Pharm16 H/5-Ht/ergot

Front 1

Measurement of excessive systemic Histamine (systemic mastocytosis)

Back 1

Urine Imidazole Acetic Acid (metabolite)

Front 2

What is the histamine triple response mediated by H1/H2

Back 2

small red spot at the center of an inradermal injection of histamine surrounded by a red edematous wheal

Front 3

Distribution of H1?
Mechanism?

Back 3

Smooth muscle
Gq, ^IP3/DAG

Front 4

Distribution of H2?
Mechanism?

Back 4

Stomach, heart, mast cells
Gs, ^cAMP

Front 5

H3 Distribution?
Mechanism?

Back 5

CNS
Gi, decrease cAMP

Front 6

H4 distribution?
Mechanism?

Back 6

Leukocytes
Gi, decrease cAMP

Front 7

5-HT1d distribution?
mechanism?

Back 7

Brain
Gi, decrease cAMP

Front 8

5-HT2 distribution?
Mechanism?

Back 8

Smooth Muscle, Platelets
Gq, ^IP3/DAG

vasodilation, diarrhea, bronchoconstriction seen in Carcinoid

Front 9

5-HT3 Distribution?
Mechanism?

Back 9

Area Postrema, sensory/enteric
Ligand-Gated Cation Channel fx

Front 10

5-HT4 Distribution?
Mechanism?

Back 10

Presynaptic nerve terminals in enteric system
Gs, ^cAMP

important in motility

Front 11

Cause of vasodilation and endothelial cell contraction with H1?

Back 11

NO release

Front 12

Major difference between First and Second generation Antihistamines?

Back 12

1st generation causes sedation

Front 13

First Generation H1 antagonists

Back 13

Dephenhydramine
Chlorpheniramine
Cyclizine
Promethazine
Dimenhydrinate

Front 14

Second Generation H1 Antagonists

Back 14

Cetirizine
Fexofenadine
Loratadine
Desloratadine

Front 15

Why do 1st generation H1 antagonists cause sedation?

Back 15

enter CNS, effects similar to muscarinic blockers / a-adrenoreceptor blockers (autonomic receptor antagonists)

Front 16

H1 antag used for management of chemotherapy induced vomiting

Back 16

Diphenhydramine

Front 17

which generation of H1 antagonist is used for motion sickness

Back 17

First Generation

Front 18

1st Generation H1 Antagonists with most sedating effects

Back 18

Diphenhydramine
Promethazine

Front 19

1st generation antagonist with orthostatic hypertension toxicity

Back 19

Promethazine

Front 20

Why were the 2nd generation H1 antagonists astemizole and terfenadine removed from the market?

Back 20

Lethal arrhythmias

Front 21

Avoidance of what other drugs with H1 antagonists?

Back 21

CYP Inhibitors
Alcohol
Benzodiazepines

Front 22

Most toxic H2 antagonist?

Back 22

Cimetidine

Front 23

Therapeutic use of H2 Antagonists?

mechanism?

Back 23

Reduction of Gastric Acid Secretion (ulcers)

prevention, accelerate healing, reduce symptoms

Front 24

Two syndromes where PPis are preferred over H@ antagonists

Back 24

GERD
Zollinger-Ellison

Front 25

Cimetidine Toxicity (3)

Back 25

CYP Inhibitor
Reduced hepatic blood flow
anti-androgen effects

Front 26

What is serotonin derived from?

Back 26

Tryptophan

Front 27

Detection of excess serotonin (carcinoid)?

Back 27

5-HIAA in urine

Front 28

First line treatment of Acute Migraine and Cluster Headaches

Back 28

-triptans (sumatriptan, naratripan)

5-HT1d AGONISTS

Front 29

5-HT4 agonist in colon removed from market because of cardiac toxicity

Back 29

Tegaserod

Front 30

Components of Fen-Phen?

Back 30

Dexfenfluramine
Phentermine

removed because of toxicity, was used for weight loss

Front 31

Common symptoms in Serotonin Syndromes?

Back 31

Fever
Encephalopathy
Vitals unstable
Elevated Enzymes
Rigidity

Front 32

Common causes of Serotonin Syndrome

Back 32

Serotonin Agonists
D2 Blockers (Haloperidol/-azines)

Front 33

Treatment for Serotonin Syndromes?

(Serotonin Syndrome, Neuroleptic Malignant Syndrome, Malignant Hyperthermia)

Back 33

Dantrolene (FA)

Diphenhydramine (Pharm)

Front 34

5-HT2 blockers (3)

Back 34

Ketanserin
Phenoxybenzamine
Cyproheptadine

Front 35

5-HT3 blockers (antiemetics)

Back 35

Ondansetron
Granisetron
Dolasetron
Alosetron (not antiemetic)

Front 36

Irreversible 5-HT2 blocker

Back 36

Phenoxybenzamine

Front 37

Clinical use of 5-HT2 antagonists?

Back 37

Carcinoid Tumors
Hypertension

(+alpha1 receptor blockade)

Front 38

5-HT2 antagonist toxicity?

