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NAPLEX STUDY > Eyes, Ears, Nose & skin conditions > Flashcards

Eyes, Ears, Nose & skin conditions Flashcards

(104 cards)

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1
Q

intranasal steroids

A

first line for chronic, moderate-to-severe symptoms of allergic rhinitis

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2
Q

oral antihistamines

A

used in milder, intermittent symptoms of allergic rhinitis

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3
Q

Common intranasal steroids

A

budesonide (rhinocort allergy) - OTC (preferred in pregnancy)
Fluticasone (flonase) - RX and OTC
Triamcinolone (Nasacort) - OTC

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4
Q

antihistamines

A

-blocking histamine at the H1 receptor
-effective at reducing symptoms of itching, sneezing, rhinorrhea
-have little effect on nasal congestion

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5
Q

1st generation antihistamines

A

benadryl, hydroxyzine, mecliizine cause more sedation

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6
Q

diphenhydramine (benadryl)

A

-treatment of acute allergic rxns
-prevention of allergic rxns
-allergic rhinitis
-cough
-sleep
-dystonic reactions (anticholinergic properties)
-motion sickness
*avoid in elderly (BEERS List-anticholinergic effects)

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7
Q

what disease states can benadryl worsen

A

BPH, constipation, dementia, glaucoma

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8
Q

benadryl dose

A

25 mg PO Q4-6H or 50 mg PO Q6-8H

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9
Q

benadryl in those < 6

A

do not use unless directed by healthcare provider

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10
Q

fenofaxidine

A

do not take with fruit juice due to decrease absorption

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11
Q

antihistamines to use in pregnancy

A

loratadine and cetirizine

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12
Q

most sedating second generation antihistamines

A

cetirizine and levocetirizine

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13
Q

least sedating second generation antihistamines

A

fexofenadine and loratidine

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14
Q

problems with afrin

A

rebound congestion if used longer than 3 days (rhinitis medicamentosa)

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15
Q

intranasal cromolyn

A

OTC mast cell stabilizer used for tx or ppx of allergic rhinitis

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16
Q

montelukast

A

leukotriene modifying agent indicated for treatment of both allergic rhinitis and asthma

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17
Q

common cold

A

zinc or vitamin C (shown to decrease days of cold symptoms)

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18
Q

dextromethorphan

A

-acts as a serotonin reuptake inhibitor at usual doses
-high doses act as an NMDA-receptor blocker and cause euphoria and hallucinations

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19
Q

safety of dextromethorphan +/- guaifenesin

A

-do not use within 14 days of MAOi
-risk of serotonin syndrome

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20
Q

codeine safety (C2 as a single agent and CIV as combined)

A

-respiratory depression/death
-ultra-rapid metabolizers due to CYP450 2D6 polymorphisms
-do not use in children under 12 or in children < 18 who underwent a tonsillectomy and/or adenoidectomy

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21
Q

combined products: D

A

decongestant (phenylephrine or pseudoephedrine)

