Steroids, ENT, Pulmonay and Dermatology drugs - Module 4

Question 1

Inflammation

Answer 1

1. Pain
2. heat
3. redness
4. swelling

Question 2

Corticosteroids

Answer 2

are a group steroidal hormones. The prototypical, naturally occurring (endogenous) corticosteroid is “cortisol”

Question 3

Cortisol

Answer 3

is secreted by the adrenals to:

• Modulate glucose levels and body responses to “stress”
• Temper the immune function, and thereby decrease the inflammatory response.

Question 4

Eicosanoids

Answer 4

are local hormones that are derived from lipid molecules on the cell membrane of virtually all body cells.

Question 5

corticosteroids and Cox-inhibitors

Answer 5

Corticosteroids are better antiinflammatories than Cox - inhibitors (like aspirin) because they inhibit all aspects of AA.

Question 6

Eicosanoids work upstream of AA

Answer 6

corticosteroids also inhibit “leukotrienes” produced from the lipoxygenase enzyme.

** some of the products from that pathway contribute to allergies and asthma, corticosteroids can help in those ailments.

Question 7

Corticosteroids - Short Term

Answer 7

First use in 1950, to treat autoimmune and allergic disease. these drugs appeared to be free of side-effects

Question 8

Corticosteroids - Long Term

Answer 8

Long term use corticosteroids have major side - effects. Over a long period of use, pt taking corticosteroids actually develop a characteristic bydy habitus (body shape), and the person is said to be “cushinoid”

Ex. use long term to treat arthritis and lupus patients

Question 9

Corticosteroids - Long Term

Cushinoid

Answer 9

moon faces, buffalo hump, thin skin with bruising, truncal obesity, muscle loss from thinning of extremities, hypertension, poor wound healing, edema…etc.

Question 10

Corticosteroids drug- Local administration

Answer 10

Nasacort (triamcinolonge) and Flonase (fluticasone), inhaled corticosteroid keeping the blood levels low and less systemic side effects

Question 11

Corticosteroids - systemic use

Answer 11

variety of creams, ointments, eye drops, ear drops, oral and systemic forms of corticosteroids.

Question 12

Corticosteroids popular drugs - systemic use

Answer 12

Prednissone
triamcinolonge(Kenalog) - I.M
methylprednisolone( Solu-Medrol)- IV

Question 13

methylprednisolone( Solu-Medrol)- IV

Answer 13

Can be used to treat an emergency anaphylactic reation

Question 14

Sex Steroids “compare” to corticosteroids

Answer 14

different therapeutic effects and side effects compare to corticosteroids.

Question 15

Sex Steroids

Answer 15

include a group of male and female sex hormones, responsible for the development of secondary “Sexual characteristics” in men and women and for libido.

Question 16

Sex Steroids are

Answer 16

Estrogen and testosterone

Question 17

Male androgen hormones

Answer 17

are testosterone and dihydrotestosterone (DHT)

Question 18

Female estrogens

Answer 18

is estradiol (E2)

Question 19

Anabolic steroids (Anabolic-androgen steroids AAS)

Answer 19

“Roids” or “arnolds” mimic the effects of testosterone and DHT - Building more muscle tissue

Question 20

Anabolic-androgen steroids - AAS

Side effects of longer term use

Answer 20

Aggressive, behavior, coupled with decreased sperm counts and shrunken testes.
women - cause baldness and hirsutism

Question 21

Dianabol (methandrostenolone)

Answer 21

first anabolic steroid in the US - Sch III

Question 22

Human Growth Hormone

Answer 22

non-steroid, protein-based hormone r-hGH (recombinant human growth hormone)

Question 23

Anabolic steroids drugs and HGH drugs

Answer 23

are scheduled III because of high rates of abuse

Question 24

Abusing hGH

Answer 24

popular for athletes use due to the benefits:
* stimulation of muscle growth
* Loss of fat
* increased glucose output from the liver
Long term use will lead to acromegaly (large face)

Question 25

Decongestants

Answer 25

The epinephrine-like drugs not only act on Beta RC, but also act as Alpha-agonist vasoconstrictors to reduce upper airway congestion.

