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102 Cards in this Set
- Front
- Back
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What dilates small blood vessels and increases capillary permeability, bronchi constriction
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Histamine
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Where are the two main types of cells where histamine is stored?
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mast cells are in the skin and soft tissue
basophils are in blood |
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What is the anticholinergic side effects of anti-histamines (h1 blockers)? (common in 1 generation)
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Cant see--sedation
Cant pee--urinary hesitancy Cant spit--dry mouth Cant poop--constipation |
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What is an example of a 1st generation anti-histamine?
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Diphenydramine (Benadryl)
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What is an example of a 2nd generation anti-histamine?
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Loratadine (Claritan)
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What does anticholinergic mean?
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opposing or blocking the physiologic action of ACH.
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What are the side effects of Benadryl?
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sedation, dizziness, n/v d/c
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In the vascular system, histamine does what?
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dilates small blood vessels and increases capillary permeability
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In the bronchi, histamine does what?
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produces constriction
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In the central nervous system, histamine does what?
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acts as a neurotransmitter
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In the stomach, histamine does what?
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stimulates secretion of acid
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The initial requirement for allergic release of histamine is the production of antibodies of the ??? class
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IgE
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The principal causative agents in anaphylactic shock are???
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Leukotrienes
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Overdose with antihistamines can produce ???and ???? frequently result.
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produce CNS stimulation, and convulsions
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Antihistamines are of ????? against the common cold
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no value
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Why do 2nd generation antihistamines exert little or no sedative effect?
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Because they are unable to cross the blood-brain barrier.
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How do 1st generation antihistamines (h1) blockers work?
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By blocking the receptor sites on the cell so the histamine can not bind. (histamine has already been released)
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What are the for different histamine receptors?
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H1, H2, H3, H4
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What you hear H1 receptor stimulation what should you think?
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'Allergic reaction"
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When a H1 receptor is stimulated what is the reaction?
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vasodilation, bronchoconstriction, increased cap.
permeablility, secretion of mucus, sensory nerves-pain/itch |
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What does H1 blockers NOT do?
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They do not block the release of histamine from bast cells or basophils
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How do H1 blockers work?
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they bind selectively to H1 receptors
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What is the peripheral effects of H1 blockers (antihistamines)
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reduces flushing, edema, itching, pain, mucus secretion
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How do H1 blockers affect the CNS?
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a therapeutic dose depresses the CNS, too much and it stimulates the CNS-overdoses
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What is the undesired effects of H1 blockers-the adverse effects?
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All H1 blockers can produce:
sedation GI-N/V dry mucus membranes urinary retention |
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What are some 2nd generation antihistamine drugs?
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Zyrtec, Claritin, Allegra
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What are some intra-nasal medications:
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Astelin, Astepro, Pantanase
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What are some glucocorticoids allergy medications?
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Flonase, Nasonex
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What are some intranasal medication antihistamines?
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asteline, astepro, pantanase
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What is a oral leukotriene antagonist medication?
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Singulair
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What does opioid antitussives do?
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Act on the CNS to elevate cough threshold
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What is the #1 ingredient in opioid antitussives?
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codeine is #1
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What is a non-opioid antitussive medication?
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Dextromethorophan is #1, it reduces pain and Benadryl is a antitussive in larger doses and makes you drowsy
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How do Cold meds work?
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Nothing makes a cold go away
Meds only give symptom relief Antihistamines dry up mucus membranes Decongestants releive nasal congestion |
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What are two decongestants?
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Sudafed and Neo-synephrine a nasal spray
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What is a side effect of Neo-Synephrine?
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Use is limited because of rebound congestion (3days)
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Why is Sudafed behind the counter now?
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because of meth production
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What is the #1 1st generation antihistamine?
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Benadryl
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What is Zophran used for?
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anit-nausea/vomit
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What are some therapeutic uses for H1 blockers?
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allergy, motion sickness, insomnia
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What is are some "drug interactions" of H1 blockers?
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Intensifies CNS depression, alcohol, lactation (excreted in breast milk)
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What triggers allergies?
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dust mites, dander, dust, cock roaches, mold
foods like wheat, eggs, milk, nuts Seasonal-inhaled pollen |
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Is perennial all year long or seasonal
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Perennial is all year long
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What is allergic rhinitis?
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runny noise from an allergy
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What are some contributing conditions of allergic rhinitis?
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sleep disorders, fatigue, learning disorders
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When do allergies come about?
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the onset is very common in childhood, adolescence, and early adulthood
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Do symptoms go away with allergies?
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They often wane, but may develop or persist at any age
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What is an allergic salute?
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a crease in the nose from rubbing it upward
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What is allergic shiners
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swollen, watery eyes
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How do most people with allergies manager AR?
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avoid the allergen, take some antihistamines, intranasal glucocorticoids, decongestants
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What is a intranasal glucocorticoid medication?
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Flonase. Helps runny noises/watery eyes
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What are some adverse effects of flonase?
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dry mucosa, epistaxis, throat discomfort
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What does intranasal "Chromolyn Sodium" do?
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suppresses histamine and other inflammatory mediators from mast cells. used for prophylaxis, not treatment. Has no side effects, no rebound
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What do decongestants do?
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the only relieve nasal congestion
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What is the name of a common decongestant?
