Miscellaneous Quiz / anti-histamines

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Can you name the anti-histamines?

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HintAnswer
Drug interactions: metabolized by CYP, inhibitors, and inducers effect therapy and toxicity
Other action: OTC 'cold' med
Physiologic antagonist for anaphylaxis
May inhibit absorption of other drugs through active transport mechanism and CYP metabolism
Carbinoxamine class
Chloropheniramine class
SE: muscarinic receptor blockage: dry mouth, urinary retention, constipation, ED, blurred vision, ST; alpha receptor blockade: orthostatic hypotension, reflex tachycardia;
SE: > placebo = viral infection, N/V, dysmenorrhea, drowsiness, dyspepsia, and fatigue
SE: serotonin-receptor blockade (increased appetite). Sedation, drowsiness, memory impairment, dystonia, dyskinesia, hallucinations, mydriasis, dry eye, weight gain.
Pyrilamine class
Anti-cholinergic + / Sedation ++
Containdications for histamine agonist
Loratodine class
Contraindicated in glaucoma and BPH
Little CNS penetration
Anti-cholinergic +++ / Sedation +++
Other action: Anti-serotonin action and weight gain
Doxylamine class
Other action: sleep aid
Diphenhydramine class
Kinetics: less CNS penetration (dose related sedation), CYP3A4 metabolism (drug interactions). Active metabolites (hydroxyzine -> cetirizine; terfen
Other action: Anti-emetic
Other action: OTC 'sleep aid'
HintAnswer
Anti-cholinergic - / Sedation +++
Release inhibitors used in asthma and AR
Cetirizine class
Class with anti-parkinsonian effects
Cyproheptadine class
Anti-cholinergic +++ / Sedation ++
Anti-cholinergic + / Sedation +
Tripelennamine class
Cyclizine class
Fexofenadine class
Not very useful except for inducing bronchial hyperreactivity to check pulmonary function
Agents with local anesthetic effect via sodium channel blockage in nerves
Anti-cholinergic - / Sedation +
Hydroxyzine class
Meclizine class
Brompheniramine class
SE: high dose sedation
Anti-cholinergic - / Sedation +/-
Promethazine class
SE: flushing hypotension, tachycardia, HA, wheal and flare reactions, bronchoconstriction, GI upset
Other action: anti-motion sickness
Drug interactions: metabolized in the liver, DOA 4-6 hours, caution w/ drug sedative drug combos and antimuscarinic drugs. Lethal ventricular arrhythmias --> prolonged QT.

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