Flashcards in ENT cont'd Deck (21)
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1
Two classes of Sympathomimetic Decongestants
Pseudoephedrine
Phenylephrine
**both Alpha Agonists**
2
Three Ocular Decongestants (classes?)
Oxymetazoline (Afrin) - Direct acting, non selective, alpha agonist
Naphazoline
Xylometazoline
**O and N are both Alpha Agonists**
3
Areas that are inhibited by Sympathomimetics
Gut, bronchial tree, skeletal muscles
4
Mechanisms of sympathomimetics which results in decongestion
Vasoconstriction:
- reduced capillary hydrostatic pressure / blood flow / volume
- decreases edema, reduces "leakage"
5
Cardiac effects of sympathomimetics
Increased heart rate (positive chronotropic) and contractility (positive inotropic)
6
Metabolic effects of sympathomimetics
"stress - like" effects
1. increased glycogenloysis
2. free fatty acid liberation from tissues
7
CNS effects of sympathomimetics
1. Respiratory stimulation
2. Wakefulness
3. Anxiety
4. Appetite reduction
8
Phenlyephrine found in which products?
1. Sudafed PE
2. Tylenol Cold "day time"
3. Hemorrhoidal suppositories
9
3 ADR's of Phenylephrine
1. Increase BP and compensatory decrease HR (dose-dependent)
2. Arrhythmia, tachycardia
3. Shaking
10
Phenylephrine drugs are contraindicated for which patients?
1. HTN
2. heart disease
3. hyperthyroid
4. BPH (benign prostate hyperplasia)
11
Pseudoephedrine
** Mixed-acting agonist **
same effects as Phenylephrine
Onset of action 15-30 mins, peak effect <60 mins
*"behind" the counter, can be reduced to methamphetamine*
12
3 Intranasal Steroids
1ST LINE, MOST EFFECTIVE TREATMENT
FOR ALLERGIC RHINITIS
1. Fluticasone (Flonase) **for 12 yrs and up only**
2. Mometasone (Nasonex)
3. Triamcinolone (Nasocort) **for 12 years and up only**
13
Intranasal Steroids for Peds 2+
1. Fluticasone furoate (veramyst)
2. Mometasone
14
3 ADRs of Intranasal Steroids
1. Epistaxis
2. Candida infection
3. Nasal septal perforation
15
Mast Cell Stabilizer
Cromolyn Sodium (Nasalcrom)
- Allergic rhinitis (ocular, nasal, bronchial preps)
16
Cromolyn Sodium MOA
Prevents mast cell degranulation and histamine release
17
3 Leukotrine Inhibitors
1. Montelukast (Singulair)
2. Zafirlukast
3. Zileuton
18
Indications for Leukotrine Inhibitors
*Best used w antihistamines*
Good for chronic asthma
19
3 ADR's for Leukotrine Inhibitors
1. Headache
2. Dizziness
3. Anxiety
20
Recommended treatment for cough from URI
1st gen antihistamine + decongestant
21
