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Rx Prep > Allergic Rhinitis, Cough, Cold - Quiz 2 > Flashcards

Allergic Rhinitis, Cough, Cold - Quiz 2 Flashcards

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1
Q

What is rhinorrhea?

A

Runny nose

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2
Q

What is allergic rhinitis?

A

Congestion, rhinorrhea, sneezing, and itchy eyes caused by exposure to an allergen

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3
Q

What are sx of a cold?

A
  1. Sneezing
  2. Runny nose
  3. Thick dark mucus
  4. Sore throat
  5. Body aches
  6. Sx about 3 days and last about a week
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4
Q

Sx of allergy?

A
  1. Sneezing
  2. Runny nose
  3. Thin, clear mucus
  4. Wheezing
  5. Red, watery eyes
  6. Sx lasts more days to months after contact with allergen
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5
Q

How can we test for allergies?

A

IGE-MEDIATED SKIN PRICK TEST

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6
Q

What are common allergies?

A
  1. Pollen
  2. Mold
  3. Dust mites
  4. Animal dander
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7
Q

Non pharm to avoid allergies?`

A
  1. Vacuuming
  2. Checking AQI
  3. Checking pollen counting
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8
Q

What are nasal gels?

A

Petrolatum (Allergen Block) that is applied around the nose to physically block pollen and allergens from entering the nose
* safe for chidren and pregnancy

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9
Q

Ex of wetting agents?

A
  1. Ocean Little Remedies
  2. Simply Saline
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10
Q

Ex of nasal irrigation?

A
  1. NeilMed Sinus Rinse
  2. Isotonic or hypertolic saline
  3. Homemade or store bought distilled, boiled and cooled saline mixure
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11
Q

What should you not do for nasal irrigation?

A

Tap water increases risk for infection

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12
Q

Counseling on how to use nasal irrigation?`

A

Prepared saline olution is placed in neti pot then poured into one nostril and drained out the other while breathing through the mouth

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13
Q

What is first line for chronic moderate to severe sx?

A

Intranasal steroids

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14
Q

What is tx for mild sx?

A

PO antihistamines

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15
Q

What is the purpose of IN sterois?

A

Decreases inflammation for oderate severe sx

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16
Q

Examples of IN steroids?

A
  1. Budesonide (Rhinocort Allergy)
  2. Fluticase (Flonase)
  3. Triamcinolone (Nasacort)
  4. Mometasone (Nasonex)
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17
Q

ADRs of IN steroids?

A

Epistaxis

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18
Q

How long can you use IN steroids for relief?

A

One week

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19
Q

What are the preferred IN steroids for pregnancy?

A

Budesonide and beclomethasone

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20
Q

Budesonide

A

Rhinocort

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21
Q

Flutiasone

A

Flonase

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22
Q

Triamcilone

A

Nasocort

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23
Q

MOA of antihistamine?

A

Blocks histamine release by binding to H1 recepotr site

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24
Q

Which antihistamines are more sedating?

