Pseudoephedrine
True/ False
Pseudoephedrine is used as a decongestant (sympathomimetic) relieving the symptoms of cold, allergies, and hay fever.
True
The symptoms for when you would use Nyquil
Temporary relief of cold and flu symptoms including cough, sore throat, headache, minor aches and pain, fever, runny nose, sneezing.
Name two indications for use of loratadine
allergic rhinitis, urticaria, and allergic conjunctivitis
What is the brand name for Pseudoephedrine?
Sudafed
Mucinex
Theraflu
Tylenol
Sudafed
The three types of drug in Nyquil
acetaminophen, dextromethorphan, and doxylamine
Which receptor does Loratadine act on? (Please be specific)
peripheral histamine H1 receptors
What type of drug is pseduoephedrine? and what is its mechanism of action? (main receptor it works on)
Alpha-Adrenergic Antagonist, results in vasodilation and increases nasal and sinus congestion.
Alpha-Adrenergic Agonist, results in vasoconstriction and decreases nasal and sinus congestion.
Beta-Adrenergic Agonist, results in easier breathing and relaxes the muscles of the airway.
Beta-Adrenergic Antagonist, results in vasodilation and is used to treat high blood pressure, chest pain (angina), and other cardiac complications
Which drug is most similar to pseudoephedrine?
Norepinephrine
Prazosin
Quinidine
Hydrochlorothiazide
Alpha-Adrenergic Agonist, results in vasoconstriction and decreases nasal and sinus congestion.
The contraindication of NyQuil?
During or within 14 days of MAOIs. Concomitant other acetaminophen products.
What antibiotic inhibits Loratadine's hepatic metabolism?
Oral erythromycin will increase the level or effect of loratadine oral affecting hepatic/intestinal enzyme CYP3A4 metabolism - this should be taken into account when prescribing medication.
Which drug is most similar to pseudoephedrine?
Norepinephrine
Prazosin
Quinidine
Hydrochlorothiazide
Norepinephrine
Symptoms you would see with NyQuil Toxicity
The symptoms for acetaminophen toxicity and liver failure. Nausea, pain in upper stomach, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes)
What is the mechanism of action?
Loratadine is a second-generation histamine H1 receptor antagonist with anti-allergic properties and without sedative effects. It blocks the peripheral H1 histamine receptors and prevents the symptoms that are caused by histamine activity on capillaries, bronchial smooth muscle, and gastrointestinal smooth muscle, including vasodilatation, increased capillary permeability, bronchoconstriction, and spasmodic contraction of gastrointestinal smooth muscle. Loratadine does not cross the blood-brain barrier and does not cause central nervous system effects.
Which drug has the WORST side effects when taken with pseudoephedrine? (a sympathomimetic)
Linezolid (MAO Inhibitor)
Procainamide (Class 1a antiarrhythmic)
Verapamil (Calcium Channel Blocker)
Propranolol (Beta Blocker)
Linezolid (MAO Inhibitor)
The toxicity mechanism of NyQuil
Acetaminophen overdose is the main reason for toxicity. Acetaminophen is largely converted to nontoxic glucuronate or sulfate conjugates and secreted in the urine. A minor amount of acetaminophen is metabolized via the cytochrome P450 system to intermediates that can be toxic, particularly N-acetyl-p-benzoquinoneimine. Ordinarily, this intermediate is rapidly conjugated to reduced glutathione, detoxified and secreted. If levels of glutathione are low or the pathway is overwhelmed by high doses of acetaminophen, the reactive intermediate accumulates and binds to intracellular macromolecules that can lead to cell injury, usually through apoptotic pathways.
What do the H1, H2, H3 and H4 receptors mediate?
H1 receptor-Gq coupled-see above. H2 receptor—This Gs-coupled receptor mediates gastric acid secretion by parietal cells in the stomach. It also has a cardiac stimulant effect. A third action is to reduce histamine release from mast cells—a negative feedback effect. H3 receptors are Gi coupled and primarily found in the brain and are inhibitory autoreceptors located on histaminergic nerve terminals, which modulate the release of histamine. H4 receptor—Gi coupled and located on leukocytes (especially eosinophils) and mast cells and is involved in chemotactic responses by these cells.