Antihistamines
What is the difference between 1st and 2nd generation antihistamines?
1st generation cause sedation (diphenhydramine), 2nd generation are less sedating (loratadine, fexofenadine).
What is the risk of using oxymetazoline (Afrin) longer than 3 days?
Rebound congestion.
What is fluticasone used for?
Long-term asthma/allergic rhinitis control.
What is albuterol used for?
Rescue inhaler for acute asthma attacks
What is montelukast used for?
Long-term asthma management and allergic rhinitis.
Name a common side effect of diphenhydramine.
Sedation, dry mouth, urinary retention.
Which antitussive is an opioid? Which is not?
Codeine is opioid; dextromethorphan is non-opioid.
What is a common side effect of inhaled corticosteroids?
Oral thrush (candidiasis).
Which bronchodilator has a narrow therapeutic range? What is the range?
Theophylline (10–20 mcg/mL).
When should montelukast be taken?
In the evening, once daily.
Why is loratadine safer for the elderly than diphenhydramine?
Because it has less sedation and anticholinergic effects.
What is the purpose of guaifenesin?
Expectorant: thins mucus for productive cough.
Why must prednisone be tapered off?
To prevent adrenal insufficiency/crisis.
What’s the difference between SABA and LABA?
SABA = quick relief (albuterol); LABA = maintenance (salmeterol).
What is cromolyn’s mechanism of action?
Mast cell stabilizer that prevents histamine release.
Why should patients avoid alcohol when taking antihistamines?
It increases CNS depression.
What does acetylcysteine smell like, and what else is it used for?
Rotten eggs; also antidote for acetaminophen overdose.
What should patients do after using an inhaled corticosteroid?
Rinse mouth to prevent thrush.
Why should salmeterol never be used for acute asthma attacks?
It has a delayed onset; not a rescue drug.
What is omalizumab’s major safety concern?
Risk of Anaphylaxis
Compare diphenhydramine and fexofenadine in terms of sedation and patient teaching
Diphenhydramine causes sedation; fexofenadine is non-sedating and should not be taken with fruit juice.
Why should codeine-containing cough syrups be used cautiously?
Risk of sedation, respiratory depression, and dependence.
What is a serious risk of long-term systemic corticosteroid use?
Hyperglycemia, osteoporosis, immunosuppression.
What is the risk of combining caffeine with theophylline?
Increased CNS stimulation and risk of toxicity.
Why is montelukast not for acute asthma attacks?
It does not provide immediate bronchodilation