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  1. Diphenhydramine HCL
    • (Benadryl)
    • -1st gen. antihistamine

    • -for allergies, sedation
    • -some anticholinergic effects
  2. Deminhydrinate
    • (Dramamine)
    • -1st gen. antihistamine

    -for motion sickness prevention, vestibular disturbances

    -some anticholinergic effects
  3. Hydroxyzine HCL
    • (Atarax)
    • -1st gen. antihistamine

    -sedative and mild anxiolytic properties
  4. Meclizine HCL
    • (Antivert)
    • -1st gen. antihistamine

    -to treat vestibular disturbances
  5. Promethazine HCL
    • (Phenergan)
    • -1st gen. antihistamine

    • -used for antiemetic, sedating
    • -prevention and treatment of N/V
    • -PO, parenteral, transdermal
    • -alpha blocking activity, dopamine blocking
  6. Cyproheptadine
    • (Periactin)
    • -1st gen. antihistamine

    • -may be used to enhance appetite
    • -serotonin blocking actions
  7. Doxepin
    -1st gen. antihistamine

    -very potent tricyclic antidpressant
  8. Cetirizine
    • (zyrtec)
    • -2nd generation antihistamines
  9. Fexofenadine
    • (Allegra)
    • -2nd generation antihistamines
  10. Loratidine
    • (Claritin)
    • -2nd generation antihistamines
  11. Desloratidine
    • (Clarinex)
    • -2nd generation antihistamines
  12. Phenylephrine HCL
    Short acting topical decongestant
  13. Naphazoline HCL
    Intermediate acting topical decongestant
  14. Tetrahydrolozine HCL
    Intermediate acting topical decongestant
  15. Oxymetazoline HCL
    Long acting topical decongestant
  16. Xylometazoline HCL
    Long acting topical decongestant
  17. Pseudoephedrine
    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)
  18. Side effects of systemic decongestant (5)
    • 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
  19. Guaifenesin
    • (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
  20. Veramyst
    -nasal spray for seasonal and perennial allergic rhinitis

    -contains aqueous suspension of micronized fluticasone furoate
  21. Xyzal
    (levocetirizine dihidrochloride)

    -oral h1 blocker for season and perennail allergic rhinitis and chronic urticaria
  22. Loperamide
    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
  23. Diphenoxylate
    • (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
  24. Polycarbophil

    -only FDA recommended OTC adsorbent

    -absorbs tons of water and used for constipation and diarrhea

    -AE: bloating and farting
  25. To treat traveler's diarrhea (3)
    • 1. Rifaximin (Xifaxan) for non-invasive E.coli
    • 2. Fluoroquinolon: ciprofloxacin, levofloxacin
    •      - for severe illness/dysentery
  26. Bulk formers for constipation (3)
    • 1. Psyllium (Metamucil)
    • 2. Methylcellulose (Citrucel)
    • 3. Polycarbophils (Fibercon)
  27. Emollient laxatives (2)
    • 1. Docusate salts (Colace)
    • 2. Glycerin suppositories - safe and effective in children
  28. Lactulose
    -osmotic agent for constipation

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

    -also uses for chronic liver failure, hepatic encephalopathy

  29. Sorbitol
    Osmotic agent used for chronic constipation

    AE: farting, cramps

    -less expensive than lactulose and works just as well
  30. Antraquinone derivatives (2)

    MOA and AE
    • 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
  31. Bisacodyl
    Irritant to colon mucosa and should be used for short term relief of constipation ONLY

    May cause abdominal cramping
  32. Saline laxatives (2)
    • 1. Magnesium salts
    • 2. Sodium phosphate

    -used for bowel cleansing prior to certain procedures
  33. Polyethlene Glycol (PEG)
    (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
  34. Amitiza

    -used for constipation

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

    -AE: nausea
  35. Hycoscyamine sulfate
    • (Levsin, Levsin drops, Levbid)
    • -antispasmotics

    -anticholinergic agent for IBS

    AE: drowsiness, anticholinergic effects
  36. Librax
    Antispasmotic for IBS

  37. Dicyclomine hydrochloride
    • (Bentyl)
    • -antispasmotic for IBS

    -decreases fecal urgency and pain
  38. When are anticholinergic agents contraindicated?
    GI or GU obstruction
  39. Tegaserod
    • (Zelnorm)
    • -drug used for IBS in women

    -recently withdrawn due to increased incidence of CV events
  40. 5-ASA compounds (5)
    • -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
  41. AE of 5-ASA compounds (6)
    • 1. N/GI upset -- diarrhea
    • 2. HA
    • 3. arthralgias
    • 4. myalgias
    • 5. bone marrow suppression
    • 6. hypersensitivity rxns (sulfa containing)
  42. Oral Prednisone
    Used for severe exacerbations of IBD

    - can also be used as enema, IV, or topical (newer)
  43. Thioguanine derivatives (3)
    • 1. 6-Mercaptopurine
    • 2. Azathioprine
    • 3. Methotrexate for steroid dependent Crohn's 

    Immunosuppressive agents for IBD

    AE: bone marrow suppression
  44. Infliximab
    • (Remicade)
    • -immuniglobulin that binds to TNF for severe Crohn's, esp. fistulizing and steroid dependent


    -more frequent URI, delayed hypersensitivity, infections (TB, Hep B)
Card Set:
2013-02-12 08:36:24
Pharm 2B

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