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pharm ENT Module > Test#3: random tid bits > Flashcards

Test#3: random tid bits Flashcards

1
Q

what do you use for allergic rhinitis in a person with glaucoma?

A

cromolyn sodium; only nasal spray that can be used in glaucoma

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2
Q

what happens when you use diphenhydramine in children? what would you want to switch them to?

A

makes them crazy, “aggitated” and restless.Switch to: flexophenadine, makes them less excitatory, follow up in 24 hours for craziness

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3
Q

what causes vasomotor rhinitis? treatment for that?

A

thinning of the membrane causes clear rhinnoreah that doesn’t stop.SYMPTOMATIC TX

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4
Q

what causes rhinnoreah in pregnant women? treatment?

A

increase levels of estrogenSYMPTOMATIC TX

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5
Q

what do you do for a man who has been using oxymatazolone for years and what do you want to put him on instead?

A

ween him off slowly otherwise will get medicamatosa, slowly transition him to fluticasone corticosteroid, have him use the oxymetazalone first and then the steroid so it can get in there, take away oxymetazalone when steroids at full dose!

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6
Q

how long does fluticasone or corticosteroids take to show their effects? whats their bioavaliavility?

A

7-14 days, only 1-2% which is why it takes so long

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7
Q

what is the DOC for a 1 year old with acute ottitis media? what if they were already prescribed that in the last month?

A

-amoxicillin-augmentin

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8
Q

how long does it take to seen abx relief?

A

48-72 hours

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9
Q

when CAN benzocain ottic be used? what is the efficacy in children and for how long?

A

when TM is intacteffective in 50% of children for 30-60 mins

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10
Q

what is the DOC for ottitis externa? If they are sensitive to this drug what is the next one you should use?

A

-Cortasporin, if sensitive to neomycin use 2nd.-cipro-ottic: thin so can be absorbed by an earwick

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11
Q

if someone is sensitive to neomycin what would you typically see? what percent of people are sensitive to neomycin?

A

15%creates symptoms of ottis externa and a rash

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12
Q

what should you use instead of otic drops if the TM is perforated?

A

opthalmic drops that are PH neutral

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13
Q

Caution: what do over the counter sleep aids contain? why is this a problem is someone is taking ipratropium bromide?what can they switch to?

A

sleep aids contain diphenhydramine, this has a sedrating effect that is increased with other anticholerengic drugs. Ipratropium bromide has anticholergenic properties so it increase the sedation and confusion!!!melatonin safer instead, observe for 48 hours!

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14
Q

what should you use to treat BPPV? how should it be prescribed? what should you watch for?

A

meclazine, scheduled not PRN because then you have to wait for symptoms to presentBRONCIAL SECRETIONS/SEDATION SINCE ANTICHOLERGNCI. NO ALCOHOL OR DRIVING!!

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15
Q

what is the DOC for dental pain/abcess? how is it prescribed?

A

penicillin, prescribed for as long as it takes them to get in a see a dentist because the infection will come back if it isn’t treated untill seen by a dentist

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16
Q

what can make glaucoma even worse and you would definitely want to treat?

A

diabetes

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17
Q

tramadole and codeine are what type of drugs?

A

PRODRUGS

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18
Q

what populations of people specifically are slow metabolizers of prodrugs? what system effects a persons ability to break down prodrugs?

A

Asians! 20% chance of being a slow metabolizer, substitute with tylenol or injections instead! P450 highlight

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19
Q

what populations (2) can be hypermetabolizers of prodrugs?

A

moms who are breastfeeding and post op children (especially when tonsils are removed!) can lead to DEATH

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20
Q

when can you use a ottic-analgesic?

A

when pain in the ear when TM is intact

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21
Q

what things can set a person up for thrush?

A

T2DM, corticosteroids, antibiotics, symbicort inhaler for COPD

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22
Q

what should you use to treat oral thrush and how long for healthy and unhealthy individuals?

A

nystatin, swish, swirl, and swallow7 days in healthy, 10 in unhealthy

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23
Q

what is the appearance of thrush in children and adults?

A

children: white patchesadults: BRIGHT RED with SMOOTH tongue, make sure to look under the dentures

24
Q

if someone is flying on a plane and has congestion, what can you suggest they use?