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Sudafed...it just decreases the swelling
Afrin |
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What is a side effect to taking Afrin?
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Should not take it for more than 3 days. Has a rebound effect that makes congestion worse, have to tapper it off
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What are some other AR treatments?
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Atrovent inhibits glandular secretions
Singlulair mediates inflammation response |
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When does anaphylaxis occur?
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When an allergic response triggers a quick release of large quantities of histamines, protaglandins and leukotrienes
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What does anaphylaxis lead to?
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systemic vasodilation bronchoconstriction with edema of bronchial mucosa
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What is the 1st treatment for anaphylaxis?
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Epinephrine (adrenaline) Epi pen
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Does Benadryl do much for anaphyaxis?
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Not much but it is give some relief. The leukotrienes and prostaglandines are not affected by Benadryl
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What does epinephrine do for anaphylaxis?
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causes vasoconstriction and is a powerful bronchodilator
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Do EpiPens last very long?
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No but long enough to get help. It also makes people feel sick
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What is the pathophysiology of a common cold?
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Rhinovirus, infection with acute inflammation of mucous membrane of the nasal cavity
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What is the best first-line therapy for a common cold?
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grandma and chicken soup. The hot salty fluid can relieve symptoms only
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What are some common antitussive medications?
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Opioid antitussives with codeine or hydrocodone: Rhomatussin DM
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What are the peak months for a common cold?
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Sept, January, April
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What are come complications from a common cold
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bronchitis, pneumonia, conjunctivisis
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What are the clinical manifestations of a common cold?
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nasal congestion, sore throat, sneezing, malaise, afebrile, h/a, cough
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What should be the focus when you have a common cold?
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Focus on relief/comfort care. Antihistamines, decongestants, anti-tussives
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Why is it beneficial to have a cough?
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to get the stuff out
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What is a common nonopioid antitussive medication?
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dextromethorphan
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Dexthromethorphan is ????? by teens
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It is abused. Can OD. naloxone may be given for abuse
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What does an expectorant do?
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It helps get the mucus out. It does not thin it. just renders coughs more productive
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What is a common expectorant?
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Mucinex
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What is the patho of a sinus infection?
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inflammation of the mucus membrane of one or more sinuses blocks the egress of the sinuses
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What is the #1 cause of a sinus infection?
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bacterial infection. They can be viral too
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What are the clinical manifestations of sinus infections?
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pain, anosnia(cant smell), h/a, fever, fatique, foul breath
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How are sinus infections treated?
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antiboitics, analgesics for pain, nasal decongestants to help drainage, mucolytic agents, lots of fluid and some times surgery
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What is asthma?
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A chronic inflammatory lung disease in which the airways become blocked or narrowed
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What are some common asthma triggers?
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dust/dust mite [poop], conckroaches, mammal fur/saliva/urine, mold, pollen, 2nd hand smoke, chemical irritants, exercise [when finished]
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How could asthma affect a childs height?
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lack of sleep, and depends on the treatment, oral leukocordicoids may stop growth for a while
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What are some asthma treatments?
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anti-inflammatory agents like glucocorticoids, chromolyn on a fixed schedule. Bronchodialtors [beta-2 agonists] on a fixed schedule or PRN {abuteral}
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What does MDI stand for
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metered dose inhaler
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What does DPI stand for
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dry powder inhaler
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What route are most asthma treatments given
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inhaled drugs with a metered dose inhaler, etc
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What is the proper use for an MDI?
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shake, breath out completely place lips on the MDI mouthpiece, Press MDI once, take 5-1- deep breaths, exhale slowly, repeat after 1 minute. rinse mouth
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What is a short acting beta-2 agonist bronchodilator?
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Albuterol
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What is a long acting Beta-2 agonist bronchodilator?
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Formoteral, Salmerterol
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What does glucocorticoids do for asthma?
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The suppress inflammation, decrease edema, decrease mucus production,
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What should you watch for in someones mouth if they take glucocorticoids?
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Watch for thrush, horaseness
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What is a common glucocorticoid bronchdilator?
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Prednisone, beclamethasome
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What are some other drugs used for asthma? (besides glucocorticoids or Beta-2 agonists?
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spiriva (a anticholinergies)
singulair ( a leukotriene modifier) |
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What should be given first albuterol or beclamethasone?
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albuterol because its a bronchodilator
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What is the safest asthma drug
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Chromolyn; it suppresses inflammation, stabilizes mast cells cytoplasma membrane, prevents histamine release
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What is COPD?
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a set of lung diseases that limit air flow and are not fully reversible
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When does a person get COPD?
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usually in mid-life. It's a slow progressive disease mostly from long smokers
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What are the two main diseases associated with COPD?
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chronic bronchitis
enphysema |
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What does Cromolyn do?
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suppresses inflammation
Stabilizes cytoplasmic membrane of mast cells, preventing histamine release |
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What is the objectives to COPD management?
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to stop/slow the progression of the disease
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How is COPD treated>
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bronchodilators (albuterol-short acting; Salmeterol-long acting) steroids (oral-prednisolone or inhaled-fluticasone)
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What is other interventions for a COPD pt?
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influenza vaccines, pneumococcal vaccine, antitussives, mucolytic agents
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