1. Describe the action of Antihistamine.

Why Diphenhydramine should not be

used by patients with narrow-angle glaucoma?
2. As a nurse, what is your advice to a client who is employed as a truck driver
and currently taking first-generation Antihistamine?
3. Explain the action of a Decongestant. Why this drug is contraindicated to
patients with glaucoma, diabetes, hypertension, CAD and thyroid diseases?
4. How do nasal decongestants cause rebound congestion?
5. Describe the action of a beta adrenergic bronchodilator. Why beta-adrenergic
drug should not be advised to a patient with Ischemic Heart Disease?
6. Describe the effects of beta 1 receptor stimulation?
7. Why Corticosteroids should not be given to patients with active infection of
the respiratory system?
8. Why do you advise the patient to rinse the mouth after using the steroid
inhaler?
9. What are the effects of Leukotrienes in the body?
10. Describe the action of Montelukast?

1. Wheezing, sneezing, and watery eyes may occur when histamine, a chemical
produced by the immune system, overreacts to an allergen such as pollen or
animal dander. Antihistamines are drugs to treat asthma, as well as digestive
issues, colds, nausea, and other conditions. In certain patients with narrow
angles, antihistamines can induce an angle closure glaucoma attack (when fluid
is totally blocked from leaving the eye, creating a dangerous increase in
pressure).
2. Patients should be advised that antihistamines may cause drowsiness, and
concurrent use of alcohol or other CNS depressants should be avoided. Do not
drive after taking this medication. Antihistamines of the first generation induce
drowsiness. There is no indication that the patient can force drinks, take the drug
with an empty stomach, or put it on hold for some length of time.
3. A decongestant is a drug that aids in the relief of congestion. Congestion in the
nose, sinuses, and chest is caused by dilated blood vessels in the nasal and
airway membranes. Decongestants reduce swelling and inflammation by
narrowing the blood vessels. Because the use of decongestants is associated
with cardiovascular stimulation, including arrhythmia, elevated blood pressure,
palpitations, and tachycardia, they may exacerbate conditions that are sensitive
to adrenergic stimulation, including coronary artery disease, hypertension, and
ischemic heart disease, as well as interact with several other medications.
4. When you use a nasal decongestant more times in one day or more days than
the label suggests, you risk developing rebound congestion. Sinus membranes
swell as the drug wears off, causing inflammation, and a person can respond by
taking a stronger decongestant.
5. Bronchodilators that are beta-adrenergic loosen the muscles that line the
airways, allowing them to expand. Beta-2 agonists are beta-adrenergic
bronchodilators. These drugs activate beta-2 receptors in the smooth muscle
cells that line the airways, allowing them to relax and expand the airways.
Because of the negative inotropic results associated with an increase in
peripheral vascular resistance due to b2-blockade, these agents are not well
tolerated in heart failure.
6. When beta-1 receptors are activated, the heart rate and contractility (the speed
of the heart's contraction) rise. The bronchioles of the lungs and the arteries of
the skeletal muscles contain beta-2 receptors.
7. Because of their proven immunosuppressive effects and concerns about long-
term risks, doctors have traditionally opposed prescribing corticosteroids for
active infection. They looked at the results of randomized, double-blind studies
compared corticosteroids and placebo in infections that had been released.
8. A tiny dose of steroid will bind to your mouth and throat as it works its way into
your lungs to help you breathe while you use a steroid inhaler. This tiny amount
of steroid, if not rinsed out of the interior of your mouth or throat, will cause
thrush, a fungal infection.
9. Leukotrienes are inflammatory chemicals produced by the body in response to
exposure to an allergen or allergy cause. Leukotrienes cause airway muscle
contracting as well as the formation of extra mucus and fluid. These compounds
play a vital role in allergies, allergic rhinitis, and asthma, as well as inducing
airway constriction, rendering breathing difficult.
10. Montelukast functions similarly to zafirlukast (Accolate) in that it prevents certain
leukotrienes from binding to the cells that induce inflammation. Montelukast has
little effect on CYP2C9 or CYP3A4, two liver enzymes involved in the breakdown
and elimination of several products. As a result, unlike zafirlukast, montelukast is
unlikely to interfere with the elimination of other medications.