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OTC > Allergic Rhinitis, Asthma, COPD, Viral Rhinitis > Flashcards

Allergic Rhinitis, Asthma, COPD, Viral Rhinitis Flashcards

1
Q

Differentiating factors between URTI and allergies

A

URTI- more episodic, sore throat or fever often, no itch. Allergies nasal obstruction and rhinorrhea common, with itching and eye sx often and sneeze

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2
Q

non drug choices in allergies

A

saline nose spray, irrigation systems, lubricant eye drops, avoid triggers, use air ocnditioning,

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3
Q

antihistamines help with congestion T or F

A

F- not usually recommended-desloratidine may be the only one that has some partial benefit. Work for sneeze rhinorrhea, itch, conjuntivitis

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4
Q

when should antihistamines be started for allergies

A

prophylactically- but can be used prn too

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5
Q

which 2nd gen antihistamine is most likley to cause sedation

A

cetirizine

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6
Q

treat mild to moderate allergy sx

A

allergen avoidance and antihistamine with or without prn decongestant. DOesn’t work? try intranasal steroid regularly

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7
Q

treat mod to severe allergy sx

A

allergen avoidance and intranasal steroid with or without: antihistamine, decongestant prn, eye drops for eye sx

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8
Q

when should decongestants be used with caution

A

uncontrolled blood pressure, hyperthyroidism, ischemic heart disease and not at all in those receiving MOAIs

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9
Q

how long can topical nasal decongestsants be used

A

3-7 days to prevent rebound congestion

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10
Q

how long can topical nasal steroids be used

A

as long as needed- qd or prn for allergy sx is fine, probably best daily

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11
Q

which intransasl steroids are safe for kids

A

mometasone, fluticasone furoate and propionate die to low oral F and absence of growth suppression long term

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12
Q

first line choice for allergies in kids

A

2nd gen antihistamines

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13
Q

what can/can’t you use for allergies in preg

A

can use 2nd gen antihistamines, montelukast, intranasal steroids. Can’t use oral decongestants in first trimester of preg

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14
Q

SE of decongestants

A

insomnia, tremor, irritable, HA, tachycardia, urinary retention

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15
Q

SE of 1st gen antihistamines

A

sedation, fatigue, dizzy, impaired cog, antichol.

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16
Q

steps in asthma therapy (adult)? How does it change in kids under 6?

A

saba prn, add ics, add laba, add leukotriene/increase ics/theophylline. Change in kids? reverse LTRA and laba

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17
Q

name SABAs- SE?

A

salbutamol, terbutaline- tremor, tachy, nervousness

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18
Q

name LABAs-how often are they used, when are they given in asthma? Which one is only for COPD?

A

salmetorol, formoterol- use BID. Given only with ICS. Indacterol also one but only for COPD. Vilanterol too.

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19
Q

when are anticholinergics used in asthma. SE?

A

not routinely- maybe if very susceptible to tremor or tachy from BAs, or for BB indued bronchospasm (ipra only, not tio it doesn’t act fast enough). SE= dry mouth, metallic taste

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20
Q

short term and long term side effects from high dose systemic CS therapy (ie for acute asthma exacerbation, etc)

A

short; fluid retention, glucose intolerance (hyperglycemia) , HTN, increased appetite, mood alterations, weight gain. Long; adrenal axis suppression, cataracts, dermal thinning, diabetes, glaucoma, HTN, myopathy, OP

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21
Q

asthma and preg

A

use meds! all safe. Uncontrolled asthma much higher risk (pre term birth, low BW< congenital anomalies, pre eclampsia, etc)

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22
Q

how soon to use a SABA before exercise and how long does it last?

A

5-10 minutes, lasts 2-4 hours

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23
Q

diagnostic criteria for COPD

A

FEV1 less than 80% and FEV1/FVC ration less than 0.7

24
Q

COPD treatment

A

start with SABA or SAAC (ie a short acting bronchodilator) (combo of the 2 even better, long acting bronchodilator if sx persistent, LABA/LAMA combo, add ICS, add O2

25
Q

tio vs ipratropium in COPD

A

tio preferred as it deposits better in airways of patients with low inspiratory flow rates and gives activity 24 hours vs up to 8 with ipra.

