Pharmacology of Antihistamines and Decongestants
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Questions and Answers

What is the primary action of decongestants on the nasal mucosa?

  • Enhance fluid production in nasal membranes
  • Dilate capillaries in the nasal passages
  • Increase blood flow to nasal tissues
  • Stimulate alpha adrenergic receptors (correct)

    • What is a potential side effect of using nasal decongestants?

  • Weight gain
  • Nausea
  • Dizziness (correct)
  • Increased appetite

    • What condition should prompt caution when using pseudoephedrine?

  • Mild headaches
  • Seasonal allergies
  • Gastrointestinal disorders
  • Hypertension (correct)

    • How long should nasal decongestants typically be used to avoid adverse effects?

    <p>3 days</p> Signup and view all the answers

    What beneficial effect does nasal decongestants have compared to systemic decongestants?

    <p>Fewer adverse effects</p> Signup and view all the answers

    What is a common use of pseudoephedrine?

    <p>Relieving nasal congestion due to rhinitis</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with nasal decongestant use?

    <p>Nasal drainage</p> Signup and view all the answers

    What mechanism allows decongestants to reduce nasal congestion?

    <p>Vasoconstriction of capillaries</p> Signup and view all the answers

    What effect do intranasal glucocorticoids have on nasal mucosa?

    <p>Produce anti-inflammatory effects</p> Signup and view all the answers

    What is a potential interaction of intranasal glucocorticoids with beta blockers?

    <p>Decrease the effectiveness of beta blockers</p> Signup and view all the answers

    What adverse effect might occur with the use of intranasal glucocorticoids?

    <p>Headaches and blurred vision</p> Signup and view all the answers

    Why should large amounts of caffeine be avoided when using intranasal glucocorticoids?

    <p>It may exacerbate hypertension</p> Signup and view all the answers

    What is the recommended duration for using intranasal glucocorticoids?

    <p>Only for short-term use</p> Signup and view all the answers

    What should be monitored when using intranasal glucocorticoids alongside OTC cold medicines?

    <p>Interaction effects on heart rate</p> Signup and view all the answers

    What condition may be worsened due to the use of intranasal glucocorticoids when interacting with MAOIs?

    <p>Hypertension</p> Signup and view all the answers

    What is a common side effect of prolonged use of intranasal glucocorticoids?

    <p>Nasal congestion rebound</p> Signup and view all the answers

    What is one of the primary actions of diphenhydramine?

    <p>Antagonizes H1-receptor sites</p> Signup and view all the answers

    Which of the following adverse effects is associated with diphenhydramine?

    <p>Anticholinergic symptoms</p> Signup and view all the answers

    What distinguishes loratadine from diphenhydramine?

    <p>It is less sedating than diphenhydramine</p> Signup and view all the answers

    Under what conditions should diphenhydramine be administered with caution?

    <p>Patients with glaucoma and COPD</p> Signup and view all the answers

    Which indication is listed for loratadine?

    <p>Urticaria</p> Signup and view all the answers

    What is a characteristic of second-generation antihistamines like loratadine compared to first-generation like diphenhydramine?

    <p>They generally have fewer anticholinergic symptoms</p> Signup and view all the answers

    What adverse effect is most commonly associated with decongestants?

    <p>Rebound congestion</p> Signup and view all the answers

    What is a potential consequence of using decongestants improperly?

    <p>Increased blood pressure</p> Signup and view all the answers

    What is the primary action of antitussives?

    <p>They suppress the cough reflex.</p> Signup and view all the answers

    What condition is fluticasone primarily indicated for?

    <p>Allergic rhinitis symptoms.</p> Signup and view all the answers

    Which adverse effect is associated with dextromethorphan?

    <p>Dizziness.</p> Signup and view all the answers

    What is the expected effect of guaifenesin in the body?

    <p>It loosens bronchial sections.</p> Signup and view all the answers

    How quickly does dextromethorphan typically begin to work after administration?

    <p>15-30 minutes.</p> Signup and view all the answers

    What is a common side effect of expectorants like guaifenesin?

    <p>Headaches.</p> Signup and view all the answers

    For which of the following conditions is fluticasone NOT typically indicated?

    <p>Nasal candidiasis.</p> Signup and view all the answers

    What is the duration of action for dextromethorphan?

    <p>3-6 hours.</p> Signup and view all the answers

    What is the primary purpose of mucolytics like Acetylcysteine?

    <p>To thin mucous secretions</p> Signup and view all the answers

    In which condition should mucolytics be avoided due to the risk of exacerbating symptoms?

    <p>Asthma</p> Signup and view all the answers

    What is an important consideration when administering Acetylcysteine orally?

