Pharmacology

Front 1

The symptoms of an allergic reaction indicate that individuals have become ________ to certain antigens in the environment. Antigens are substances such as pollen, mold, dust, and insect venom that stimulate the production of antibodies in the blood and tissues.

Back 1

sensitized

Front 2

People who suffer from _____, a chronic obstructive lung disease, are highly sensitive to antigenic stimulation. Allergic reactions that occur in asthmatic people severly restrict their ability to breath.

Back 2

asthma

Front 3

Once an antigen has initiated an allergic reation, certain cells in the body(mast cells) release active substances into the blood. The most important substance released is _____, which interacts with other cells to produce most of the symptoms of allergy.

Back 3

histamine

Front 4

Drugs that block only the tissue action of histamine are known as _____. Such drugs alleviate the annoying discomfort that accompanies most allergic reactions.

Back 4

antihistaminics

Front 5

Histamine is found throughout the body in the _____ cells and basophilic white blood cells.

Back 5

mast

Front 6

The largest concentrations of ____ _____ are in the lungs, the gastrointestinal (GI) tract, and the skin. When an antigen comes into contact with the skin or lungs or enters the bloodstream of sensitized individuals, the mast cells and basophils immediately release histamine into the blood.

Back 6

mast cells

Front 7

What are the two type of receptors associated with histamine?

Back 7

H1 and H2 receptors

Front 8

Histamine interacts with the ____ receptors, located on blood vessels, bronchiolar smooth muscle, and intestinal smooth muscle, to mediate allergic reactions.

Back 8

H1

Front 9

The ____ receptors are located within the stomach, heart, blood vessels, and uterine tissue. The most important response mediated by these receptors is increased secretion of gastric acid.

Back 9

H2

Front 10

H2 receptors are clinically important in the management of what?

Back 10

GI ulcers

Front 11

Histamine usually produces a transient drop in blood pressure because it dilates smally blood vessels and capillaries. With large histamine concentrations, this drop can result in _____ and circulatory collapse.

Back 11

hypotension

Front 12

Dilation of cerebral blood vessels stimulates pain receptors in the skull. This action explains the throbbing headache known as histaminic _____.

Back 12

cephalgia

Front 13

Capillary dilation in the skin results in a localized redness called what?

Back 13

erythema.

Front 14

Histamine causes fluids and proteins to leak out of the capillaries. When capillary leakage occcurs in the nasal mucous membranes, nasal ___ occurs.

Back 14

congestion

Front 15

When capillary leakage occurs in the ___, edema, wheals, or hives are produced. Itching and pain occur because of histamine irritates sensory nerve ending.

Back 15

skin

Front 16

The erythema and edema produced by histamine in the skin are known as what?

Back 16

The Response of Lewis

Front 17

Histamine produces constraction of the smoooth muscle of the intestine and bronchioles by stimulating what receptors?

Back 17

H1

Front 18

Contraction of intestinal smooth muscle results in disturbances of intestinal _____.

Back 18

activity

Front 19

Contraction of the bronchiolar smooth muscle results in _____, which makes breathing difficult

Back 19

bronchoconstriction

Front 20

Histamine usually produces rapid heartbeat. However, at high levels of histamine (histamine shocK), cardiac conduction is impaired. Such impairments may lead to the development of ______ and cardiovascular collapse.

Back 20

arrhythmias

Front 21

_______ sodium (Intal, Nasalcrom) is the only availabel drug that selectively prevents the release of histamine from the mast cells. It is not a bronchodilator, a smooth muscle relaxant, or a histamine-receptor antagonist. It has no effect on histamine receptors and must be administered before histamine release has begun.

Back 21

Cromolyn

Front 22

Drugs like cromolyn sodium, which prevent the onselt of symptoms ro disease as a results of exposure before the reactive process can take place, are called _____ drugs.

Back 22

prophylactic

Front 23

_______ _______ is inhaled as a fine micronized powder. the powder form allows the drug to reach the pulmonary mast cells before any antigens can induce an allergic reaction.

