Week 3: Congestion (Bolded/Underlined Terms)

Question 1

The MOA for decongestants are _____.

Answer 1

adrenergic agonists (sympathomimetic)

Question 2

The MOA of decongestants are adrenergic agonists which:

A. stimulates _____ in the nasal blood vessels.

B. contracts _____.

C. constricts _____.

D. reduces _____ of the nasal membrane and mucous production

E. facilitates ____.

Answer 2

A. alpha-adrenergic receptors

B. nasal smooth muscles

C. nasal blood vessels

D. inflammation

E. breathing

Question 3

The topical nasal decongestant Ephedrine is ____.

Answer 3

short acting (q4-6 hrs)

Question 4

The topical nasal decongestant Epinephrine is ____.

Answer 4

short acting (q4-6 hrs)

Question 5

The topical nasal decongestant Naphazoline is ____.

Answer 5

short acting (q4-6 hrs)

Question 6

The topical nasal decongestant form of Phenylephrine is _____.

Answer 6

short acting (q4-6 hrs)

Question 7

The topical nasal decongestant Tetrahydrazoline is ____.

Answer 7

short acting (q4-6 hrs)

Question 8

The topical nasal decongestant Xylometazoline is _____.

Answer 8

intermediate acting (q8-10 hrs)

Question 9

The topical nasal decongestant Oxymetazoline is ____.

Answer 9

long acting (q~12 hrs)

Question 10

The topical nasal decongestant Neo-Synephrine is also known as ____.

Answer 10

Phenylephrine

Question 11

The topical nasal decongestant Neo-Synephrine 12 hrs is also known as ____.

Answer 11

Oxymetazoline

Question 12

The topical nasal decongestant Afrin is also known as ____.

Answer 12

Oxymetazoline

Question 13

_____ is an adverse effect of taking topical nasal decongestants. It is temporary discomfort including burning, stinging, sneezing, and increase in nasal discharge.

Answer 13

Rhinitis medicametosa (rebound congestion)

Question 14

One should limit topical nasal decongestant use to ____ due to the adverse effect of rebound congestion.

Answer 14

no more than 3 days

Question 15

______ are alternative options to nasal decongestants and may be used for the treatment of rebound congestion.

They rehydrate the nasal mucosa and liquefy dry secretions for easier removal of dry nasal crusting during dry seasons

Answer 15

Hypotonic Sodium Chloride solutions:

• Ocean
• AYR
• NeilMed Sinus Rinse

Question 16

_____ are the drug of choice (DOC) for pregnant women with nasal congestion.

Answer 16

Hypotonic Sodium Chloride solutions:

• Ocean
• AYR
• NeilMed Sinus Rinse

Question 17

Systemic decongestants have a _____ than topical products because they last longer in our body.

Answer 17

slower onset

Question 18

Sudafed PE is the systemic decongestant form of Phenylephrine with a daily max of ____ for ages 12 years and older.

Answer 18

60 mg

Question 19

Pseudoephedrine (Sudafed, Nexafed, Zephrex-D, Claritin D, Drixoral, Alavert D) is a systemic decongestant with a daily max of _____ for ages 12 years and older.

Answer 19

240 mg

Question 20

Phenylephrine (Sudafed PE) is a systemic decongestant that is available _____.

Answer 20

OTC

Question 21

Pseudoephedrine (Sudafed, Nexafed, Zephrex-D, Claritin D, Drixoral, Alavert D) is a systemic decongestant that is available ____.

Answer 21

behind the counter and dispensed by pharmacists

Question 22

_____ is a systemic decongestant that is available OTC and has a daily max of 60mg.

Answer 22

Phenylephrine (Sudafed PE)

Question 23

_____ is a systemic decongestant that is available behind the counter and has a daily max of 240 mg.

Answer 23

Pseudoephedrine

• Sudafed
• Nexafed
• Zephrex-D
• Claritin D
• Drixoral
• Alavert D

Question 24

You must be 18 years old with a valid ID to purchase ____.

Answer 24

pseudoephedrine

Question 25

The systemic decongestant, pseudoephedrine, contains a purchase limit of ______ /month OR _____ /day PER patient.

Answer 25

9 grams 3.6 grams

Question 26

Traditional formations of systemic decongestants such as ___ and ____ are NOT meth-resistant pseudoephrine and would produce a yield of 505 mg of methamphetamine per box of pseudo ephedrine.

Answer 26

Sudafed (Pseudoephedrine) Claritin-D (Pseudoephedrine + Loratadine)

Question 27

New formations of systemic decongestants such as ___ and ____ are meth-resistant pseudoephrine and would produce a yield of 0 mg of methamphetamine per box of pseudo ephedrine.

Answer 27

Nexafed | Zephrex-D

Question 28

The Drug-Drug interactions (DDI) with systemic decongestants such as MAO or COMT inhibitors can cause _____,

Answer 28

increase in blood pressure

Question 29

MAO inhibitors are a drug-drug interaction with systemic decongestants and can cause increase in blood pressure. Do NOT take systemic decongestants for at least _____ after the MAOIs are discontinued.

Answer 29

14 days

Question 30

Systemic decongestants are _____ for women who are pregnant and lactating.

Answer 30

category C - only use if the benefit outweighs risk to the fetus - use alternative agents if possible (like Ocean Spray or Afrin)

Question 31

Systemic decongestants may decrease _____ and ____.

Answer 31

- breast milk production | - fetal blood flow

Question 32

For patient counseling on systemic decongestants, tell the patient to AVOID taking ____

Answer 32

right before sleep because it has a stimulant effect. instead, take it 2-3 hours prior to sleep

Question 33

For patient counseling on systemic decongestants, caution patients with ____.

Answer 33

hypertension (HTN) because it may increase heart rate

Question 34

For patient counseling on systemic decongestants, tell the patient to stop use and ask a doctor if _____.

Answer 34

symptoms did not improve after 7 days.

Question 35

REVIEW: | _____ may cause rebound congestion.

Answer 35

topical nasal decongestants | systemic nasal decongestants DO not cause rebound congestion

Question 36

REVIEW: Stop use of Nasal decongestants after ____. Stop use of Systemic decongestants after ____.

Answer 36

nasal: 3 days systemic: 7 days

Question 37

REVIEW: The onset of Nasal decongestants are ____. The onset of Systemic decongestants are ____.

Answer 37

nasal: fast systemic: slow

Question 38

REVIEW: | Is there DDI with MAOIs when taking Nasal decongestants?

Answer 38

NO

Question 39

REVIEW: | Is there DDI with MAOIs when taking Systemic decongestants?

Answer 39

YES

Question 40

Are Nasal decongestants kept behind the counter?

Answer 40

NO

Question 41

Are Systemic decongestants kept behind the counter?

Answer 41

Phenylephrine: NO Pseudoephedrine: YES