What Medication Am I?

(Cough, Cold & Allergy)

 Bret Tokash
 NUR-650 Advanced Pharmacology
 Thomas Edison State University
 Professor Kessel
 Treatments for Cough, Cold & Allergies
 Antihistamines (Cetirizine)
 Antitussives (Dextromethorphan)
 Expectorants (Guaifenesin)
 Bronchodilators (Albuterol)
 Decongestants (Pseudoephedrine)
 Leukotriene Modifiers (Montelukast)
 Corticosteroids (Solumedrol)
 Inhaled Anti-Inflammatory Agents
(Cromolyn)
 Anticholinergics (Atropine)
 Availability
 This medication is highly and
readily available OTC
 Easy to find in most pharmacy
stores
 Easy to obtain and cheaper if
buying generic
 Has been around for a while, can
be purchased in bulk
 Pharmacokinetics
 Second Generation Antihistamine
 Onset: 1 Hour
 Peak: 2.6 Hours
 Duration: 12 Hours
 Protein Binding: 60-70%
 Half Life: 14.4 Hours
 Metabolism: 95% Excreted Unchanged
 Elimination: 80% Fecal and Renal 11%
 Pharmacodynamics
 H1 Receptor Antagonist
 Second Generation Antihistamine
 Inhibit respiratory, vascular and GI smooth
muscle constriction
 Prevent increased capillary formation,
edema and wheel
 Prevent exocrine secretions (saliva, lacrimal)
 Decrease flare and itch response (pruritus)
on peripheral nerve endings
 Less sedating
 Do not cross the blood brain barrier
 Have a drying effect
 Pharmacotherapeutics
 Contraindications: Pregnancy
Category C, children younger than
age 6

 Dosing: Tablets 180mg, 60mg, 30mg.

Children and adults greater than 12
years of age: 60mg BID PO

 Adverse Drug Reactions: Dry mouth

 Drug Interactions: Ketoconazole and

Erythromycin, antacids, ethanol
 Pharmacogenomics
 Specific Transport Molecules
 ABCB1 (1236C>T, 2677G>A/T &
3435C>T have contradictory results
 SLCO (2B1 (SLCO2B1c) Reduced
transport function
 Drug transport gene polymorphisms
 Decreased plasma concentration
with ABCB1
 OATp1B1, 1B3, 2B1 involved in liver
metabolism
 OATP, P-gp and MRP2 lead to strong
responses
 Pharmacoeconomics
 Generic 30-day supply 24-hour
tablets: $9.57 at CVS
 Brand name 30-day supply 30 tabs
24 hour: $34.90 at CVS
 Has a high-cost effectiveness
compared to other second-
generation antihistamines in its
class
 High net cost, good net health
benefit
 Effectiveness with Hypertension and COPD
 This medication does not raise blood pressure
 Combined with a decongestant, can increase blood pressure and heart rate
 Affects those with prior cardiac conditions such as heart palpitations and
hypertension
 Helps with COPD by binding to ACE2
 Inhibits RBD ACE2 Interaction
 Interactions of hydrogen bond with Lys 74, Ala 99,
 Ser 105, Ser 106, Trp 203 and Asp 509
 Teaching Plan
 Aware of dosing for longer acting second
generation antihistamines
 Typically taken once or twice per day (12 hrs.
or 24 hrs.)
 Do not double up or increase dosages
without consulting a provider
 Do not take closer together
 Do not crush or chew sustained released
tablets
 Can cause GI upset, take with food
 No drowsiness associated
 Avoid triggers and environmental and
seasonal allergies, including those found
from pet dander
 References
 Compare prices. GoodRx. (n.d.). Retrieved November 12, 2022, from https://www.goodrx.com/?dosage=24-
hour&form=tablet&label_override=&quantity=30&sort_type=popularity&slug=
 Huang, C. Z., Jiang, Z. H., Wang, J., Luo, Y., & Peng, H. (2019). Antihistamine effects and safety of : a systematic review and
Meta-analysis of randomized controlled trials. BMC pharmacology & toxicology, 20(1), 72. https://doi.org/10.1186/s40360-
019-0363-1
 Li, L., Liu, R., Peng, C., Chen, X., & Li, J. (2022). Pharmacogenomics for the efficacy and side effects of antihistamines.
Experimental Dermatology, 31(7), 993–1004. https://doi.org/10.1111/exd.14602
 Pentewar, G. S., Wagh, R. J., & Chincholkar, A. S. (2017). Pharmacoeconomic assessment and comparing efficacy
between cetirizine, levocetirizine, Loratadine and in allergic rhinitis patients. International Journal of Basic & Clinical P
harmacology, 6(11), 2684. https://doi.org/10.18203/2319-2003.ijbcp20174788
 - side effects, dosage, precautions, uses. Yashoda Hospitals. (n.d.). Retrieved November 13, 2022, from
https://www.yashodahospitals.com/medicine-faqs//
 Tristán-Flores, F. E., Casique-Aguirre, D., Pliego-Arreaga, R., Cervantes-Montelongo, J. A., García-Gutierrez, P., Acosta-García,
G., & Silva-Martínez, G. A. (2021). Identification of potential inhibitors of SARS-CoV-2 S protein- ACE2 interaction by in
silico drug repurposing. F1000Research, 10, Chem Inf Sci-358. https://doi.org/10.12688/f1000research.52168.2
 Woo, T., & Robinson, M., (2020). Pharmacotherapeutics for advanced practice nurse providers. (5th ed.). FA. Davis.