Nose drugs Flashcards
(66 cards)
1
Q
drug classes for allergic rhinitis
A
anti-histamines decongestants intranasal steroids mast cell stabilizer leukotriene inhibitors
2
Q
nasal anithistamines (names and generations)
A
1st: meclizine hydroxyzine dimenthydrinate diphenhydramine promethazine brompheniramine chloropheniramine doxylamine 2nd: loratadine desloratadine fexofenadine certizine levocetirizine
3
Q
nasal decongestant (names)
A
pseudoephedrine
phenylephrine
4
Q
intranasal steroids (names)
A
beclomethasone budesonide ciclesonide flunisolide fluticasone mometasone triamcinolone
5
Q
mast cell stabilizer (names)
A
cromolyn sodium
6
Q
leukotriene inhibitors (names)
A
montelukast
zafirlukast
zileuton
7
Q
histamine (actions, where it is and where it goes, what causes its release)
A
- mediates allergic and inflamm rxns
- gastric acid secretion
- NT
- in mast cells and basophils (released upon contact with allergen)
- receptors H1 (smooth musc, brain, heart, CNS), H2 (gastric), H3 (CNS), H4 (immune)
- released with ROTA (red-man [vancomycin], opioids, tubocurarine [anestehtic], amphoteicin [antifungal])
8
Q
epinephrine class
A
?
9
Q
epinephrine MOA
A
functional antagonist to hist-induced bronchoconstriction alpha agonist (decreas vasodilation) B2 agonist (relax bronchial smooth musc)
10
Q
epinephrine indications
A
emergency tx of type I allergic rxns
11
Q
epinephrine cautions
A
elderly
heart conditions
12
Q
epinephrine ADR
A
anxiety restlessness tremor weakness palpitations pallor N/V HA respiratory probs
13
Q
antihist (1st gen) class
A
antihist
14
Q
antihist (1st gen) MOA
A
block H1 receptor (nonselective) inhibit hist effect on smooth musc anticholinergic effects alpha blocker effects serotonin blocker effects
15
Q
antihist (1st gen) indications
A
allergies motion sickness (meclizine/dimenhydrinate) nausea (promethazine) insomnia block EPS (extra pyramidal side effects) local anesthesia itching (hydroxyzine)
16
Q
antihist (1st gen) ADRs
A
increased sedation
decreased cognitive and psychomotor performance
increased appetite
stim CNS (restless, nervousness, insomnia, etc)
17
Q
fexofenadine class
A
antihist (2nd gen)
18
Q
fexofenadine MOA
A
still H1 blocker, but more selective (b/c 2nd gen)
19
Q
fexofenadine indications
A
allergic rhinitis > 2 y/o
chronic urticaria > 6 mo
20
Q
fexofenadine ADR
A
HA cough URI fever back pn dysmenorrhea
21
Q
fexofenadine drug interactions
A
ketoconazole
erythromycin
P450
Al and Mg antacids
22
Q
fexofenadine caution
A
renal dosing
23
Q
cetirizine class
A
antihistamine
24
Q
cetirtizine MOA
A
H1 receptor blocker (crosses BBB –> a little less selective for 2nd gen)
25
cetirizine indication
allergic rhinitis > 6 mo
| chronic urticaria > 6 mo
26
cetirizine ADRs
somnolence
dizziness
HA
abd pn/nausea
27
cetirizine caution
dosing with renal probs
28
antihistamine uses
tx of allergic rhinitis (ocular s/s, nasopharyng itch, sneeze, rhinorrhea)
not good for URI (except 1st gen for sedation)
29
sympathomimetics
excite blood vessels, salivary/sweat glands
vasoconstrict
inhib gut
relax bronchial tree
increase HR and squeeze
increase gluc
CNS: awake, decrease appetite, increase NT
30
phenylephrine class
alpha agonist (decongestant)
31
phenylephrine MOA
alpha 1 selective agonist
32
phenylephrine indication
nasal decongestant
mydriatic
hemorroid treatment
33
phenylephrine ADR
```
increase HR
increase BP
HA
dizziness
sweats/shakes
```
34
phenylephrine caution
HTN
heart dz
hyperthyroid (graves)
BPH
35
pseudoephedrine class
alpha agonist (decongestant)
36
pseudoephedrine indications
congestion due to rhinitis or URI
| ET congestion
37
pseudoephedrine ADRs
vasoconstriction
increase BP
arrhythmia
38
pseudoephedrine drug interations
MAOIs
B-blockers
Digoxin
39
pseudoephedrine caution
HTN
cardiac dz
hyperthyroid
taking after exercise (tachy)
40
intranasal steroid class
steroid
41
intranasal steroid MOA
decrease inflammation of nasal mucosa
block inflammatory mediators
antihist + decongest
42
differences in intranasal steriod drug efficacy
they're all the same!!
43
intranasal steroid indication
allergic rhinitis (ocular s/s/, nasopharyng itch, sneezing, rhinorrhea, nasal congest)
44
intranasal steroid caution
peds: different times for diff drugs
45
intranasal steroid ADRs
epistaxis
HA
cough/URI/pharyngitis
some systemic (nasal septal perforation, candidia, glaucoma)
46
Cromolyn sodium class
mast cell stabilizer
47
cromolyn sodium indications
tx and prevention of allergic rhinits
48
cromolyn sodium MOA
prevents mast cell degranulation and hist release
49
cromolyn sodium ADRs
sneezing, stinging
50
leukotriene inhib MOA
```
leukotriene receptor antag -->
inhib leukotrienes that:
from arachadonic acid
produced by airway inflammatory cells
increase cap perm, WBC mvt, adhesion & aggreg.
```
51
leukotriene inhibitor indications
```
nasal congestion
rhinorrhea
conjunctivitis
bronchial symptoms
chronic asthma
```
52
montelukast class
leukotreine inhibitor
53
montelukast MOA
selective antag for leukotreine receptor (found in airway and inflammory cells)
54
montelukast indications
asthma > 1 y/o
allergic rhinits > 6 mo
exercise-induced asthma > 15 y/o
55
montelukast ADRs
```
some GI discomfort
HA
fever
dizziness
neuropsych (rare) in peds (anxiety, agitate, depress, dreams, hallucinate)
```
56
zafirlukast class
leukotriene inhibitor
57
zafirlukast MOA
compeititive antag for diff leukotreine receptor.
| prevent increased vasc perm
58
zafirlukast indication
chronic asthma > 5 y/o (prevent and tx)
59
zafirlukast CI
hepatic probs (includes cirrhosis)
60
zafirlukast ADRs
neuropsych (insomia, depress)
liver damage (jaundice, n/v, abd pn...)
churg-strauss syndrome (syst vasculitis, asthma, rash, GI bleed, extremity pn)
61
zileuton class
leukotriene inhibitor
62
zileuton MOA
prevent leukotriene synthesis
63
zileuton indications
asthma > 12 y/o (prevention and tx)
64
zileuton CI
active liver dz
65
zileuton drug interactions
increases warfarin levels
| increases [propranolol]
66
zileuton ADRs
```
neuropsych (insomia, behavior)
hepatotoxicits
sinusitis
nausea
sore throat
```
