1. What is the immune system?
    The human body has the ability to resist almost all types of organisms or toxins that tend to damage the tissues and organs.
  2. What is an antigen?
    • The substances that the immune system attacks.
    • Bacteria, Viruses, Toxins
  3. What is an antibody?
    • Humoral Immunity
    • B-cells (Bursa of Fabricus)
    • Also formed before and shortly after birth
    • Fights slowly growing bacteria
  4. Haptens
    • Smaller substances that must combine with a protein to become an antigen.
    • Drugs
    • Dust
    • Dander
    • Chemicals
    • Smoke
  5. Where are histamine 1 (H1) receptors found?
    • Blood vessels
    • Bronchial smooth muscles
    • Intestinal smooth muscles
  6. Where are histamine 2 (H2) receptors found?
    • Stomach
    • Heart
    • Blood vessels
    • Uterine tissue
  7. How do antihistamines work?
  8. Nonselective antihistamines.
    • Promethazine (Phenergan? - used for nausea)
    • Tripelennamine (PBZ?)
    • Azatadine (Optimine?)
    • Azelastine (Astelin? - nasal spray)
    • Clemastine (Tavist?)
    • Cyproheptadine (Periactin? - used for itching, appetite stimulating)
    • Dexchlorpheniramine (Polaramine?)
    • Diphenhydramine (Benadryl?) sleep-aid
    • Hydroxyzine (Atarax?, Vistaril? - used for itching, nausea)
    • Meclizine (Antivert?, �C used for nausea and dizziness/vertigo)
  9. selective antihistamines.
    • Fexofenadine (Allegra?)
    • Desloratidine (Clarinex?)
    • Levocetirizine (Xyzal?): OTC
    • Bepotastine (Bepreve? - ophthalmic drug)
    • Olopatadine (Patanol? - ophthalmic drop, eye contact)
  10. Why are decongestants often combined with antihistamines? Give an example of a combination antihistamine/decongestant product found on our Top 200 list.
  11. Why are nasal steroids used in patients with allergies? Give an example of a nasal steroid found on our Top 200.
    • Intranasal steroids are very effective in preventing acute allergic attacks.
    • Budesonide (Rhinocort?)
    • Fluticasone (Flonase?)
    • Mometasone (Nasonex?)
  12. Why are antileukotriences used in patients with nasal allergies? Give an example of an antileukotriene found on our Top 200.
    • These agents inhibit leukotrienes. Leukotrienes are released in the nasal passages after allergen exposure and lead to the symptoms of allergic rhinitis.
    • Montelukast (Singulair?)
  13. Asthma
    narrowing of the bronchioles (bronchoconstrictor) due to contraction of smooth muscles. This can be caused by allergies, irritation, exercise, or other factors. It is associated with inflammation.
  14. Chronic Bronchitis
    inflammation of the bronchi. A patient that has excess mucous secretions on most days for 3 months of the year is said to have chronic bronchitis.
  15. Emphysema
    a breakdown in the walls of the alveoli which causes a decrease in oxygen diffusion into the blood. Smoking, miners
  16. Why are B-agonists useful in treating asthma? What side effects might they have?
  17. Why are inhaled and oral steroids used in patients with asthma? Give an example of an inhaled steroid found on our Top 200. Give an example of an oral steroid found on our Top 200.
    • Steroids decrease bronchoconstriction by decreasing the inflammatory response of the bronchi.
    • Oral Steroids: Prednisone (Deltasone?), Methylprednisolone (Medrol?)
    • Inhalation Steroids: Fluticasone (Flovent?), Budesonide (Pulmicort?), Triamcinolone (Azmacort?), Flunisolide (Aerobid?), Mometasone (Asmanex?)
  18. What is theophylline and how is it useful in treating asthma? What side effects might it have?
    • Xanthines
    • Not sure how these drugs work, they work intracellularly like the beta agonists, thus causing bronchodilation.
    • useful for maintenance therapy
    • Side effects: Nausea/Vomiting, Increased heart rate, Seizures, Arrhythmia��s
  19. What other drugs are used to treat asthma? List some that are found on our Top 200.
    • Cholinergic Antagonist: Ipratropium (Atrovent?), Tiotropium (Spiriva?)
    • Combination Products: Salmeterol/Fluticasone (Advair Diskus?), Albuterol/Ipratropium (Combivent?)
    • Antileukotrienes: Montelukast (Singulair?), Zafirlukast (Accolate?), Zileuton (Zyflo?)
    • Xanthines: Theophylline (Theo-Dur?), Aminophyllin (Aminophylline?)
    • SRS-A Inhibitor: Cromolyn (Intal?)
    • Anti-inflammatory: Nedocromil (Tilade?)
    • Expectorants: Guaifenesin, Iodine
    • Mucolytics: Acetylcysteine (Mucomyst?), Dornase Alfa (Pulmozyme?)
  20. What drugs are used to treat chronic obstructive pulmonary disease? List some that are found on our Top 200?
  21. What is an expectorant?
    • Guaifenesin: Decreases viscosity and stickiness of mucus, OTC cough preparations (Robitussin?)
    • Iodine: break up mucus. Iodine is secreted in with mucus and breaks it up, making for easier elimination.
  22. What is a mucolytic?
    • used by inhalation. They physically break up mucus for expectoration.
    • Acetylcysteine (Mucomyst?): Used for Tylol overdose
    • Dornase Alfa (Pulmozyme?)
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