Back 23

Cromolyn sodium

Front 24

Cromolyn sodium cannot be used in acute allergic or ____ attacks in which histamine has already been released.

Back 24

asthma

Front 25

_______ is availabe in capsule (Spinhaler) and solution (Nasalcrom) forms for inhalation use and as capsules for oral administration (Gastrocrom)

Back 25

Cromolyn

Front 26

The oral capsule formulation of Cromolyn (________), which contains a measured dose, is opened and the powder dissolved into a glass of hot water. The full glass of liquid must be consumed to receive the proper dose. Fruit juice, milk, or food will inhibit dissolution and absorption of the drug and therefore should not be consumed until 0.5 hour after dosing.

Back 26

Gastrocrom

Front 27

Cromolyn is currently used as a prophylactic adjunct in the management of chronic bronchial _____ and allergic ______ to prevent bronchospasms.

Back 27

asthma; rhinitis

Front 28

Oral cromolyn improves diarrhea, flushing, headaches, urticaris, abdominal pain, and nausea in some patients with _____, where mast cells accumulate in organs and tissues in excessive smounts. Patients may experience symptoms associated with excessive histamine release from the puritis to peptic ulcer and chronic diarrhea.

Back 28

mastocytosis

Front 29

What drug causes wheezing, nasal itching, nasal burning, nausea, drowsiness, headache and occasional bronchospasms?

Back 29

Cromolyn

Front 30

All of the _____ available specifically block histamine from interfacing with its H-1 receptors. Therefore, the H-1 mediated allergic reponses of histamine are prevented. They are usually administered orally because they are absorbed well from the intestinal tract.

Back 30

antihistaminics

Front 31

A few antihistaminics are available for parenteral administration. These drugs are rapidly metabolized by the ____, necessitating repeated drug administration (usually two to four times a day) to maintain a therapeutic response.

Back 31

liver

Front 32

First generation antihistamines include what four drugs? These agents are characterized by a nonselective interaction with peripheral and central histamine receptors.

Back 32

chloropheniramine (Chlor-Trimeton)
clemastine (Tavist)
diphenhydramine (Benadryl)
promethazine (Phenergen)

Front 33

In addition to inhibiting the actions of histamine, these drugs possess local _______ and anticholinergic activity.

Back 33

anesthetic

Front 34

Through a local anesthetic action, _______ can depress sensory nerve activity and thus relieve itching and ____.

Back 34

pain

Front 35

_______ (Dramamine) exerts a unique action in the brain to relieve vertigo and motion sickness and the nausea that accompanies it.

Back 35

Dimenhydrinate

Front 36

Cyproheptadine (Periactin) and azatadine (Optimine) have the ability to inhibit the actions of histamine and ______. For this reason, these two drugs may offer a wider range of relief in highly sensitized individuals.

Back 36

serotonin

Front 37

The second generation of antihistamines, which includes what three drugs, appears to be more selective for peripheral H1 receptors. These agents are not sedation or drying and demonstrate equal antiallergic activity to the older drugs.

Back 37

cetirizine (Zyrtec)
fexofenadine (Allegra)
loratadine (Claritin)

Front 38

A few antihistamines have made the move from prescription to OTC status. The most recent is ______, under the trade name Clarines as prescription, and Alavert as OTC preparation.

Back 38

loratadine

Front 39

Antihistaminins are frequently used in acute allergic reactions including urticaris, hay fever, insect bits, rhinitis, and _____.

Back 39

dermatitis

Front 40

Because of the inherent sedation, antihistaminis may be used to induce sleep in OTC sleeping adis for example, _____ or to relieve motin sickness for example Dramamine.

Back 40

nytol

Front 41

Certain antihistamines- chlorpromazine, perfenazine (Trilafon), prochlorperzine (Compazine), promethazine (Phenergen), and triflupromazine (Vesprin)- are extremely effective in reducing _____ and vomitting. These drugs are used as adjuct pre and postoperative medications to minimize anesthetic irritability and facilitate patient recovery.

