Pharm-2B

• (Benadryl)
• -1st gen. antihistamine

• -for allergies, sedation
• -some anticholinergic effects

• (Dramamine)
• -1st gen. antihistamine

-for motion sickness prevention, vestibular disturbances

-some anticholinergic effects

• (Atarax)
• -1st gen. antihistamine

-sedative and mild anxiolytic properties

• (Antivert)
• -1st gen. antihistamine

-to treat vestibular disturbances

• (Phenergan)
• -1st gen. antihistamine

• -used for antiemetic, sedating
• -prevention and treatment of N/V
• -PO, parenteral, transdermal
• -alpha blocking activity, dopamine blocking

• (Periactin)
• -1st gen. antihistamine

• -may be used to enhance appetite
• -serotonin blocking actions

-1st gen. antihistamine

-very potent tricyclic antidpressant

• (zyrtec)
• -2nd generation antihistamines

• (Allegra)
• -2nd generation antihistamines

• (Claritin)
• -2nd generation antihistamines

• (Clarinex)
• -2nd generation antihistamines

Short acting topical decongestant

Intermediate acting topical decongestant

Intermediate acting topical decongestant

Long acting topical decongestant

Long acting topical decongestant

systemic decongestant

-alpha and beta agonist activity related to ephedrine

-often used in combination with 2nd gen. antihistamine for allergic rhinitis with nasal congestion (claritin, allegra, zyrtec)

• 1. mild CNS stimulation
• 2. high doses can increase pulse and blood pressure
• 3. caution in pts w/ HTN and BPH
• 4. caution in pregnancy
• 5. behind the counter due to abuse and use to make illicit drugs

• (Duratuss & Humibid)
• -helps loosen phlegm and bronchial secretion to make coughs more productive

-used for chronic bronchitis, common col and bronchitis

-robitussin OTC

-Pregnancy category C

-nasal spray for seasonal and perennial allergic rhinitis

-contains aqueous suspension of micronized fluticasone furoate

(levocetirizine dihidrochloride)

-oral h1 blocker for season and perennail allergic rhinitis and chronic urticaria

opiate which acts as antisecretory agent

-not for pts with high fever or bloody darrhea

-can be used for traveler's diarrhea

-AE: rare, includes dizziness and constipation

• (Lomotil)
• -opiate used for acute and chronic diarrhea; not due to severe inflammatory infections

-combined w/ atropine to discourage abuse

-AE: dry mouth, blurred vision, urinary hesitancy

(Fibercon)

-only FDA recommended OTC adsorbent

-absorbs tons of water and used for constipation and diarrhea

-AE: bloating and farting

• 1. Rifaximin (Xifaxan) for non-invasive E.coli
• 2. Fluoroquinolon: ciprofloxacin, levofloxacin
•      - for severe illness/dysentery

• 1. Psyllium (Metamucil)
• 2. Methylcellulose (Citrucel)
• 3. Polycarbophils (Fibercon)

• 1. Docusate salts (Colace)
• 2. Glycerin suppositories - safe and effective in children

-osmotic agent for constipation

-metabolized by colon bacteria and lower pH --> increases peristalsis

-also uses for chronic liver failure, hepatic encephalopathy

$$$

Osmotic agent used for chronic constipation

AE: farting, cramps

-less expensive than lactulose and works just as well

• 1. Cascara
• 2. Senna

(Casanthranol and Senokot)

-metabolized by gut bacteria and irritate colon causing contractions and secretion of water

-not for daily use cus may lead to laxative dependence and abnormal function

AE: cramps, diarrhea, laxative dependence

Irritant to colon mucosa and should be used for short term relief of constipation ONLY

May cause abdominal cramping

• 1. Magnesium salts
• 2. Sodium phosphate

-used for bowel cleansing prior to certain procedures

(Colyte, Golytely, Nulytely, Miralax)

-osmotic cathartic agents

-used for bowel cleansing prior to Ba enema or colonoscopy

AE: N/V, anal irritation, cramps

-Stool should be completely liquid and clear

(Lubiprostone)

-used for constipation

-MOA: activates chloride channels locally in small intestine to increase intestinal fluid secretion; 1st selective chloride channel activator

-AE: nausea

• (Levsin, Levsin drops, Levbid)
• -antispasmotics

-anticholinergic agent for IBS

AE: drowsiness, anticholinergic effects

Antispasmotic for IBS

-anticholinergic

• (Bentyl)
• -antispasmotic for IBS

-decreases fecal urgency and pain

GI or GU obstruction

• (Zelnorm)
• -drug used for IBS in women

-recently withdrawn due to increased incidence of CV events

• -topical anti-inflmmatory for IBD (Crohn's and UC)
• ----------------For UC 1st Line----------------
• 1. sulfasalazine
• 2. balsalazide
• 3. olsalazine
• -----------------For Crohn's & UC-------
• 4. Mesalamine

• 1. N/GI upset -- diarrhea
• 2. HA
• 3. arthralgias
• 4. myalgias
• 5. bone marrow suppression
• 6. hypersensitivity rxns (sulfa containing)

Used for severe exacerbations of IBD

- can also be used as enema, IV, or topical (newer)

• 1. 6-Mercaptopurine
• 2. Azathioprine
• 3. Methotrexate for steroid dependent Crohn's 

Immunosuppressive agents for IBD

AE: bone marrow suppression

• (Remicade)
• -immuniglobulin that binds to TNF for severe Crohn's, esp. fistulizing and steroid dependent

-IV

-more frequent URI, delayed hypersensitivity, infections (TB, Hep B)