EENT Pharm

Question 1

Inflammation and / or infection of the middle ear; most common in infant and children

Answer 1

Otitis media

Question 2

Are most Otitis Media cases bacterial or viral infections?

Answer 2

40-75% acute cases are viral

Question 3

What is the most common bacterial cause of Otitis media?

Answer 3

Streptococcus pneumoniae (20% - 50% of bacterial cases are caused by this)

Question 4

Bacterial Otitis media commonly follows what kind of infection?

Answer 4

Viral Upper Respiratory Tract Infection

Question 5

How can you visually determine whether an Otitis Media infection is bacterial or viral?

Answer 5

if pt is coughing with clear drainage = viral

Question 6

What is the drug of choice for an acute bacterial Otitis Media infection?

Answer 6

Amoxicillin - ALONE

Question 7

If a patient is diagnosed with bacterial acute Otitis Media and has had amoxicillin within the last 30 days or has a serious infection what do you prescribe?

Answer 7

amoxicillin + clavulanate

Question 8

A patient diagnosed with bacterial Acute Otitis Media, failed to respond to amoxicillin + clavulanate , what do you prescribe them now?

Answer 8

a second or third generation cephalosporin

ceftriaxone, cefdinir, cefuroxime, cefpodoxime, etc.

Question 9

A patient is diagnosed with bacterial Acute Otitis Media and has a penicillin allergy, what do you prescribe her?

Answer 9

a macrolide such as azithromycin or clarithromycin
*z-pack - in class he said that these are pretty much almost not useful at this point because of increased resistance

Question 10

A patient presents with an acute bacterial Otits Media infection, with trouble breathing, swelling of the tongue, hives and anaphylactic. What do you want to avoid in this patient?

Answer 10

cephalosporins because there is a 10% chance of cross reaction

Question 11

inflammation of the nasal mucosa caused by IgE sensitization

Answer 11

Allergic rhinitis

Question 12

allergic rhinitis with acute symptoms

Answer 12

seasonal (hay fever) allergic rhinitis

Question 13

allergic rhinitis that is intermittent or persistent usually with more chronic, subtle symptoms

Answer 13

Perennial allergic rhinitis

Question 14

What are the symptoms of allergic rhinitis?

Answer 14

1. clear rhinorrhea
2. sneezing
3. nasal congestion
4. post nasal drip
5. allergic
6. conjunctivitis
7. itchy eyes

Question 15

Which treatment for allergic rhinitis is more effective when taken prior to exposure but can blunt response after exposure?

Answer 15

Antihistimines

Question 16

What is the difference in first and second generation antihistamines?

Answer 16

**H1 selective oral
first generation more lipophilic crosses the BBB and cause drowsiness
second generation doesnt

Question 17

intranasal formulation - antihistamine used of allergic rhinitis

Answer 17

Azelastine

Question 18

symptomatic treatment of allergic rhinitis?

Answer 18

Decongestants

Question 19

What decongestants are of choice for systematically treating allergic rhinitis?

Answer 19

pseudo ephedrine or phenylephedrine

*pseudoephedrine in MS you HAVE to have a RX in order to get! NOT OTC like phenylephedrine

Question 20

What is a decongestant given intranasally prescribed for allergic rhinitis?

Answer 20

Oxymetazoline

Question 21

Patient education is important when prescribing Oxymetazoline intranasally?

Answer 21

Oxymetazoline is highly additive, patient should use the drug 3-5 days and then stay off of it.

Question 22

What would you prescribe a patient with acute Otitis Media with associated inflammation?
*you wan to reduce the inflammation :)

Answer 22

intranasal corticosteroids

Question 23

Beclomethasone, budesonide, flunisolide, fluticosone, triamcinolone are ________.

Answer 23

intranasal corticosteroids

Question 24

T/F Intranasal Corticosteroids will blunt response after exposure immediately.

Answer 24

FALSE!!!
usually will respond in 2-3 days but CAN take up to 2-3 weeks. So if you know every May your nose starts running.. get your prescription early!! :)

Question 25

Prophylactic treatment of Allergic rhinitis; mast cell stabilizer; less side effects than anithistimines

Answer 25

Cromolyn Sodium

Question 26

T/F Cromolyn Sodium is most effective if taken a month in advance.

Answer 26

true | **take before the season :)

Question 27

What two drugs are best for patients with allergic rhinitis and asthma?

Answer 27

Ipratropium & Leukotriene receptor antagonists | *NOT IMMEDIATE RESPONSES!!!

Question 28

Which treatment for allergic rhinitis is no more effective than second generation antihistamines and less effective than intranasal corticosteroids?

Answer 28

Leukotriene receptor antagonists | ***Montelukast

Question 29

ocular disorder that leads to optic neuropathy, increased intraocular pressure, loss of visual sensitivity and field

Answer 29

glaucoma

Question 30

type of glaucoma that is slowly progressive and asymptomatic, central vision acuity is maintained

Answer 30

open angle

Question 31

intermittent prodromal symptoms, can have acute episodes, usually due to physical blockade of the trabecular meshwork

Answer 31

closed angle

Question 32

goal of therapy for glaucoma -

Answer 32

decrease IOP to levels where no further damage occurs

Question 33

dominant tone of the eye

Answer 33

para

Question 34

iris radial is contracted by

Answer 34

alpha 1

Question 35

iris circular is contracted by

Answer 35

m3

Question 36

ciliary muscle is contracted by

Answer 36

m3

Question 37

what type to applicaton is used first in treatment of ocular HTN and open angle glaucoma

Answer 37

topical

Question 38

timolol, betaxolol and carteolol are in what class

Answer 38

beta blockers

Question 39

latanoprost, bimatoprost and travoprost are in what class

Answer 39

prostaglandin analogs

Question 40

carbachol and pilocarpine are in what class

Answer 40

cholinergic agonists

Question 41

dipivefrin are in what class

Answer 41

nonspecific adrenegic agonists

Question 42

apraclondine and brimonidine are in what class

Answer 42

alpha 2 agonist

Question 43

what classes limit production of aqueous humor

Answer 43

Alpha 2 agonists beta blockers CA inhibitors ABC

Question 44

what classes promote drainage or increase absorption

Answer 44

Prostaglandin analogs Cholinegic agonist NS Adrenegic Agonist

Question 45

how much of the aqueous humor drains in the trabecular meshwork

Answer 45

85%

Question 46

treatment of closed angle

Answer 46

immediate IOP reduction

Question 47

hole in iris to facilitate posterior to anterior flow

Answer 47

iridectomy

Question 48

what drug therapy is used for an acute attack

Answer 48

mannitol and secretory inhibitor osmotic agent

Question 49

inflammation and/or infection of the membrane lining of the eyelids

Answer 49

conjunctivitis

Question 50

what type of viral usually causes conjunctiviits

Answer 50

adeno

Question 51

clear watery drainage is characteristic of

Answer 51

viral conjunctivitis

Question 52

thick, yellow or greenish discharge is characteristic of

Answer 52

bacteria conjuctivits

Question 53

gram + that cause conjunctivits

Answer 53

staph and strep

Question 54

gram - that cause conjunctivitis

Answer 54

pseudo and haemoph...

Question 55

treatment for viral conjunctivitis

Answer 55

NONE

Question 56

treatment for bacteria conjunctivitis

Answer 56

aminoglyosides, fluoroquinolones or erythomycin

Question 57

treatment for allergic conjunctivitis

Answer 57

systemic and/or opthalmic H1 antagonists and opthalmic corticosteriods