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

Eyes, Ears, Nose & skin conditions Flashcards

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
Q

guaifenesin

A

ycolytic

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26
Q

analgesic

A

contains cough and cold products

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27
Q

chlorpheniramine/hydrocodone

A

Tussicaps/Tussionex
CII

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28
Q

cough/cold products: children < 18 years

A

avoid codeine and hydrocodone - containing cough and cold products (FDA)

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29
Q

cough/cold products: children < 4 years

A

avoid otc cough and cold products

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30
Q

cough/cold products: children < 2 years

A

-avoid otc cough and cold products
-avoid promethazine
-avoid topical menthol and camphor

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31
Q

AD

A

right ear

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32
Q

AS

A

left ear

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33
Q

AU

A

each ear

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34
Q

OD

A

right eye

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35
Q

OU

A

each eye

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36
Q

OS

A

left eye

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37
Q

eye/ear solutions: 1 drop

A

0.05 mL

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38
Q

drugs that increase IOP

A

-anticholinergics
-decongestants
-chronic steroids
-topiramate

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39
Q

normal IOP

A

12-22

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40
Q

open-angle glaucoma

A

no symptoms and treated with eye drops or surgery

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41
Q

close-angle glaucoma

A

blockage and sudden increase of IOP - medical emergency and treated surgically

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42
Q

glaucoma treatment

A

-prostaglandin analogs (most effective at reducing IOP)
-ophthalmic beta-blockers (timolol) is preferable if the pressure is high in only one eye

43
Q

reduce aqueous humor production (make less fluid)

A

-beta blockers
-carbonic anhydrase inhibitors like dorzolamide

44
Q

increase aqueous humor outflow (move fluid out)

A

prostaglandin analogs (lantanoprost)

45
Q

if you want to make less fluid and move the remaining fluid out

A

alpha-2 agonists (brimonidine)

46
Q

Prostaglandin analogs (bimatoprost, latanoprost, travoprost)

A

-darkening of the iris and eyelashes
-increase eyelash length and strength
-blurred vision, stinging

47
Q

eye drop BB (timolol)

A

burning, stinging, bradycardia/fatigue, bronchospasm

48
Q

dorzolamide

A

caution use in those with sulfa allergy

49
Q

bacterial pink eye

A

moxifloxacin, neomycin/polymyxin B/dexametasone, ofloxacin, trimethoprim/polymyxin B

50
Q

eye inflammation

A

prednisolone (Pred Forte, Pred Mild)
Ketorolac (Acular)
-short term use due to increased IOP

51
Q

eye dryness

A

Refresh (OTC) and Systane
-artifical tears

52
Q

chronic dry eye

A

cyclosporine emulsion eye drops (Restatsis)

53
Q

eye redness

A

Naphazoline (clear eye redness relief)
Naphazoline/Pheniramine (Naphcon A, Visine A)
Tetrahydrozoline (Visine)

54
Q

drugs that cause retinal changes/retinopathy

A

chloroquine
hydroxychoroquine

55
Q

drugs that cause optic neuropathy

A

amiodarone, ethambutol, linezolid

56
Q

drugs that cause intraoperative floppy iris syndrome (IFIS)

A

alpha-blockers (tamsulosin)

57
Q

drugs that cause color discrimination in the eye

A

digoxin, PDE-5 inhibitors (greenish tinge), voriconazole (color vision changes)

58
Q

drugs that cause vision loss/abnormal vision

A

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
Q

otitis externa

A

ciprofloxacin and dexamethasone (ciprodex)
ciprofloxacin and hydrocortisone (cipro HC)
neomycin, colistin, hydrocortisone and thonzonium (Cortisportin-TC)

60
Q

ear wax (cerumen)

A

carbamide peroxide (Debrox)