26
Q

name LAAC (LAMAs)

A

tiotropium, glycopyrronium, aclidinium, umiclinidium

27
Q

name the only OD LABA available

A

indacaterol- both rapid acting and long acting

28
Q

most common infectious agent in COPD exacerbations

A

virus. however, if increased dyspnea, sputum or increased sputum purulance antibiotics may be indicated. Common step pneumo hameophilis, moraxella. If complicated, klebsiella or pseudomonas may be involved

29
Q

cephalosporin counselling

A

GI upset (with or without food), rash

30
Q

fluoroquinolone counselling

A

headache, peripheral neuropathy, tendon rupture, QT. Separate from antacids, Ca and iron.

31
Q

macrolides counselling

A

GI, QT, clarith bitter taste

32
Q

tetracycline counselling

A

GI, photosens, sepearte iron and antacids

33
Q

sulfonamide counselling

A

N, rash, SJS rare

34
Q

amox clav counsel

A

like other pens (GI,, rash) but more diarrhea

35
Q

viral rhinitis resolves untreated usually in; what to do in the meantime

A

7-10 days- fluids, handwash, rest, decon, antihistamines, acet/ibu,

36
Q

comment on zinc for a cold

A

may reduce duration 1-1.5 days, but low evidence. Must be initiated within 24 hours onset and has an unpleasant taste (N)

37
Q

choices for constipation in pregnancy

A

bulk forming psyllium first line (not absorbed systemically), stimulants short term only, lactulose/PEG is safe

38
Q

antidiarrheals to avoid or take in preg

A

can take loperamide, avoid diphenoxylate and bismuth

39
Q

metronidazole counselling

A

N, H/A, dry mouth, metallic taste, no alcohol with or for 48 hours after

40
Q

most common causes of PUD

A

H pylori and NSAID/ASA use

41
Q

red flags for heartburn

A

VBAD- vomitting, bleeding, anemia, dysphagia, unexplained weight loss, age over 50

42
Q

how long do you treat with PPIs empirically for dyspepsia? then what?

A

4-8 weeks. Then try stopping or step down to H2antag

43
Q

what foods should be avoided in dyspepsia

A

spicy, orange juice, coffee, fatty, large meals

44
Q

name the 2 triple therapy regimens for h pylori eradication

A

ppi bid, clarith 500mg BID and amox 1g BID. OR ppi BID, clarith 250 bid, metro 500bid. for 10-14 days

45
Q

non pharm GERD management

A

modify diet (caffeine, chocolate, acidic, large fatty meals), decrease body weight, avoid eating 3 hours before bed, avoid lying down after meals, elevate head of bed, stop smoking, avoid tight clothes

46
Q

can you get tachyphylaxis from H2 receptor antagonists? PPIs?

A

H2- yes (also no meal associated acid suppression), PPI no

47
Q

difference between UC and crohns

A

UC only colon, crohns anywhere

48
Q

when are live attenuated vaccines CI (antrhax, intranasal influenze, MMR, polio live oral, smallpox, TB BCG, typhoid live oral, yellow fever, varicella)

A

TNF alpha inhibitors or immunomodulator

49
Q

what vaccines are recommended even on therapy in IBD

A

yearly flu shot, pneumococcal q3-5 years, HPV in young females

50
Q

other names for 5 asa, and how is it given

A

5 aminosalicylic acid, mesalamine, mesalazine. Given oral or PR, all equally effective and safe

51
Q

5ASA is formulated for targetted release how

A

salofalk, mesasal and pentasa release in small bowel (available there and in colon) or sulfasalazine, olsalazine, asacol and mesavant only release in colon

52
Q

typical treatments for IBD

A

5ASA (maintenance of remission), corticosteroids (induce remission- not for MOR), immunosuppressors (azathioprine, 6 mercaptopurine- used to reduce steroid doses and to maintain remission if needed)

53
Q

when might ginger gravol be useful

A

preg and postoperative N/V

54
Q

what is in diclectin and what is it approved for, what is max dose

A

doxylamine and pyridoxine (B6)- NV preg. 2 tabs HS, 1 in AM and 1 in afternoon (ie max 4 tabs daily)

55
Q

first line agents in N/V pregnancy

A

diclectin, dimenhydrinate (can be added to diclectin), promethazine

56
Q

what are domperidone and metoclopromide used for? differences>

A

both gastropareisis. D has less SE (both have D, cramp, HA, hyperprolactinemia), used for functional dyspepsia as well. M used for drug induced N, migraine N, and has more SE (add drowsy, fatigue, EPS)

OTC (21 decks)

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