Question 26

Combo drugs (Decongestants + antihistamines)

Answer 26

* Phenylephrine (Neo-synephrine) * Oxymetazoline (Afrin Nasal Spray) cold remedies

Question 27

Sudafed

Answer 27

Decongestants OTC | doesn't contain pseudoephedrine, now contain "Phynyleprine"

Question 28

Oxymetazoline (Afrin)

Answer 28

nasal spray for decongestants OTC

Question 29

Antihistamines

Answer 29

drugs for allergy these drugs block H1 RC on cells found in the nose and throat. * when the H1 rc are blocked, histamine, which is released from mast cells, cannot bin and cause allergic effects.

Question 30

Seldane and Hismanal

Answer 30

are antihistamines, were taking off the market in 1997 - cause fatal dysrhythmias

Question 31

Claritine (loratadine)

Answer 31

antihistamines 2nd generation use today

Question 32

OTC Antihistamines

Answer 32

* Claritin (loratadine) * Fexofenadine (Allegra) * Cetirizine (Zyrtec)

Question 33

Antihistamines - 3rd generation

Answer 33

Allegra (fexofenadine) approved 1996 | Zyrtec (cetirizine)

Question 34

Antihistamines - first generation

Answer 34

* benadryl (diphenhydramine) * Phenergan (promethazine) tended to cause drowsiness, this side effect is used in many OTC sleep medicine * Dimetane (brompheniramine *Chlor-Trimeton (chlorpheniramine)

Question 35

Leukotriene Rc bloockers

Answer 35

are inflammatory mediators (eicosanoids) produced in AA pathway. they are involved in asthma and allergies

Question 36

Leukotriene Rc blockers drugs

Answer 36

have been approved ONLY for the treatment of asthma and servere hay fever not responding to antihistamine therapy

Question 37

Singulair (montelukast)

Answer 37

Leukotrience rc blockers drug belong to " -Leukast" family

Question 38

mast cell stabilizers

Answer 38

are used for allergies and asthma | * coat mast cells and prevent the release of their histamine granules (this causes the symptoms of an allergic reaction)

Question 39

cromolyn (NasalCrom)

Answer 39

first mast cell stabilizers type drug and still in widespread use. Allergy prevention

Question 40

Flonase (fluticasone) and Nasacort AQ (Triamcinolone)

Answer 40

treating airway inflammation (allergic rhinitis) | 1st corticosteroid nasal spraythat can be purchased w/o a prescription hit the shelve in Spring 2014.

Question 41

Antibioltics for ENT use

Answer 41

these drugs are used for bacterial (NOT VIRAL) infections in middle ear, nose and throat * Pen VK, * Ammoxicillin - Penicillin family * Biaxin (clarithromycin) - Macrolide family * ciprofloxacin (Cipro) - fluoroquinolone family

Question 42

Antibioltics for ENT use - topical creams/ointments

Answer 42

ex. impetigo infections around the nose and mouth * Bactroban (mupirocin) * Neosporin ointment is called "triple antibiotic ointment" (neomycin + polymyxin B + bacitracin)

Question 43

Floxin Otic (ofloxacin)

Answer 43

is a otic solution of a fluoroquninolone antibiotic - otitis externa or swimmers ear.

Question 44

Antivirals for ENT

Answer 44

the common cold is a acute, viral, upper respiratory infection - cased by viruses (usually rhino viruses)

Question 45

Symptomatic therapy

Answer 45

means therapy that is directed a the symptoms of an illness, and not at the underlying cause of the disease.

Question 46

3 viral infections of the upper respiratory tract

Answer 46

influenza - can be treated with "Relenza, Tamiflu or IIV4" RSV in infants - don't require drug therapy herpectic cold sores - can be treated with "acyclovir"

Question 47

3 antifungal drugs for ENT use

Answer 47

Miconazole clotrimazole nystatin for oral thrush infections and can also be part of treating some sinus infections.