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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

Recommended treatment for cough from chronic bronchitis / COPD

1. Ipatropium bromide
2. Dextromethorphan or Codeine