Back 41

nausea

Front 42

Antihistaminics are frequentsly found in cold remedies and cough syrups because of their ability to dry nasal _____.

Back 42

secretions

Front 43

The anticholinergic component of H1 antagonists provides relief from symptoms associated with the commoncold as well as allergic reactions such as ____ _____.

Back 43

runny nose

Front 44

In addition, sedcation caused by an antihistaminic in a multiingredient cold product aids recovery by promoting what?

Back 44

bed rest

Front 45

The most common side effects produced by the antihistaminics are drowsiness and _____.

Back 45

sedation

Front 46

Another frequently occuring side effect of antihistaminics is dry mouth or _________. Most of these drugs exert an antiholinergic effect that dries the mucous lining of the mouth and nasal passages. This side effect is therapeutically useful in treating the common cold.

Back 46

xerostomia

Front 47

Other adverse side effects of antihistaminics include: hypotension, rapid heartbeat, anorexia, epigastric distress and ________ _______.

Back 47

urinary retention

Front 48

What three antihistamines cause sedation most often?

Back 48

diphenhydramine (Benadrdyl
promethazine (Phenergan)
hydroxyzine (Vistaril)

Front 49

What two antihistamines cause little or no sedation?

Back 49

chlorpheniramine (Chlor-Trimeton)
cyproheptadine (Periactin)

Front 50

Patients may become nervous and uable to sleep (insomnia) while taking ___________.

Back 50

chlorpheniramine

Front 51

Because of their anticholinergic activity, antihistaminis drugs should be used with caution in patients with cardiovascular disease or hypertension or patients predisposed to developing an increase in ______ pressure or urinary retention.

Back 51

intraocular

Front 52

Antihistaminics should not be used by patients with a known hypersensitivity to antihistaminics or patients with ____-_____ glaucoma, stenosing peptic ulcer, or prostatic hypertrophy; newborn or premature infant, nursing mother, and dehydrated children.

Back 52

narrow- angle

Front 53

Phenothiazine antihistaminics such as _____ (Phenergen) are contraindicated for use in patients with CNS depression or a history of phenothiazine-induced jaundice.

Back 53

promethazine

Front 54

______ (Hismanal) and _____ (Seldane), both second generation antihistamines, have been removed from the market because they produced serious cardiovascular and hepatic effects that were fatal in some patients.

Back 54

Astemizole
terfenadine

Front 55

The proclonged indiscriminate use of topical antihistaminic preparations can lead to the development of hypersensitivity in some people. This hypersensitivity may range form rashes to _______ dermatitis, in which lesions on the skin surface ooze and develop scaly crusts.

Back 55

eczematoid

Front 56

Some ______, muscle relaxants (curare), and narcotic analgesics (morphine) cause the release of histamine from mast cells.

Back 56

antibiotics

Front 57

Drugs that depress the activity of the CNS (_____, tranquilizers, and alcohol) increase the incidence of drowsiness when takne with antihistamines, this synergistic effect is most likely to occur with OTC products that contain an antihistaminic in additon to alcohol as an active ingredient.

Back 57

sedatives

Front 58

________ (Hismanal) has potentially serious interactions with a wide variety of drugs. This drug must be taken on an empty stomach. Food interacts with this to inhibit absorption so that the effective dose is not achieved.

Back 58

Astemizole

Front 59

______ antibiotics, erythromycin, clarithromyin, troleandomycin, and antifunguls, ketoconazole, itraconazole, and miconazole, elevate the plasma levels of these antihistamines when taken concurrently. The mechanism of interaction in inhibition of hepatic metabolism predisposing the patient to potentially life- threatening cardiotoxid effects.

Back 59

Macrolide

Front 60

_______- release preparations should not be chewed or crushed. These capsules should not be opened to devide the dose. The pellets are coated to release the drug as a variety of time intervals that cannot be determined by the patient. They shoudl be swallowed intact with water.

Back 60

sustained