    <p>It protects the liver from toxicity</p> Signup and view all the answers

    Which of the following practices is advised before administering Acetylcysteine via nebulizer?

    <p>Administering a bronchodilator</p> Signup and view all the answers

    What side effect is potentially associated with Acetylcysteine?

    <p>Rash</p> Signup and view all the answers

    Which of the following is a contraindication for using acetylcysteine?

    <p>Dextromethorphan use</p> Signup and view all the answers

    How does Acetylcysteine help with airway clearance?

    <p>By making cough more productive</p> Signup and view all the answers

    What is a suggested intake of water for optimal mucous clearance?

    <p>8 glasses/day</p> Signup and view all the answers

    Study Notes

    Antihistamines

    • Diphenhydramine is a first-generation antihistamine
      • It completes with histamine for binding at H1-receptor sites and antagonizes histamine effects
      • Indications include allergic rhinitis, common cold, pruritus, and urticaria
      • Adverse effects include drowsiness, dizziness, fatigue, and disturbed coordination
      • Caution: Avoid driving or operating dangerous machinery and alcohol use
      • Avoid: in patients with glaucoma and COPD
    • Loratadine is a second-generation antihistamine
      • Indications include allergic rhinitis, pruritus, and urticaria
      • Adverse effects are similar to first-generation antihistamines, but is less sedating and has fewer anticholinergic symptoms
      • Given PO, IM, or IV
      • Found in many OTC cold medicines

    Decongestants

    • Oxymetazoline is a nasal decongestant
      • Stimulates alpha-adrenergic receptors resulting in vasoconstriction of capillaries in the nasal mucosa which shrinks nasal mucous membranes and decreases fluid (runny nose)
      • Indications include nasal congestion
      • Adverse effects include rebound congestion, nasal irritation, blurred vision, dry eyes, and headache
      • Extreme Caution: in patients with HTN, cardiac disease, hyperthyroidism, and diabetes
      • Limit use to 3 days
      • Acts quickly and has fewer adverse effects than systemic decongestants
    • Pseudoephedrine is a systemic decongestant
      • Stimulates alpha-adrenergic receptors resulting in vasoconstriction of capillaries in the nasal mucosa which shrinks nasal mucous membranes and decreases fluid (runny nose)
      • Indications include rhinitis and the common cold
      • Adverse effects include:
        • CNS: dizziness, headache, restlessness, insomnia
        • CV: palpitations, dysrhythmias, HTN and tachycardia
      • Extreme Caution: in patients with HTN, cardiac disease, hyperthyroidism, and diabetes
      • Interactions: increase HTN with MAOIs and beta blockers
      • Avoid large amounts of caffeine
      • Given PO in regular and extended-release
      • Combined with other drugs in OTC cold medicines
      • Works longer than nasal forms of decongestants

    Intranasal Glucocorticoids

    • Fluticasone is an intranasal glucocorticoid
      • Produces anti-inflammation resulting in a decrease in allergic rhinitis symptoms
      • Indications include allergic rhinitis and asthma
      • Adverse effects include headache, blurred vision, fatigue, insomnia, pharyngitis, nasal candidiasis/irritation
      • Short-term use only
        • 2 sprays per nostril per week 1
        • 1-2 sprays qd PRN

    Antitussives

    • Dextromethorphan is an antitussive
      • Acts on the cough control center in the medulla to suppress the cough reflex
      • Indication is temporary cough relief of a non-productive cough due to sore throat, irritation, or cold
      • Rapid absorption, works in 15-30 minutes and lasts 3-6 hours
      • Used in many OTC cold medicines

    Expectorants

    • Guaifenesin is an expectorant
      • Loosens bronchial sections to be eliminated by coughing
      • Indications include cough with URI and cold
      • Adverse effects include headache, dizziness, drowsiness, nausea, vomiting
      • Hydration is important, take with a full glass of water
      • Drink 8 glasses/day
      • In many OTC cold medicines

    Mucolytics

    • Acetylcysteine is a mucolytic
      • Thins mucous secretions
      • Indications include cystic fibrosis, atelectasis
      • Adverse effects include GI irritation, rash, oropharyngeal irritation
      • Avoid with: asthma, agents with dextromethorphan(cough suppressant), and agents with acetaminophen (liver toxicity)
      • Given via nebulizer
      • Given 5 minutes before a bronchodilator

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    Description

    This quiz covers important information on antihistamines and decongestants, including their classifications, indications, and adverse effects. It focuses on first-generation antihistamines like Diphenhydramine and second-generation ones like Loratadine, along with the decongestant Oxymetazoline. Test your understanding of their uses and precautions in pharmacology.

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