Allergic Rhinitis, Cough And Cold Flashcards Preview

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Flashcards in Allergic Rhinitis, Cough And Cold Deck (80):
0

What is allergic rhinitis (hay fever)?

Inflammation of the membrane linings in the nose.

1

Sx of AR

Sneezing

Itchy nose, eyes or throat

Watery eyes

Rhinorrhea

Nasal congestion

Postnasal drip

2

What's the main environmental control of allergic rhinitis?

Avoiding exposure to allergens

3

List nasal wetting agents

Saline

Propylene

PEG sprays

4

Nasal irrigation agents

Warm saline (isotonic or hypertonic)

5

What's the first line tx for Chronic, Moderate-to-Severe rhinitis?

Intranasal corticosteroids

6

What's the tx for milder, intermittent sx of hay fever?

Oral antihistamines

7

List Intranasal corticosteroids (1st line for chronic mod-to-severe hayfever)

Beclomethasone (Qnasi, Beconase AQ)

Budesonide (Rhinocort Aqua)

Ciclesonide (Omnaris, Zetonna)

Triamcinolone (Nasacort AQ)

Flunks oldie

Fluticasone (Flonase, Veramyst)

Fluticasone + Azelastine (Dymista)

Mometasone (Nasonex)

8

Remember "NASO" on a med name means nose

Ok

9

What's the brand name for mometasone?

Nasonex

10

What's the brand name for Triamcinolone?

Nasacort AQ

11

What's the main warning ass. with Intranasal corticosteroids?

Delayed wound healing

AVOID use if recent nasal septal ulcers, surgery, trauma until healing has occurred

12

Effect of Intranasal corticosteroids on peds?

May cause red in growth

Use lowest possible dose

Monitor dose

13

Which is the preferred IC in pregnacy?

Budesonide (Rhinocort Aqua) - preg cat B

14

What's the first line agents for mild-mod hayfever?

Oral antihistamine

15

What sx are oral antihistamines effective in reducing?

Itching

Sneezing

Rhinorrhea

16

What sx are oral antihistamines NOT effective in reducing?

Nasal congestion

17

What's the main first gen oral antihistamines?

Diphenhydramine (Benadryl)

18

All first gen. oral antihistamines are safe for preg, but which is considered first line?

Chlorpheniramine (Chlor-Trimeton)

19

What's the dose for diphenhydramine (Benadryl)?

25-50 mg PO Q4-6H (max. 300 mg/day)

20

Which first gen AH can't be used in children < 2 years?

Carbinoxamine ER (Karbunak ER)

Promethazine (Phenergan)

21

What's the main SE of first gen AH?

Sedation

22

List the 2nd gen AH agents

Cetirizine (Zyrtec, Zyrtec D)

Desloratadine (Clarinex, Clarinex D, Clarinex RediTabs)

Fexofenadine (Allegra, Allegra D 12H;24H, children's Allegra ODT)

Levocetirizine (Xyzal)

Loratadine (Claritin, Claritin-D 24 hr, Claritin RediTabs, Alavert

23

What's the brand name of cetirizine?

Zyrtec, Zyrtec D

24

What's the brand name of desloratadine?

Clarinex, Clarinex D, Clarinex RediTabs

25

What's the brand name of Fexofenadine?

Allegra, Allegra D 12H; 24H, children's Allegra ODT

26

What's the brand name of Levocetirizine?

Xyzal

27

What's the brand name of loratadine?

Claritin, Claritin-D 24 hr, Claritin RediTabs, Alavert

28

Which 2nd gen AH is sedation most common in (still less than 1st gen)?

Cetirizine (Zyrtec)

Levocetirizine (Xyzal)

29

Which 2nd gen AH works the fastest of the group?

Cetirizine (Zyrtec)

Levocetirizine (Xyzal)

30

Name the agents/food that LOWER GI absorption of Fexofenadine (Allegra)?

What's the timeframe for separation?

Orange juice

Grapefruit juice

Apple juice

Antacids containing Al or Mg

Separate by 2 hrs

31

Name the agents/food that INCREASE GI absorption of Fexofenadine (Allegra)?

What's the timeframe for separation?

Ketoconazole

Erythromycin


No timeframe! AVOID this combo

32

What's the age group oral AH is indicated for?

> 2 yrs

33

List agents for Intranasal AH?

Azelastine (Astelin, Astepro)

Azelastine + Fluticasone (Dymista)

Olopatadine (Patanase)

34

What's the brand name for Azelastine? (Intranasal AH)

Astelin

Astepro

35

What's the brand name for Azelastine + Fluticasone (Intranasal AH)?

