A client diagnosed with allergic rhinitis is prescribed an antihistamine to assist with symptoms. Which of the following medications below would be considered a second-generation antihistamine?
cetirizine (Zyrtec)
chlorpheniramine (Aller-Chlor)
diphenhydramine (Benadryl)
montelukast (Singulair)
The Correct Answer is A
A) Cetirizine (Zyrtec): This medication is classified as a second-generation antihistamine. Second-generation antihistamines are designed to be less sedating than first-generation agents, as they are less likely to cross the blood-brain barrier. Cetirizine effectively alleviates symptoms of allergic rhinitis by blocking histamine receptors and is commonly used due to its efficacy and reduced sedation compared to older antihistamines.
B) Chlorpheniramine (Aller-Chlor): Chlorpheniramine is a first-generation antihistamine. It tends to cause more sedation and has a higher likelihood of causing side effects such as drowsiness, dry mouth, and dizziness. First-generation antihistamines are typically less selective and can affect the central nervous system more significantly than their second-generation counterparts.
C) Diphenhydramine (Benadryl): This medication is also a first-generation antihistamine. It is well-known for its sedative effects and is often used for allergic reactions, as well as for its sleep-inducing properties. Like other first-generation antihistamines, diphenhydramine can cause significant drowsiness and other anticholinergic effects.
D) Montelukast (Singulair): Montelukast is not an antihistamine but rather a leukotriene receptor antagonist. It is used for the management of allergic rhinitis and asthma but works through a different mechanism by blocking leukotriene receptors, thereby reducing inflammation and mucus production. It is not classified as an antihistamine, either first or second generation.
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Correct Answer is C
Explanation
A. CNS Depressants: While there may be general concerns about using multiple medications that affect the central nervous system, CNS depressants do not have a direct interaction with oxymetazoline. Oxymetazoline is primarily a nasal decongestant and its interactions are more specific to other classes of medications.
B. Short Acting Beta Agonist: Short-acting beta agonists (SABAs) are bronchodilators used in asthma management. There is no direct interaction with oxymetazoline; they are used for different purposes and act on different receptors.
C. Monoamine oxidase inhibitors (MAOIs): This option is correct. MAOIs can potentially interact with oxymetazoline, leading to increased blood pressure and other cardiovascular effects. The combination can cause vasoconstriction due to the stimulant effects of both oxymetazoline and the increased levels of norepinephrine resulting from MAOI inhibition.
D. Mast Cell Inhibitors: Mast cell stabilizers do not interact directly with oxymetazoline. These medications are used primarily to manage allergic responses and asthma symptoms and do not have a significant effect on the actions of oxymetazoline.
Correct Answer is ["A","C"]
Explanation
A) Decongestants: These medications are primarily used to relieve nasal congestion associated with upper respiratory conditions such as allergic rhinitis and the common cold. They work by constricting blood vessels in the nasal passages, thereby reducing swelling and congestion. Common examples include pseudoephedrine and phenylephrine.
B) H2 Antagonist: H2 antagonists are primarily used to reduce gastric acid secretion and treat conditions such as peptic ulcers and gastroesophageal reflux disease (GERD). They are not indicated for upper respiratory conditions, so this option does not apply.
C) H1 Antagonist: H1 antagonists, or antihistamines, are used to alleviate symptoms of allergies, hay fever, and other upper respiratory conditions by blocking the effects of histamine. This class includes both first-generation antihistamines (like diphenhydramine) and second-generation antihistamines (like cetirizine), making them relevant for upper respiratory issues.
D) Long-Acting Beta Agonist (LABA): LABAs are primarily used for the management of asthma and chronic obstructive pulmonary disease (COPD), targeting the lower respiratory tract. They are not typically used for upper respiratory conditions, so this option does not apply.
E) Short Acting Beta Agonist (SABA): SABAs, such as albuterol, are primarily used for acute asthma attacks and bronchospasm in conditions like COPD. They act on the lower respiratory tract and are not indicated for upper respiratory conditions.
F) Mast Cell Stabilizers: These medications are used to prevent allergic reactions and asthma symptoms by stabilizing mast cells and preventing the release of histamine and other inflammatory mediators. While they may have a role in allergic rhinitis, they are not the primary treatment for upper respiratory tract conditions, making this option less applicable compared to decongestants and H1 antagonists.