A

First gen

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25
Examples of first gen antihistamines?
Diphenhydramine (Benadryl) Chlorpheniramine (Aller-Chlor) Doxylamine (Unisom-SleepTabs)
26
Diphenhydramie
Benadryl
27
Chlorpheniramine
AllerChlor
28
Doxylamine
Unisom SleepTabs
29
Dosing of Benadryl in adults
25 mg PO Q4-6H or 50 mg PO Q6-8H (Max 300mg/day)
30
Avoid Benadryl is children under?
6
31
CI of first gen AH?
1. Neonates (<2Y) 2. Premature infants 3. Breadfeeding 4. Avoid in eldely
32
Patient populations cautioned for use of fist gen AH?
1. BPH (prostate enlargement) 2. Glaucoma
33
ADRs of first gen AH?
1. Somnolence 2. Cognitive impairment 3. Anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation)
34
What disease states are worsened with first gen antihistamines?
1. BPH 2. Constipation 3. Dementia 4. Glaucoma
35
What are 2nd gen AH>
1. Cetirizine (Zyrtec) 2. Levocetirizine (Xyzal) 3. Fexofenadine (Allegra) 4. Loratadine (Claritin)
36
Examples of IN antihistamines?
Azelastine (Astepro Allergy) Azelastin+Fluticasone (Dymista) Olopatadine (Patanase)
37
Cetirizine
Zyrtec
38
Levocetirizine
Xyzal
39
Fexofenadine
Allegra w/ Pseudophedrine (Allegra-D)
40
Loratadine
Claritin w/ Pseudophedrine (Claritin-D)
41
Azelastine
Astepro W/ Fluticasone (Dymista)
42
Olopatadine
Patanase
43
What 2nd gen AH are preferred in pregnancy?
Loratidine and Cetirizine
44
Which 2nd gen are more sedating?
Zyrtec and Xyzal
45
# 0 What 2nd gens are least sedating?
Fexofenadine Loratadine
46
What 2nd gen have a faster onset for some patients?
Cetirizine and levocetirizine
47
Counseling for Allegra
Take with water not fruit juice due to decreased absorption * Avoid Aluminum or Mag products
48
Can IN AH be used with IN steroids?
Yes, but increases ost and risk for side effects
49
MOA of decongestants
Alpha-adrenergic agonist that cause vasoconstriction of sinus vessels and decreases engorgement and mucosul edema
50
What are the APIs of decongestatns?
D: phenylephrine or pseudophedrine
51
What is the difference between phenylephrine and pseudoephrine?
**Phenylephrine:** poor PO absorption that comes in a nasal spray and lasts for a shorter amount of time **Pseudophedrine:** effective systemic decongestants that is a precursor to methamphetamine
52
# i Federal max amount of pseudoephedrine?
3-6 grams/day 9 grams/30 day
53
Systemic decongestants?
1. Phenylephrine (Sudafed PE) 2. Pseudoephedrine (Sudafed, Nexafed, Zephrex-D)
54
Topical decongestants?
Oxymetazoline (Afrin)
55
CI of systemic decongestants?
1. Don't use with MAOI 2. Avoid in children <2Ys (FDA), <4Ys (package labeling) 3. First trimester in pregnancy
56
ADRs of systemic decongestants?
1. Tachycardia 2. Palpitations 3. Increased BP 4. Insomnia 5. Decreased appetite
57
Warning of using Afrin? ADRs?
**Warning:** BPH **ADR:** Rhinitis medicamentosa (rebound congestion) if used longer than 3 days
58
Phenylephrine
Sudafed PE
59
Pseudoephedrine
Sudafed, Nexafed, Zephrex-D
60
OTC mast cell stabilizer
IN cromolyn (Nasal Crom)
61
Indications for Cromolyn?
Used regularly not prn * Safe in children ≥2Y and in pregnancy
62
What is used for the treatment of both allergic rhinitis and asthma?
Montelukast (Singular)
63
What medication is know to cause nasal dryness?
IN ipratropium
64
Montelukast
Singular
65
What is used for prevenative tx for allergies?
Immunotherapy by slowly increasing exposure to the allergen
66
What is the minimum tx for allergies usign immunotherapy
3 yrs
67
How is ht SL immunotherapy initiated?
First dose is given in a medical office where the patient can be monitored for 30 minutes * If tolerated, patient can take doses at home * Epinephrine auto injector shoul be given to patients on SL immunotherapy
68
How are colds transmitted?
Mucus secretions
69
How is cold transmission prevented?
Hand washing
70
What are natural products used for colds?
1. Zinc 2. Vitamin C 3. Echinacea 4. Airborne 5. Emergen-C
71
What are expectorants?
Used for productive cough to thin out mucus moving secretions out of respiratory tract
72
Examples of expectorants?
(Mucinex, Robitussin Mucus, RObafen Coughcongestion) W/ Dextromethrophan (Robafen DM, Robitussin DM)
73
Guaifenesin
(Mucinex, Robitussin Mucus, RObafen Coughcongestion) W/ Dextromethrophan (Robafen DM, Robitussin DM)
74
MOA of dextromethorphan?
Serotonin reuptake inhibitor but at high doses it acts as an NMDA-receptor blocker (euphoria and hallucinations)
75
What are cough suppressants?
Suppresses the cough reflex
76
Because of its abuse potential, who is not allowed to purchase Dextromethorphan or codiene?
<18Y
77
Examples of cough suppressants?
1. Dextromethorphan (Delsym, Robafen Cough, Robitussin Cough) W/ Guaifenesin (Robafen DM, Robitussin DM) 2. Codiene 3. Benzonatate (Tessalon Pearles) 4. Diphenhydramine (Benadryl)
78
What are the types of schedules for codiene?
CII: pain CV: combo for cough and cold
79
CI for Dextromethorphan?
1. Don't use within 14 days of MAOI 2. Serotonin syndrome
80
Products that contain dextromethorphan have what in their product name?
M
81
BBW of codiene?
1. Respiratory depression and death in children with tonsillectomy and adenoidectmy and ultra-rapid metabolizers from CYP2D6 polymorphism 2. Nursing infants
82
CI of codiene?
Children <12 of any indication <18 Y after tonsillectomy and/or adenoidectomy Avoid codien-containing cough and cold products for <18Y
83
Dextromethrophan
Delsym, Robafen Cough, Robitussin Cough
84
Benzonatate
Tessalon Perles
85
Brompheniramine/PE/D
Bromfed DM
86
What schedule is Promethazine/Codiene?
V
87
Chlorpheniramine/Hydrocodone? Schedule?
TussiCaps C-II
88
D
Decongestant (phenylephrine or pseudophedrine)
89
PE
Phenylephrine
90
DM
Dextromethorphan
91
AC
Codeine
92
Cold products that should be avoided in <18Y?
Codient and hydrocodone
93
Cold products that should be avoided in <4Y?
OTC cough and cold products
94
Cold products that should be avoided in <2Y?
1. OTC cough and cold products 2. Promethazine 3. Topical menthol and comphor
95
Menthol
Vicks Vaporub
96
Don't use phenylalanine if patient has ___?
Phenylketonuria

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