Back 38

Hypotension

Front 39

5-HT3 antagonist associated with QRS and QTc prolongation, contraindicated with Heart Disease

Back 39

Dolasteron

Front 40

5-HT3 antagonist associated with possibly fatal constipation

Back 40

Alosetron

Front 41

Treatment of women with Irritable Bowel Syndrome associated with diarrhea

Back 41

Alosetron

Front 42

Chemotherapy and postoperative vomiting treatment

Back 42

Odansetron + congeners

Front 43

"St. Anthony's Fire"

Back 43

Ergot Alkaloid toxicity

Front 44

Mechanism of Ergotamine vasoconstriction? Previous use?

Back 44

a-receptor blockade

migraine (with caffeine)

Front 45

Ergotamine toxicity?

Back 45

Ischemia and gangrene of limbs

Front 46

What is used for reduction of postpartum bleeding?

Back 46

Ergonovine (or ergotamine)

Front 47

What is essential in use of Ergonovine?

Back 47

Avoid during pregnancy
DO NOT give until placenta is delivered

Front 48

Used to reduce size or prolactin producing tumors

Back 48

Bromocriptine

Front 49

What could cause a epidemic ergot toxicity outbreak?

Back 49

spoiled grain

Front 50

Antitode for Ergot Poisoning?

Back 50

Nitroprusside

Front 51

Toxicity of Ergots? (3)

Back 51

Fibroplasia - hydronephrosis, cardiac valve/conduction malfunction
N/V/D
Abortion

Front 52

Ergots with potent D2 effects in the basal ganglia

Back 52

Bromocriptine
Pergolide

Front 53

Carcinoid Tumors

Back 53

Serotonin excess - bronchoconstriction, diarrhea, flushing

treatment is 5-HT2 antagonists

Front 54

physiologic antagonist of H1 actions on SmM?

Back 54

Epinephrine

Front 55

blurred vision

Back 55

older H1 Antagonists

Front 56

Disease caused by excess ergot alkaloids

Back 56

St. Anthony's Fire

Front 57

Endogenous substances commonly interpreted as histamine, serotonin, PGs, and vasoactive peptides

Back 57

Autocoids

Front 58

Syndrome of hypersecretion of gastic acid and pepsin usually caused by gastrinoma, associated with severe PUD and diarrhea

Back 58

ZE

Front 59

Drug that causes contraction of the uterus

Back 59

Oxytocin

Front 60

Distribution of H1

Back 60

Smooth Muscle

Front 61

Distribution of H2

Back 61

Stomach

Heart
Mast Cells

Front 62

Distribution of H3

Back 62

CNS

Front 63

Prototype antagonist of H1

Back 63

Diphenhydramine

Front 64

Prototype antagonist of H2 receptors

Back 64

Cimetridine

Front 65

1st generation antihistamines that is highly sedating

Back 65

Diphenhydramine

Front 66

1st generation antihistamine that is least sedating

Back 66

Chlorpheniramine
Cyclizine

Front 67

2nd Generation antihistamines

Back 67

Fexofenadine
Loratadine
Cetirizine

Front 68

Generation of antihistamine thathas the mst cNS effects

Back 68

First generation, more lipid soluble

Front 69

Major indication for H1 receptor antagonist

Back 69

Use in IgE mediated allergic reaction

Front 70

Antihistamine that can be used for anxiety and insomnia and is not addictive

Back 70

Hydroxyzine (atarax)

Front 71

H1 antagonist used in motion sickness

Back 71

Demnhydrinate
Meclizine

(other 1st generations)

Front 72

Most common SE of 1st generation antihistamines

Back 72

Sedation

Front 73

Lethal arrhythmias resulting from concurrent therapy with azole fungals (CYP3A4 metabolized) and these antihistamines which inhibit 3A4 isoenzyme

Back 73

Terfenadine and Astemizole (removed from market)

Front 74

H2 blocker that causes the most interactions with other drugs

Back 74

Cimetidine

Front 75

Clinical use for H2 blockers

Back 75

Acid Reflux
Duodenal/Peptic ulcers

Front 76

receptors for serotonin (5-HT1) are located

Back 76

Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance

Front 77

5HT-1D agonist used for migraine headaches

Back 77

Sumatriptan
Naratriptan
Rizatriptan

Front 78

Triptan available in parenteral and nasal formulation

Back 78

Sumatriptan

Front 79

H1 blocker that is also a serotonin antagonist

Back 79

Cyproheptadine

Front 80

Agents for reduction of postpartum bleeding

Back 80

Oxytocin
Ergonovine
Ergotamine

Front 81

Agents used in treatment of carcinoid tumor

Back 81

Ketaserin
Cyproheptadine
Phenoxybenzamine

Front 82

5HT-3 antagnoist used in chemotherapeutic induced emesis

Back 82

Ondansetron
Granisetron
Dolasetron
Alosetron

Front 83

5HT-3 antagnoist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease

Back 83

Dolasetron

Front 84

DOC to treat chemo-induced nausea and vomiting

Back 84

Odansetron

Front 85

Drug used in ergot alkaloids overdose, ischemia and gangrene

Back 85

Nitroprusside

Front 86

Reason ergot alkaloids are contraindicated in pregnancy

Back 86

Uterine contractions

Front 87

SE or ergot alkaloids

Back 87

Hallucinations resembling psychosis

Front 88

Ergot alkaloid used as an illicit drug

Back 88

LSD

Front 89

Dopamine agonist used in hyperprolactinemia

Back 89

Bromocriptine