Dymista

36

Whats the age indicated for

Oloptadine

Azelastine

O - >= 6 yrs

A - >= 5 yrs

37

MOA of decongestants

Alpha adrenergic AGONIST (sympathomimetics) that work by causing vasoconstriction

38

If a pdt contains a D after the name eg. Mucinex D or Robitussin D, what does it usu contain?

Decongestants (Phenyephrine or Pseudoephedrine)

39

List the systemic (oral) decongestants used in AH?

Phenyephrine HCL (Sudafed PE)

Pseudoephedrine (Sudafed)

40

What's the adult dose of systemic (oral) - Phenyephrine HCL?

Max dose?

10mg PO. Q4H PRN

Max. 60mg/d

41

What's the adult dose of systemic (oral) - Pseudoephedrine?

Max dose?

60mg PO Q4-6H PRN

240mg/d

42

Brand name of Phenyephrine HCL?

Sudafed PE

43

Brand name of Pseudoephedrine?

Sudafed

44

Which is the more effective agent of the oral systemic decongestants?

Pseudoephedrine (Sudafed)

45

List the agents used as topical (Intranasal) decongestants.

Naphazoline

Oxymetazoline 0.05% (Afrin)

Phenyephrine 0.25%, 0.5%, 1%

Tetrahydrozoline 0.5%, 0.1%

Xylometazoline 0.5%, 0.1%

46

What's the brand name of Oxymetazoline?

Afrin

47

Which of the topical Intranasal decongestants is rx only?

Tetrahydrozoline (Tyzine)

48

What's the limit on the use of topical Intranasal decongestants? Why?

Limit use to less =< 3 days

To prevent rebound congestion

49

List the additional allergy agents

Intranasal cromolyn (Nasalcrom)

Intranasal ipratropium bromide (Atrovent nasal spray)

Oral antileukotrienes (Montelukast - singular)

50

Which of the additional allergy agents is used in young children and pregnancy (becuz of its safety panel)?

Intranasal cromolyn (Nasalcrom)

51

What's the main use of Atrovent Nasal Spray?

Rhinorrhea ONLY

used in combo with other agents when rhinorrhea

52

What's the maximum Pseudoephedrine that can be bought at once?

3.6 grams

OR

120 of the 30mg tablets

53

What's the maximum Pseudoephedrine that can be bought over a 30 day period?

9 grams (300 tablets)

54

What's the primary transmission method of colds and influenza?

Mucus secretions via patient's hands

55

What's virus causes about half of all colds?

Rhinovirus

56

List the natural cold pdts rated as possible effective?

Zinc

Vitamin C

Echinacea

57

What form of zinc is to be avoided?

Zinc nasal swabs or sprays

58

Both guaifenesin and Dextromethropan are preg cat. C. What's the caveat to their use in preg?

Guaifenesin - do NOT recommend in 1st trimester

Dextromethropan - leave to dr to recommend use

59

What should never be dispensed for a breastfeeding woman?

Codeine

Cold result in fatal respiratory depression in the infant nursed

60

What's the most commonly used cough suppressant?

Dextromethropan

61

What's the most common brand name for Dextromethropan?

Delsym

62

A pdt that contains DM at the end of the name contains what?

Dextromethropan

63

When taken in high doses, whats the concern with DM?

Risk of SEROTONERGIC syndrome, if taken with other serotonergic meds.

64

Is DM a drug of abuse?

Yes. When taken in high doses

65

MOA of DM as a drug of abuse (when taken in high doses)?

NMDA-receptor blocker which gives euphoric, hallucinogenic properties similar to PCP.

66

At what dose is the toxic sx of Dextromethorphan usually observed?

> 10 mg/kg

67

What's used in the illicit combo "purple drink"?

DM

68

MOA of guaifenesin?

Expectorant

DECREASES phlegm thickness in LOWER respiratory tract
INCREASES secretion in UPPER respiratory tract

69

Most common brand name of guaifenesin?

Mucinex

70

OTC cough and cold pdts should NOT be used in children under?

Age 4

71

Combo cough and cold pdts should NOT be used in children under?

2 yrs (FDA)

6 yrs (AAP)

72

Children should avoid combo cold & flu pdts. Why?

Severe skin rxns

73

What should always be dispensed with the liquid meds for kids?

Calibrated oral syringe/ dosing cup/

74

What should NOT be use to dispense liquid meds for kids?

Teaspoons

BC they come in diff sizes

75

T/F? Advise pts to keep well hydrated?

TRUS

76

Dose of acetaminophen in kids? (> 4yrs)

160mg/5ml Q4-6H PRN

77

Dose of ibuprofen in infant?

50mg/1.25ml (10-15mg/kg) Q6-8H PRN

78

Dose of ibuprofen in kids?

100mg/5ml Q4-6H PRN

79

Pt counseling for Flonase b4 using?

Shake gently

Prime at 1st use or if not used in about 1week

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