A

oxymetazalone 20 mins before taking off and landing, one spray and then one more time, will decongest and allow the eutachian tube to work properally

25
Q

if someone has post nasal drip with bilateral nasal polys that look like peeled grapes what should they take?

A

use oxymatazalone first to get the fluticasone into the nose, and then taper the oxymatazalone

26
Q

what is the difference between unilateral and bilateral nasal polys?

A

bilateral…probally chronic allergiesunilateral…more likely cancerous GET TO ENT

27
Q

Explain the DOC methodology for strep throat!!

A

DOC: 1. penicillin2. allergic to penicillin->clindamycin (sadly expensive and also causes c.diff) so may also choose3. macrolides (erythromycin, azithromycin, clarithromycin) IF clinda is too expsenive or if there is resistance in the community!!

28
Q

strep throat contact spread is _______. ______ of cases aren’t infectious after 24 hours of antibiotic

A

strep throat contact spread is 35%. 80% of cases aren’t infectious after 24 hours of antibiotic

29
Q

what is the only nasal spray you can/should use in glaucoma?

A

cromolyn sodium, mast cell stabalizer

30
Q

what should you avoid in gluacoma?

A
  1. ALL ANTIHISTAMINES (azelastine, diphenhydramine, fexophenadine)2. All nasal sprays except cromolyn sodium
31
Q

when you are taking oxymatazalone it is important to stop______

A

taking oral decongestants like pseudophedrine and phenylephrine

32
Q

which drug can cause anxiety?

A

azelastine HCL, nasal antihistamine spray

33
Q

which drug should you worry about nasal septum perforation in and avoid using in people with cataracts?

A

fluticasone

34
Q

whats is the systemic bioavaliability of fluticasone

A

1-2%

35
Q

fluticasone is avaliable as _______ for asthma

A

Flovent

36
Q

what percent of strep is resistant now

A

20%

37
Q

what is the maximum dose you can prescribe to a obses child?

A

the max dose is the max dose for an adult. NEVER GO OVER THIS!!!

38
Q

what are the percentages for ipratropium bromide for children and adults?

A

.03% for children.06% for adults

39
Q

what drug is good for children and pregnant women and has a bad taste?

A

cromolyn sodium

40
Q

if a patient is taking diphenhydramine and is confused…what do you always want to do?

A

take a UTI culture because UTIs cause confusion too

41
Q

Fexophenadine’s effects are increased by which drug specifically?

A

Verapamil ( Heart med)

42
Q

Don’t use antihistamines in dementia patients!f

A

FUN FACT

43
Q

which drug is too toxic for systemic use

A

nystatin, oral form is NOT absorbed systemically…..thank god!

44
Q

which drug causes bronchial secretion thickening?

A

anti-vertigo meclizine

45
Q

how soon does BVVP ususally resolve?

A

30 days

46
Q

which is the only drug on our list that causes delirium and seizures in OD and is renally cleared?

A

acyclovir

47
Q

what increases the renal and neuro toxicity of acyclovir?

A

probenicid cimetadine

48
Q

why does acyclovir only work on viruses and not our cells?

A

it requires viral kinases, we don’t have those so it acculates 40-100x in infected cells

49
Q

what is the oral bioavaliability of acyclovir? what happens when you increase the dose?

A

10-30%, increasing dose decreases bioavaliability. HUH…….

50
Q

Valcyclovir is the…..

A

prodrug for acyclovir

51
Q

how long can you use acyclovir and how much does it decrease viral shedding and transmission

A

1-10 yearsdecreases shedding 90%decreases transmission 50%

52
Q

Betaxolol has a half life of

A

12 hours

53
Q

bimatoprost has a halflife of ______, and this is why it is a first line drug, its QUICK!

A

45 mins!

54
Q

dorzolomide has a halflife of _________. don’t use with a eGFR ______

A

dorzolomide has a halflife of 4 months! what? don’t use with a eGFR

55
Q

what glaucoma med can cause steve johnson syndrome and superficial punctinate keratitis?

A

dorzolomide

56
Q

what gluacoma med causes an increase in HTZ and CNS deprsesion?

A

brimonidine

57
Q

first line drug for glaucoma is______. second line drug is ______.

A

1st-bimatoprost2nd-beta blocker

pharm ENT Module (2 decks)

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