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22
Q

combined products: PE

A

phenylephrine

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23
Q

combined products: DM

A

dextromethorphan

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24
Q

combined products: AC

A

contains codeine

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25
guaifenesin
ycolytic
26
analgesic
contains cough and cold products
27
chlorpheniramine/hydrocodone
Tussicaps/Tussionex CII
28
cough/cold products: children < 18 years
avoid codeine and hydrocodone - containing cough and cold products (FDA)
29
cough/cold products: children < 4 years
avoid otc cough and cold products
30
cough/cold products: children < 2 years
-avoid otc cough and cold products -avoid promethazine -avoid topical menthol and camphor
31
AD
right ear
32
AS
left ear
33
AU
each ear
34
OD
right eye
35
OU
each eye
36
OS
left eye
37
eye/ear solutions: 1 drop
0.05 mL
38
drugs that increase IOP
-anticholinergics -decongestants -chronic steroids -topiramate
39
normal IOP
12-22
40
open-angle glaucoma
no symptoms and treated with eye drops or surgery
41
close-angle glaucoma
blockage and sudden increase of IOP - medical emergency and treated surgically
42
glaucoma treatment
-prostaglandin analogs (most effective at reducing IOP) -ophthalmic beta-blockers (timolol) is preferable if the pressure is high in only one eye
43
reduce aqueous humor production (make less fluid)
-beta blockers -carbonic anhydrase inhibitors like dorzolamide
44
increase aqueous humor outflow (move fluid out)
prostaglandin analogs (lantanoprost)
45
if you want to make less fluid and move the remaining fluid out
alpha-2 agonists (brimonidine)
46
Prostaglandin analogs (bimatoprost, latanoprost, travoprost)
-darkening of the iris and eyelashes -increase eyelash length and strength -blurred vision, stinging
47
eye drop BB (timolol)
burning, stinging, bradycardia/fatigue, bronchospasm
48
dorzolamide
caution use in those with sulfa allergy
49
bacterial pink eye
moxifloxacin, neomycin/polymyxin B/dexametasone, ofloxacin, trimethoprim/polymyxin B
50
eye inflammation
prednisolone (Pred Forte, Pred Mild) Ketorolac (Acular) -short term use due to increased IOP
51
eye dryness
Refresh (OTC) and Systane -artifical tears
52
chronic dry eye
cyclosporine emulsion eye drops (Restatsis)
53
eye redness
Naphazoline (clear eye redness relief) Naphazoline/Pheniramine (Naphcon A, Visine A) Tetrahydrozoline (Visine)
54
drugs that cause retinal changes/retinopathy
chloroquine hydroxychoroquine
55
drugs that cause optic neuropathy
amiodarone, ethambutol, linezolid
56
drugs that cause intraoperative floppy iris syndrome (IFIS)
alpha-blockers (tamsulosin)
57
drugs that cause color discrimination in the eye
digoxin, PDE-5 inhibitors (greenish tinge), voriconazole (color vision changes)
58
drugs that cause vision loss/abnormal vision
digoxin (halos), PDE-5 (vision loss; can be permanent), isotretinoin (decreased night vision - can be permanent, dryness, irritation), topiramate (visual field objects), vigabatrin (permanent vision loss), voriconazole (abnormal vision, photophobia)
59
otitis externa
ciprofloxacin and dexamethasone (ciprodex) ciprofloxacin and hydrocortisone (cipro HC) neomycin, colistin, hydrocortisone and thonzonium (Cortisportin-TC)
60
ear wax (cerumen)
carbamide peroxide (Debrox)
61
drugs that turn skin/secretions: brown
entacapone, levodopa, methyldopa
62
drugs that turn skin/secretions: brown/black/green
iron (black stool) methocarbamol
63
drugs that turn skin/secretions: brown/yellow
nitrofurantoin flagyl tinidazole riboflavin
64
drugs that turn skin/secretions: purple/orange/red
chlorzoxazone
65
drugs that turn skin/secretions: orange/yellow
sulfasalazine
66
drugs that turn skin/secretions: yellow-green
propofol, flutamide
67
drugs that turn skin/secretions: red-orange
phenoazopyridine, rifampin, rifapentine
68
drugs that turn skin/secretions: red
anthracyclines, deferasirox (urine)
69
drugs that turn skin/secretions: blue
methylene blue, mitoxantrone
70
drugs that turn skin/secretion: blue-gray
amiodarone, chloroquine
71
acne treatment options
OTC benzoyl peroxide and salicylic acid retinoids, topical or systemic oral abx, and systemic isotretinoin -some women benefit from birth control -azelaic acid -clascoterone
72
retinoids
take 4-12 weeks to work and acne can worsen initially
73
isotretinoin (Acutane)
-severe, recalcitrant nodular acne only -REMS -Tetraogenic - pregnancy test required; do not get pregnant for 1 month before, while taking, or 1 month after this drug; 2 negative test required before starting -cholesterol testing required -dry chapped lips, eyes, and skin
74
mild acne treatment
first line: topical - BPO and/or retinoid
75
moderate acne treatment
first line: topicals combination or PO abx + BPO + topical retinoid +/- topical antibiotic
76
severe acne treatment
first line: topical combination + PO abx or PO isotretinoin
77
minocycline
photosensitivity, fetal harm, discoloration in teeth `
78
cold sores
abreva: apply 5x daily at first sign of outbreak Zovirax: apply 5x daily for 4 days
79
Dandruff
OTC: ketoconazole 1% shampoo, selenium sulfide, pyrithione zinc (head and shoulders), coal tar shampoos RX: ketoconazole 2%
80
drugs that can cause alopecia
chemotherapy, valporate, spironolactone, heparin, warfarin
81
alopecia: finasteride
-finasteride (propecia) - takes 3 months to see effect -procar is used for BPH -do not dispense propecia if patient is on procar for BPH -contraindicated in pregnancy -hazardous to women in child bearing age
82
alopecia: minoxidil
-OTC solutions and Rx used for HTN
83
bimatoprost (latisse)
used for thining of eyelashes - do not use with prostaglandin analogs due to risk of increased IOP
84
eczema: OTC
aquaphor, eucerin
85
eczema: topical calcineurin inhibitors
tacrolimus (protopic) or pimecrolimus (elidel) -do not use in children < 2 years of age; associated with lymphoma and skin cancer; use only as second-line drugs for short term
86
eczema: topical phosphodiesterase-4 inhibitor
crisaborole (Eucrisa)
87
eczema: IL-4 antagonist
dupilumab (dupixent)
88
eczema: janus kinase inhibitors
ruxolitinib (opzelura) and upadacitinib (rinvoq)
89
athlete's foot (tinea pedis)
itching, peeling redness, mild burning
90
jock itch (tinea cruris)
red, itchy, sometimes ring shaped rash in the genitals, inner thighs, or buttocks
91
ringworm (tinea corporis)
circular, red, flat sores
92
cutaneous (skin) candida infections
red, itchy, rashes in the groin, armpits, and skin folds
93
counseling for topical antifungals
apply 1-2 inches beyond rash apply for 2-4 weeks even if it appears healed reduce moisture to the infected area
94
onychomycosis (toe nail fungus)
terbinafine (topical for mild infections and systemically for severe infections) - typically used with topicals -labs for liver function prior to therapy due to hepatotoxicity
95
vaginal fungal infection
-mild infection: 1, 3, 7 day tx available -severe infection needs to be evaluated by physician for longer tx of 7-10 days clomtrimazole, miconazole, butoconazole, fluconazole oral
96
diaper rash
destin (petrolatum/zinc oxide)
97
hemorrhoids
preparation H (phenylephrine)
98
pinworm
pyrantel pamoate
99
lice
permethrin or pyrethrin/piprtonyl butoxide
100
minor wounds
neosporin (polymyxin/bacitracin/neomycin) bactroban (mupirocin) cortisporin (bacitracin/neomycin/polymixin B/ hydrocortisone)
101
topical steroids: very high potency
clobetasol proprinate flucinonide 0.1% cream
102
topical steroids: high potency
betamethasone dipropionate 0.05% cream fluocinonide 0.05% ointment mometasone furoate 0.1% ointment
103
topical steroids: high-medium potency
fluocinonide 0.05% cream
104
topical steroids: medium potency
mometasone furorate 0.1% cream triamcinolone acetonide 0.1% cream

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