation and release of mediators from eosinophils and epithelial cells
- irritant effect of powder
VERY SAFE

Front 60

Zafirlukast
- kind of drug
- indications
- mechanism

Back 60

- leukotriene modifiers oral
- prevention of mild persistent asthma
- leukotriene inhibitor (LT D4 and LT E4)
receptor blockers on bronchial smooth muscle

Front 61

Montelukast
- kind of drug
- indications
- mechanism

Back 61

- leukotriene modifiers oral
- prevention of mild persistent asthma
- leukotriene inhibitor (LT D4 and LT E4)
receptor blockers on bronchial smooth muscle

Front 62

Zileuton
- kind of drug
- indications
- mechanism

Back 62

- leukotriene modifiers oral
- prevention of mild persistent asthma
- enzyme blocker: 5-lipoxygenase inhibitor

Front 63

Salmeterol (brace yourself)
- kind of drug
- indications
- mechanism

Back 63

- long acting inhaled beta 2 adrenoceptor agonist
- long term prevention of symptoms, especially nocturnal symptoms. prevention of exercise- induced bronchospasm
- bronchodilation by stimulating cAMP which causes relaxation

Front 64

Salmeterol continued
- adverse effects
- therapeutic comments

Back 64

- skeletal muscle tremor, tachycardia, hypokalemia
- not to be used to treat acute symptoms or exacerbations. to achieve 75% maximal effect takes one hour compare to 5 min for short acting inhaled beta 2 adrenoceptor agonists

Front 65

Prednisone
- kind of drug
- indications
- mechanism
- adverse effects

Back 65

- systemic corticosteroid
- long term prevention of symptoms in severe asthma
- anti-inflammatory by reduce airway hyperresponsiveness. inhibit cytokine production, adhesion protein activation, and inflammatory cell migration and activation
- adrenal axis suppression, growth suppression, moon face, buffalo hump, mood alterations

Front 66

Methylxanthine
- where is it found
- indications
- mechanism
- adverse effects

Back 66

- coffee and tea
- prevention of symptoms especially nocturnal symptoms
- very good bronchodilator. mainstay in tx of bronchial asthma.
serum concentration monitoring is essential due to signif. toxicity, narrow therapeutic range and individual difference in metabolic clearance
- too much can cause cardiac arrythmias and seizures so measure blood levels at least once a month
increases cyclic AMP