61
Q

drugs that turn skin/secretions: brown

A

entacapone, levodopa, methyldopa

62
Q

drugs that turn skin/secretions: brown/black/green

A

iron (black stool)
methocarbamol

63
Q

drugs that turn skin/secretions: brown/yellow

A

nitrofurantoin
flagyl
tinidazole
riboflavin

64
Q

drugs that turn skin/secretions: purple/orange/red

A

chlorzoxazone

65
Q

drugs that turn skin/secretions: orange/yellow

A

sulfasalazine

66
Q

drugs that turn skin/secretions: yellow-green

A

propofol, flutamide

67
Q

drugs that turn skin/secretions: red-orange

A

phenoazopyridine, rifampin, rifapentine

68
Q

drugs that turn skin/secretions: red

A

anthracyclines, deferasirox (urine)

69
Q

drugs that turn skin/secretions: blue

A

methylene blue, mitoxantrone

70
Q

drugs that turn skin/secretion: blue-gray

A

amiodarone, chloroquine

71
Q

acne treatment options

A

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
Q

retinoids

A

take 4-12 weeks to work and acne can worsen initially

73
Q

isotretinoin (Acutane)

A

-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
Q

mild acne treatment

A

first line: topical - BPO and/or retinoid

75
Q

moderate acne treatment

A

first line: topicals combination or PO abx + BPO + topical retinoid +/- topical antibiotic

76
Q

severe acne treatment

A

first line: topical combination + PO abx or PO isotretinoin

77
Q

minocycline

A

photosensitivity, fetal harm, discoloration in teeth `

78
Q

cold sores

A

abreva: apply 5x daily at first sign of outbreak
Zovirax: apply 5x daily for 4 days

79
Q

Dandruff

A

OTC: ketoconazole 1% shampoo, selenium sulfide, pyrithione zinc (head and shoulders), coal tar shampoos
RX: ketoconazole 2%

80
Q

drugs that can cause alopecia

A

chemotherapy, valporate, spironolactone, heparin, warfarin

81
Q

alopecia: finasteride

A

-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
Q

alopecia: minoxidil

A

-OTC solutions and Rx used for HTN

83
Q

bimatoprost (latisse)

A

used for thining of eyelashes - do not use with prostaglandin analogs due to risk of increased IOP

84
Q

eczema: OTC

A

aquaphor, eucerin

85
Q

eczema: topical calcineurin inhibitors

A

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
Q

eczema: topical phosphodiesterase-4 inhibitor

A

crisaborole (Eucrisa)

87
Q

eczema: IL-4 antagonist

A

dupilumab (dupixent)

88
Q

eczema: janus kinase inhibitors

A

ruxolitinib (opzelura) and upadacitinib (rinvoq)

89
Q

athlete’s foot (tinea pedis)

A

itching, peeling redness, mild burning

90
Q

jock itch (tinea cruris)

A

red, itchy, sometimes ring shaped rash in the genitals, inner thighs, or buttocks

91
Q

ringworm (tinea corporis)

A

circular, red, flat sores

92
Q

cutaneous (skin) candida infections

A

red, itchy, rashes in the groin, armpits, and skin folds

93
Q

counseling for topical antifungals

A

apply 1-2 inches beyond rash
apply for 2-4 weeks even if it appears healed
reduce moisture to the infected area

94
Q

onychomycosis (toe nail fungus)

A

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
Q

vaginal fungal infection

A

-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
Q

diaper rash

A

destin (petrolatum/zinc oxide)

97
Q

hemorrhoids

A

preparation H (phenylephrine)

98
Q

pinworm

A

pyrantel pamoate

99
Q

lice

A

permethrin or pyrethrin/piprtonyl butoxide

100
Q

minor wounds

A

neosporin (polymyxin/bacitracin/neomycin)
bactroban (mupirocin)
cortisporin (bacitracin/neomycin/polymixin B/ hydrocortisone)

101
Q

topical steroids: very high potency

A

clobetasol proprinate
flucinonide 0.1% cream

102
Q

topical steroids: high potency

A

betamethasone dipropionate 0.05% cream
fluocinonide 0.05% ointment
mometasone furoate 0.1% ointment

103
Q

topical steroids: high-medium potency

A

fluocinonide 0.05% cream

104
Q

topical steroids: medium potency

A

mometasone furorate 0.1% cream
triamcinolone acetonide 0.1% cream

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