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Flashcards in Ear, nose drugs Deck (24):
1

First generation antihistamines

Diphenhydramine (Benadryl), Brompheniramine (Dimetane), Chlorpheniramine (ChloroTrimeton), Promethazine (Phenergan), many times daily

2

Second generation antihistamines

Loratadine (Claritin), Fexofenadine (Allegra), Cetirizine (Zyrtec), Desloratadine (Clarinex), Levocetirizine (Xyzal), once daily

3

Combo products

Loratadine/Pseudoephedrine (Claritin-D), Fexofenadine/pseudoephedrine (Allegra-D), MANY

4

Antihistamine MOA

blocks histamine receptor to suppress itching, sneezing, rhinorrhea, and ocular symptoms

5

Antihistamine ADR

Sedation, anticholinergic side effects, cog dysfunction

6

Pearls for antihistamines

best for prevention of sx, start routine admin in March, don't wait for symptoms, take additional if mowing, use combo products, very safe for long term use, caution with alzheimer's, BPH and glaucoma

7

Which antihistamines are good for peds

Zyrtec and claritin, not so much with benadryl

8

Azelastine (Astelin)

nasal spray antihistamine, helps with ocular sx, can cause drowsiness, nasal irritation, $$$

9

Dymista

Azelastine+fluticasone, nasal antihistamine combo, $$$$$$

10

Decongestants

Pseudoephedrine (Sudafed), Phenylephrine (Sudafed PE tablets and Neo-synephrine Nasal spray), Oxymetazoline (afrin, nasal), Sodium chloride (Ocean spray, increases humidity)

11

Decongestant use and ADR

focus in nasal congestion, insomnia, tachy, HTN (in uncontrolled); overall safe but shouldn't be used long term

12

Nasal corticosteroids

Budesonide (Rhinocort), Flunisolide (Nasarel), Fluticasone (Flonase and Veramyst), Mometasone (Nasonex), Triamcinolone (Nasacort)

13

Nasal corticosteroids Pearls

not for short term use, does not have immediate results, not first line, usually combo, can cause oral thrush, nasal irritation, sore throat, sneezing

14

Anticholinergics

Ipratropium (atrovent), spray decreases rhinorrhea, best for non allergic rhinitis, limited use

15

Montelukast (Singulair)

leukotriene receptor blocker, ideal pt w/ asthma, once daily, approved for children, never first line, safe but efficacy?

16

Immunotherapy for nose

sub-cutaneous injections of antigens weekly with slow transition with increased dose, reserved for pt that do not respond

17

Pathogens of acute otitis externa

pseuromonas aeruginosa, staph aureus

18

approaches to treating AOE

acidifying agents (acetic, boric acid), astringents (aluminum acetate), analgesic/anesthetic (antiprene/benzocaine), anti-inflammatory (hydrocortisone, dexamethasone), antibiotics

19

Antibacterials used for mild to moderate infection

neomycin/colistin/hydrocortisone (Coly-Mycin Otic), Neomycin/polymixin B/hydrocortisone (Cortisporin Otic)

20

antibacterials for Severe infections

Ofloxacin (Floxin), Ciprofloxacin/hydrocortisone (cipro HC otic), Ciprofloxacin/dexamethasone (ciprodex otic)

21

Antipyrene/Benzocaine (AB otic, AUrodex)

for ear pain and swelling, 3-4 drops every few hours, safe, onset 30 mins, cheap

22

Acetic acid (VoSol HC Otic, Vosol Otic)

use limited, helps inhibit bacterial growth

23

Acetic acid/aluminum acetate (Domeboro)

good if pt has breakdown of ear canal

24

Ear Hygiene option

Swim ear-Isopropyl alcohol, anhydrous glycerin, efficacy?, Dri ear- boric acid, isopropyl alcohol; Debrox- carbamide peroxide, glycerin, propylene glycol (helps w/ear wax); 50/50 H2O2/H2O