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NAPLEX > Allergic Rhinitis, Cough And Cold > Flashcards

Allergic Rhinitis, Cough And Cold Flashcards

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0
Q

Sx of AR

A

Sneezing

Itchy nose, eyes or throat

Watery eyes

Rhinorrhea

Nasal congestion

Postnasal drip

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1
Q

What is allergic rhinitis (hay fever)?

A

Inflammation of the membrane linings in the nose.

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2
Q

What’s the main environmental control of allergic rhinitis?

A

Avoiding exposure to allergens

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3
Q

List nasal wetting agents

A

Saline

Propylene

PEG sprays

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4
Q

Nasal irrigation agents

A

Warm saline (isotonic or hypertonic)

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5
Q

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

A

Intranasal corticosteroids

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6
Q

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

A

Oral antihistamines

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7
Q

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

A

Beclomethasone (Qnasi, Beconase AQ)

Budesonide (Rhinocort Aqua)

Ciclesonide (Omnaris, Zetonna)

Triamcinolone (Nasacort AQ)

Flunks oldie

Fluticasone (Flonase, Veramyst)

Fluticasone + Azelastine (Dymista)

Mometasone (Nasonex)

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8
Q

Remember “NASO” on a med name means nose

A

Ok

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9
Q

What’s the brand name for mometasone?

A

Nasonex

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10
Q

What’s the brand name for Triamcinolone?

A

Nasacort AQ

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11
Q

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

A

Delayed wound healing

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

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12
Q

Effect of Intranasal corticosteroids on peds?

A

May cause red in growth

Use lowest possible dose

Monitor dose

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13
Q

Which is the preferred IC in pregnacy?

A

Budesonide (Rhinocort Aqua) - preg cat B

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14
Q

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

A

Oral antihistamine

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15
Q

What sx are oral antihistamines effective in reducing?

A

Itching

Sneezing

Rhinorrhea

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16
Q

What sx are oral antihistamines NOT effective in reducing?

A

Nasal congestion

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17
Q

What’s the main first gen oral antihistamines?

A

Diphenhydramine (Benadryl)

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18
Q

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

A

Chlorpheniramine (Chlor-Trimeton)

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19
Q

What’s the dose for diphenhydramine (Benadryl)?

A

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

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20
Q

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

A

Carbinoxamine ER (Karbunak ER)

Promethazine (Phenergan)

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21
Q

What’s the main SE of first gen AH?

A

Sedation

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22
Q

List the 2nd gen AH agents

A

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

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23
Q

What’s the brand name of cetirizine?

A

Zyrtec, Zyrtec D

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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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