Unit 9 EENT and Pulmonary Agents ppt. slides

Question 0

Generally the provider should avoid ______ when treating cough; because it is a prodrug requiring activation.

Answer 0

Codeine

Question 1

Ephedrine and phenylephrine should not be take with ________ because of the increase risk of severe hypertension, arrhythmias, fever, and death.

Answer 1

MAOIs:Class 1 recommendation
Linezolid : class 2 recommendation

These are non-pharmacogenomically based DDIs

Question 2

What is the most common eye disease?

Answer 2

Conjunctivitis

Question 3

Viral rhinitis or upper respiratory viral infection tx

Answer 3

Decongestants
Intranasal steroids & cromolyn
Antitussives and expectorants

Question 4

Mechanism of action decongestants

Pseudoephedrine / phenylephrine

Answer 4

a-Adrenergic receptor agonist (sympathomimetic)
Produces vasoconstriction
Reduces tissue edema, nasal congestion, increases nasal patency, opens obstructed eustachian ochia
State restricts it ! Pts can make meth

Question 5

Mechanism of action antihistamines:

Answer 5

Compete for histamine at H1 receptor sites
Treat IgE- mediated allergy ( allergic rhinitis and urticaria)
Anticholinergic, antipruritic, and sedative effects

Question 6

Mechanism of action Intranasal steroids

Answer 6

Potent glucocorticoid and weak mineralocorticoid activity
Local antiinflammatory effects
Control symptoms of allergic rhinitis
Pt must use consistently daily for med to work May take weeks!

Question 7

What are the four major symptoms of allergic rhinitis ?

Answer 7

Rhinorrhea
Congestion
Sneezing 
Nasal itch
( can all be controlled by Intranasal steroids)

Question 8

Mechanism of action Antitussives:

Answer 8

Codeine and Dextromethorphan:

act on medulla to suppress cough

Question 9

Mechanism of Action: Expectorants

Answer 9

Increase respiratory tract secretions,
Loosen bronchial secretions by reducing adhesiveness and surface tension ,
Help mucociliary movement of secretions from airways

Question 10

Non pharmacological treatment of upper respiratory

Answer 10

Rest
fluid
identify environment precipitants
normal saline nasal sprays

Question 11

Treatment of upper airway with differing severities

Answer 11

1. Mild: antihistamine/decongestant.
2. Moderate: regular Intranasal corticosteroid. (decongestant if
   needed)
3. Moderate & Persistent: combo of Intranasal corticosteroids + nonsedating antihistamine + (decongestant if needed)
4. Severe: all of the above if needed and consider oral steroid and use of oxymetazoline.

Question 12

Decongestants are very effective but should be used with caution in:

Answer 12

Elderly

HTN, CVD, PVD, hyperthyroidism, DM, prostatic hyperplasia, urinary retention, increased intraocular pressure

Question 13

Decongestants are Contraindicated in:

Answer 13

Patients with mitral valve prolapse and cardiac palpitations

Question 14

Patient presents with any of the following: allergic of no allergic pruritic symptoms, urticaria, angioedema, previous reaction to blood plasma product, anaphylactic reaction then the prescriber would give

Answer 14

An antihistamine

Also can be used for antiemetic effects and vertigo

Question 15

Most effective agent for management of allergic rhinitis:

Answer 15

Intranasal steroids

Can also help shrink nasal polyps

Question 16

Over the counter drug effective in seasonal allergies that the patient starts 3-4 weeks prior to allergy season

Answer 16

Cromolyn

Intranasal mast cell stabilizer

Question 17

In general a cough should not be suppressed. Antitussives should not be suppressed unless;

Answer 17

The patient is having a nonproductive cough that is causing muscle pain or is interfering with sleep.

Question 18

A patient is insistent on a cough remedy for a presenting respiratory tract infection. What do you prescribe?

Answer 18

Expectorant

Question 19

A patient is prescribed an expectorant. What is important educational info while taking this drug

Answer 19

Fluid intake up to 1 gallon of water a day in pts who don’t have fluid restriction

Question 20

The Use of Intranasal corticosteroids in prepubescent children poses a potential risk for :

Answer 20

Growth suppression

Watch out for beclomethasone dipropionate

Question 21

Antihistamine therapy is contraindicated in :

Answer 21

Third trimester of pregnancy
Infants
Nursing mothers

Question 22

The primary symptom management drug for COPD :

Answer 22

Bronchodilator

Question 23

Long term treatment of asthma consists of :

Answer 23

Inhaled corticosteroids: help airflow by reducing inflamed bronchioles
Mast cell stabilizers: prevent and reduce bronchial wall inflammation
Leukotriene modifiers: act on inflammatory mediators (alt to steroids)
Long acting B2 agonists: smooth muscle relaxation
Methylxanthines: promote bronchodilation

Question 24

Maintenance treatment for COPD consists of :

Answer 24

Anticholinergics: blocks bronchoconstriction, reduce airway secretions
B2 Adrenergic agonist bronchodilators: smooth muscle relaxation
Methylxanthines: promote bronchodilation
Corticosteroids: reduce airflow obst. Reduce inflamed bronchioles
Expectorants : increase and loosen respiratory tract secretions