ENT Flashcards by Mollie Hunter

Epinephrine MOA

Functional antagonist to histamine bronchoconstriction

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Epinephrine contraindications

Heart disease

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Epinephrine adverse reactions

Restlessness, anxiety, tremors, weakness, palpitations, NV, pallor

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1st gen antihistamine

Meclizine, hydroxyzine, dimenhydrinate, diphenhydramine, promethazine, brompheniramine, chlorpheniramine, doxylamine

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Meclizine

1st generation antihistamine

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Hydroxyzine

1st generation antihistamine

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Dimenhydrinate

1st generation antihistamine

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Diphenhydramine

1st generation antihistamine

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promethazine

1st generation antihistamine

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brompheniramine

1st generation antihistamine

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chlorpheniramine

1st generation antihistamine

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Doxylamine

1st generation antihistamine

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1st generation antihistamine indications

allergic reactions, motion sickness, nausea, insomnia, Blocks EPS, local anesthetic

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Difference between 1st gen and 2nd gen antihistamines

1st gen is more sedative, non-selective and has more side effects

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Effects of non selective H1 blockers

inhibition of histamine in smooth muscle, decrease in inflammation, CNS neurotransmitter release, cognitive and psychomotor function. increase in appetite and sedation. Anti-cholinergic effects.

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2nd generation antihistamines

loratidine, desloratidine, fexofenadine, cetirizine, levocetirizine,

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2nd generation antihistamines with some sedation

cetirizine and levocetirizine

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loratidine

2nd generation antihistamine

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desloratidine

2nd generation antihistamine

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fenofenadine

2nd generation antihistamine

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cetirizine

2nd generation antihistamine

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levocetirizine

2nd generation antihistamine

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Nasal antihistamines

Azelastine, olapatadine

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Ocular antihistamines

azelastine, olapatadine, ketotifin fumurate

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Decongestant classes

alpha agonists, steroids, mast cell stabilizers, leukotriene inhibitors

Alpha Agonists

Phenylephrine, Pseudoephedrine, oxymetalozine, Naphazoline

Nasal Steroids

Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone, Mometasone, Triamcinolone

Mast Cell Stabilize

cromolyn sodium

Leukotriene inhibitors

montelukast, zafirlukast, zileuton

Phenylephrine MOA

a1 selective agonist. Potent vasoconstrictor

Phenylephrine indications

nasal decongestant, mydratic, hemorrhoid

Phenylephrine ADR

dizziness, increased BP, insomnia, nervousness, headache, excess sweating, shaking

Phenylephrine contrindications

heart disease, htn, hyperthyroid, BPH

Pseudoephedrine MOA

Mixed acting agonist. vasoconstrictor

Pseudoephedrine indications

eustachian tube congestion, allergic rhinitis congestion or URI

Direct acting sympathomimetics

act directly on one or more adrenergic receptors

indirect acting sympathomimetics

increase availability of NE or Epi to receptors

mixed acting sympathomimetics

indirectly release NE, directly activate receptors

Azelastine

Nasal and ocular antihistamine

olapatadine

nasal and ocular antihistamine

ketotifin fumurate

ocular antihistamine

pseudoephedrine

alpha agonist decongestant

phenylephrine

alpha agonist decongestant

oxymetolazine

alpha agonist ocular decongestant

Naphazoline

alpha agonist ocular decongestant

xylometolazine

alpha agonist ocular decongestant

Beclomethasone

nasal steroid

budenoside

nasal steroid

flunisolide

nasal steroid

ciclesonide

nasal steroid

fluticasone

nasal steroid

mometasone

nasal steroid

triamcinolone

nasal steroid

Nasal steroids MOA

blocks inflammatory mediators to decrease inflammation of the nasal mucosa

Nasal steroids indications

allergic rhinitis

Nasal Steroid ADR

nasal septum perforations, decreased wound healing, candida infections, epistaxis, adrenal suppression, growth suppression, cough, sneezing, URI, headache

cromolyn sodium

mast cell stabilizer

Mast Cell stabilizer MOA

prevents mast cell degranulation and histamine release

Mast Cell Stabilizer contraindication

requires start 2-4 wks before onset of symptoms

Leukotriene inhibitors MOA

block the production of leukotrienes which increase inflammatory response in the airways

Leukotriene inhibitors indications

allergic rhinitis, nasal congestion, bronchoconstriction, conjunctivitis

Montelukast

leukotriene inhibitors

zafirlukast

leukotriene inhibitor

zileuton

leukotriene inhibitor

Common leukotriene inhibitor ADR

neuropsych events

Butterbur MOA

contains petasin a leukotriene inhibitor

Butterbur contraindication

ragweed allergy

Antitussives

Cough drops, dextromethorphan, codeine, lidocaine, benzonatate

Cough drops

menthol, pectin, gelatin, phenol, guaifenesin

Anesthetics

menthol, phenol

expectorant

guaifenesin

demulcents

pectin, gelatin

Dextromethorphan hydrobromide

opioid like, anesthetic action, crosses BBB

Codeine

cough suppressant or pain reliever

Codeine ADR

drowsiness, dizziness, headaches, NVD, Rash, itching, tachycardia

Benzonatate MOA

anesthetizes stretch receptors in respiratory passages

Benzonatate ADR

sedation, GI upset, hallucination, dizziness

Benzonatate warning

do not crush or chew!