NR566 Midterm – Questions & Complete Solutions
Histamine acts primarily through which two receptors? Right Ans - H1 and
H2
Effects of H1 stimulation Right Ans - vasodilation, increased capillary
permeability, bronchoconstriction, CNS effects, itching, pain, and increased
mucus secretion.
Should antihistamines be used for treatment of asthma? Right Ans - No. H1
stimulation causes bronchiole constriction. This will causes severe
bronchoconstriction in the asthmatic patient.
Effects of H2 receptors Right Ans - Gastric acid secretion.
Two types of antihistamines Right Ans - H1 & H2 antagonists.
When to treat a patient with a H1 antagonist medication Right Ans - to
treat mild allergic reactions.
When to treat a patient with a H2 antagonist medication Right Ans - gastric
and duodenal ulcers
What is the main difference between an first and second generation H1
antagonist medication? Right Ans - First generation are highly sedative
where as second generation are not.
H1 antagonist MOA Right Ans - bind selectively to H1-histaminic receptors
which blocks the action of histamine at these sites.
Antihistamine overdose Right Ans - can cause CNS excitation - seizures.
children especially at risk.
Effects of antihistamines at a therapeutic level Right Ans - CNS depression.
Antihistamines in infants Right Ans - caution due to sedation. only use for
infants older than six months.
,Antihistamines in children and adolescents Right Ans - safe in smaller
doses. promethazine is contraindicated in children less than two years old.
Antihistamines in pregnancy & breastfeeding Right Ans - avoid unless
absolutely necessary in pregnancy (class c risk). small doses okay for breast
feeding. use with caution.
Antihistamines in older adults. Right Ans - avoid if possible. BEERS criteria.
can worsen preexisting glaucoma or BPH. if use is necessary, start at smaller
dose and titrate up.
Antihistamines used to treat motion sickness. Right Ans - Promethazine
(Phenergan) or Dimenhydrinate (Dramamine).
Patient education for first generation H1 antagonist antihistamine use.
Right Ans - avoid other CNS depressants such as alcohol, benzodiazepines,
barbiturates, and opioids. do not drive while taking.
Antihistamine anticholinergic effects Right Ans - drying of mucus
membranes, urinary hesitancy, constipation, and palpitations.
Antihistamines should be used with caution for patients with which medical
diagnosis? Right Ans - BPH, chronic urinary retention, asthma, and
hypertension.
Promethazine (Phenergan) BBW Right Ans - severe respiratory depression.
extreme caution of use in young children. contraindicated for children under
two years of age.
First generation antihistamine medication examples Right Ans -
Promethazine (Phenergan), Diphenhydramine (Benadryl), Hydroxyzine
(Vistaril).
Second generation antihistamine medication examples. Right Ans -
Cetirizine (Zyrtec), Levocetirizine (Xyzal), Fexofenadine (Allegra), Loratadine
(Claritin).
, Patient education for taking Fexofenadine (Allegra) Right Ans - Avoid fruit
juices (apple, grapefruit, orange) four hours before and 1-2 hours after taking
Allegra. Reduces absorption.
Physiologic effects of endogenous glucocorticoids Right Ans - metabolism,
maintain functional integrity of vascular system, neural excitability (CNS),
stress response, fluid and electrolyte excretion, contribute it maturing of
neonatal lungs during pregnancy.
Synthesis and release of glucocorticoids are regulated by Right Ans - the
negative feedback loop (hypothalamus, anterior pituitary, and adrenal cortex).
How do NSAIDs reduce inflammation Right Ans - by inhibiting
prostaglandin production
Short acting systemic glucocorticoid examples Right Ans - Cortisone,
Hydrocortisone
Intermediate acting systemic glucocorticoid examples Right Ans -
Prednisolone, Prednisone, Methylprednisolone, Triamcinolone.
Long acting systemic glucocorticoid examples Right Ans - Dexamethasone,
Betamethasone.
Glucocorticoids are metabolized primarily by the Right Ans - liver
Therapeutic uses of glucocorticoids Right Ans - RA, lupus, IBD (UC,
Crohns), allergic conditions, asthma, dermatologic conditions, prevention of
respiratory distress syndrome (given to pregnant mom), misc. inflammatory
disorders.
Glucocorticoid use in children Right Ans - caution, can inhibit bone growth.
risk for life long osteoporosis.
Glucocorticoid use in pregnant women & breastfeeding Right Ans - avoid,
can cause fetal harm. teratogenic and physiologic harm can occur. 1st
trimester use associated with cleft palate. 3d trimester use associated with
hypoadrenalism. if must use, use smallest and shortest dose. Hydrocortisone
Histamine acts primarily through which two receptors? Right Ans - H1 and
H2
Effects of H1 stimulation Right Ans - vasodilation, increased capillary
permeability, bronchoconstriction, CNS effects, itching, pain, and increased
mucus secretion.
