29- drugs used to treat upper respiratory disease

Question 1

Nasal structures innervated by which system

Answer 1

Autonomic nervous system

Question 2

Cholinergic stimulations cause what to blood vessels lining nasal mucosa

Answer 2

 Vasodilation

Question 3

Sympathetic, primarily, alpha- adrenergic, stimulation causes what

Answer 3

 Vasoconstriction

Question 4

Cholinergic fibers also innervate secretory glands, when stimulated they produce what in nostrils

Answer 4

 Serous and mucus secretions

Question 5

Inflammation of nasal mucosa, as a result of allergic reaction is called what

Answer 5

Allergic rhinitis

Question 6

What happens when large amounts of histamine is released?

Answer 6

Extensive arterial dilation, hypotension, skin flushes becomes edematous, itching, construction and spasm of bronchial tubes. Make breathing difficult, pulmonary and gastric secretions released.

Question 7

What is rhinitis medicamentosa

Answer 7

Overuse of topical decongestants, leading to rebound effect. Secondary congestion, caused by excessive vasodilation of blood vessels and direct irritation of nasal membranes by solution.

Question 8

Anti-inflammatory agents used in AR

Answer 8

Corticosteroids and cromolyn sodium

Question 9

When are anti-inflammatory agents, corticosteroids and cromolyn sodium, used?

Answer 9

When antihistamines and sympathomimetic agents do not work

Question 10

Nasal decongestants, provide temporary relief of symptoms, what should be included in patient education

Answer 10

Read label carefully, initially symptoms will be relieved. Do not miss use or use excessively as it may cause rebound swelling.

Question 11

Why should patients with hypertension, hyperthyroidism, diabetes, cardiac disease, increased, intraocular pressure, or prostatic hyperplasia use caution when, taking an oral alpha-adrenergic agent nasal decongestant

Answer 11

Alpha-adrenergic agents can stimulate the alpha receptors at other sites of the body

Question 12

What should a patient do if they experience rebound swelling

Answer 12

Stop topical nasal decongestant at once

Question 13

Common adverse effect in the respiratory system for sympathomimetic decongestant- what can be used to help

Answer 13

Mild nasal irritation, burning or stinging, may be avoided by using a weaker solution- use nasal saline spray for nasal irritation

Question 14

What effect does sympathomimetic decongestant have on the cardiovascular system? Pts on what medication should avoid these decongestants

Answer 14

May result in significant hypertension, patients on anti-hypertensive medication should avoid using decongests

Question 15

Are oral antihistamines recommended as first line or second line agents in patients with mild symptoms of AR or those with sneezing and itching as a primary complaint

Answer 15

First line

Question 16

This first line agent reduces rhinorrhea, lacrimation, nasal and conjunctival pruritus, and sneezing, but does not stop nasal congestion

Answer 16

Oral antihistamines

Question 17

Do antihistamines work best if taken on a scheduled basis or as needed during the allergy season?

Answer 17

Scheduled basis - they are most effective taken 45 to 60 minutes before exposure to the allergen

Question 18

Which is least sedating antihistamine -first or second generation

Answer 18

Second generation

Question 19

Azelastine, fexofenadine, loratadine, cetirizine, levocetirizine, and desloratadine: what is the dug class? Are they first or second generation? Are they the most or the least sedating?

Answer 19

Second generation, antihistamines, least sedating

Question 20

Antihistamines have what kind of effect on the respiratory system- what should be done about the effect

Answer 20

Drying affect. Cough and sputum must be monitored. Give adequate fluids and increase diet fiber concurrently with anti-histamines.

Question 21

What visual effect does antihistamines have on anti-cholinergic receptors

Answer 21

Blurred vision may occur. Caution patients on their personal safety.

Question 22

Can antihistamines be taken with prescribed medication’s?

Answer 22

Not without doctors approval

Question 23

Intranasal corticosteroids are the most effective pharmacologic therapy for AR, Why should systemic corticosteroids be avoided?

Answer 23

Because of their adverse systemic effects

Question 24

Beclomethasone (Beconase Q), budesonide, fluticasone (Flonase), flunisolide are highly effective (t)_______ (a)_______ (a)_______ (s)_______ with few adverse effects

Answer 24

Topically active aerosol steroids

Question 25

What are the therapeutic effects of topically active aerosol steroids? When is the therapeutic effect observed?

Answer 25

Reduction of sneezing, nasal itching, stuffiness, rhinorrhea; ocular symptoms: including itching, redness, tearing, and puffiness. Therapeutic effect observed by the third day maximum affect evident in about two weeks

Question 26

When using internasal corticosteroid therapy, what should patient do if they have blocked nasal passages?

Answer 26

Blocked nasal passages should be treated with a topical decongestant just before beginning intranasal corticosteroids 

Question 27

Before patient uses cromolyn sodium what should they do?

Answer 27

Blow their nose before the nasal installation of this drug

Question 28

Dosage and administration for cromolyn sodium nasal spray. Maximum dose.

Answer 28

One spray is place in each nostril three or four times daily at regular intervals, maximum dose is six sprays in each nostril

Question 29

Inflammation of the nasal mucous membranes. Signs and symptoms include sneezing, nasal discharge and nasal congestion. Subclassified as acute or chronic on the basis of duration of the signs and symptoms.

Answer 29

Rhinitis

Question 30

Bacteria, trapped behind, thick, tenacious, mucus that obstructs the sinus ducts, or eustachian tubes to the middle ears can result in this

Answer 30

Sinusitis or Otitis media

Question 31

Inflammation of the nasal mucosa as a result of an allergic reaction

Answer 31

Allergic rhinitis

Question 32

This is released in response to allergic reactions and tissue damage caused by trauma or infection. Compound is derived from what

Answer 32

Histamine. Amino acid called histidine.

Question 33

H1-receptor antagonist

Answer 33

antihistamine