Should antihistamines be used for treatment of asthma? Right Ans - No. H1
stimulation causes bronchiole constriction. This will causes severe
bronchoconstriction in the asthmatic patient.
Effects of H2 receptors Right Ans - Gastric acid secretion.
Two types of antihistamines Right Ans - H1 & H2 antagonists.
When to treat a patient with a H1 antagonist medication Right Ans - to
treat mild allergic reactions.
When to treat a patient with a H2 antagonist medication Right Ans - gastric
and duodenal ulcers
What is the main difference between an first and second generation H1
antagonist medication? Right Ans - First generation are highly sedative
where as second generation are not.
H1 antagonist MOA Right Ans - bind selectively to H1-histaminic receptors
which blocks the action of histamine at these sites.
Antihistamine overdose Right Ans - can cause CNS excitation - seizures.
children especially at risk.
Effects of antihistamines at a therapeutic level Right Ans - CNS depression.
Antihistamines in infants Right Ans - caution due to sedation. only use for
infants older than six months.
,Antihistamines in children and adolescents Right Ans - safe in smaller
doses. promethazine is contraindicated in children less than two years old.
Antihistamines in pregnancy & breastfeeding Right Ans - avoid unless
absolutely necessary in pregnancy (class c risk). small doses okay for breast
feeding. use with caution.
Antihistamines in older adults. Right Ans - avoid if possible. BEERS criteria.
can worsen preexisting glaucoma or BPH. if use is necessary, start at smaller
dose and titrate up.
Antihistamines used to treat motion sickness. Right Ans - Promethazine
(Phenergan) or Dimenhydrinate (Dramamine).
Patient education for first generation H1 antagonist antihistamine use.
Right Ans - avoid other CNS depressants such as alcohol, benzodiazepines,
barbiturates, and opioids. do not drive while taking.
Antihistamine anticholinergic effects Right Ans - drying of mucus
membranes, urinary hesitancy, constipation, and palpitations.
Antihistamines should be used with caution for patients with which medical
diagnosis? Right Ans - BPH, chronic urinary retention, asthma, and
hypertension.
Promethazine (Phenergan) BBW Right Ans - severe respiratory depression.
extreme caution of use in young children. contraindicated for children under
two years of age.
First generation antihistamine medication examples Right Ans -
Promethazine (Phenergan), Diphenhydramine (Benadryl), Hydroxyzine
(Vistaril).
Second generation antihistamine medication examples. Right Ans -
Cetirizine (Zyrtec), Levocetirizine (Xyzal), Fexofenadine (Allegra), Loratadine
(Claritin).
, Patient education for taking Fexofenadine (Allegra) Right Ans - Avoid fruit
juices (apple, grapefruit, orange) four hours before and 1-2 hours after taking
Allegra. Reduces absorption.
Physiologic effects of endogenous glucocorticoids Right Ans - metabolism,
maintain functional integrity of vascular system, neural excitability (CNS),
stress response, fluid and electrolyte excretion, contribute it maturing of
neonatal lungs during pregnancy.
Synthesis and release of glucocorticoids are regulated by Right Ans - the
negative feedback loop (hypothalamus, anterior pituitary, and adrenal cortex).
How do NSAIDs reduce inflammation Right Ans - by inhibiting
prostaglandin production
Short acting systemic glucocorticoid examples Right Ans - Cortisone,
Hydrocortisone
Intermediate acting systemic glucocorticoid examples Right Ans -
Prednisolone, Prednisone, Methylprednisolone, Triamcinolone.
Long acting systemic glucocorticoid examples Right Ans - Dexamethasone,
Betamethasone.
Glucocorticoids are metabolized primarily by the Right Ans - liver
Therapeutic uses of glucocorticoids Right Ans - RA, lupus, IBD (UC,
Crohns), allergic conditions, asthma, dermatologic conditions, prevention of
respiratory distress syndrome (given to pregnant mom), misc. inflammatory
disorders.
Glucocorticoid use in children Right Ans - caution, can inhibit bone growth.
risk for life long osteoporosis.
Glucocorticoid use in pregnant women & breastfeeding Right Ans - avoid,
can cause fetal harm. teratogenic and physiologic harm can occur. 1st
trimester use associated with cleft palate. 3d trimester use associated with
hypoadrenalism. if must use, use smallest and shortest dose. Hydrocortisone
