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pharmacology > Allergic Rhinitis and Cough > Flashcards

Allergic Rhinitis and Cough Flashcards

1
Q

What are adverse reactions to inhaled corticosteroids (4) ?

A
  • headaches
  • cough
  • epistaxis
  • pharyngitis
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2
Q

What is MOA of inhaled corticosteroids (3)?

A
  • vasoconstriction
  • inhibits mast cell mediated late phase rxn
  • reduces inflammation by inhibit mediator release
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3
Q

What is the AAAAI recommendation for tx of allergic rhinitis?

A

monotherapy of inhaled corticosteroid in patients 12 y/o and older

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4
Q

When should tx with intranasal corticosteroid therapy and intranasal antihistamine medication be considered?

A

when patient is 12 years or older and moderate to severe allergic rhinitis is present

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5
Q

what side effects are present with systemic corticosteroids (4)?

A

-HPA suppression
-glaucoma
cataracts
-changes in bone mineral density

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6
Q

What does SNS input do to nasal mucosa (2)?

A
  • vasoconstricts

- opens/widens airways

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7
Q

What does PNS input do to nasal mucosa (2)?

A
  • increases mucus

- vasodilates/inflamed closes airway

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8
Q

What are the effects of histamine (4)?

A
  • itching
  • increased vasopermeability
  • mucous production
  • smooth muscle contraction
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9
Q

name intranasal corticosteroids (4) ?

A
  • beclomethasone
  • flunisolide
  • budesonide
  • fluticasone
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10
Q

How long for the intranasal corticosteroid to take effect?

A

-2-3 weeks

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11
Q

What is MOA for H1-receptor antagonists?

A
  • competitive antagonist of histamine-binds receptor but does not activate it
  • binds H1 receptor and blocks it from histamine
  • best used as a prophylactic
  • reversal effects largely due to anticholinergic properties
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12
Q

Name 1st generation H1- receptor antagonist (3)?
Which can you use in pregnant women?
Do they have anticholinergic and sedative effects?

A

-diphenhydramine/benadryl
-hydroxyzine
chlorpheniramine (lowest sedative and anti cholinergic effects ) use in pregnant women
** quick effect, last 6-8 hours
-yes,

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13
Q

Name 2nd generation H1 Receptor Antagonist (3)?

A
  • Loratadine/ Claritin
  • fexofenadine/allegra
  • cetirizine/Zyrtec
  • *long duration for effect, longer duration
  • no anticholinergic or sedative effects
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14
Q

Drug interaction of H1 receptor antagonists?

A
  • CNS depressants/benzos

- anticholinergics/ ipratropium

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15
Q

Adverse effects of H1-receptor antagonists (8)?

A
  • CNS depression
  • temp dysregulation
  • flushing
  • dilated pupils
  • psychosis
  • urinary retention
  • constipation
  • dry mouth (xerostomia)
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16
Q

What are some intranasal and ophthalmic H1 receptor antagonists (2)?

A
  • Azelastine

- Olopatadine

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17
Q

What is a topical H1 receptor antagonist?

A

-diphenhydramine

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18
Q

Why are H1 receptor drugs classified as “dirty drugs”?

A

-because they bind to many receptors

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19
Q

What is MOA for decongestants?

A
  • stimulate alpha receptors and cause vasoconstriction

- pseudoephedrine stimulates beta receptors and relaxes bronchioles and increases HR and contractility

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20
Q

What is rebound congestion?

A

-overuse of intranasal decongestants (more than three to four days) can lead to vasodilation and mucous production (overstimulation of SNS mechanism)

21
Q

Name oral decongestants (2)?

A
  • phenylephrine

- pseudoephedrine

22
Q

Name intranasal decongestants (4)?

A
  • naphazoline
  • oxymetazoline
  • phenylephrine
  • tetrahydrozoline
23
Q

What are adverse rxns to decongestants?

A

-rebound congestion

24
Q

Why should you monitor BP and heart rate for people taking decongestants ?

A

-decongestants can increase HR and contractility and may present complication to patients with heart issues

25
Q

What is a contraindications use for decongestants?

A

-do not use if MAOI use within 14 days

26
Q

What is MOA of leukotriene receptor antagonist?

A

-binds cysteinyl leukotriene receptor and stops mast cells from releasing cysteinyl leukotriene

27
Q

What are two LR drugs?

A
  • montelukast

- Zafirlukast

28
Q

Adverse rxns of LR anatagonist?

A
  • dyspepsia/indigestion
  • headaches
  • mental status changes
29
Q

Drug Interactions with LR Antagonists?

A

CYP3A4 and CYP2C9 interactions

30
Q

What is MOA of cromolyn spray?

A

mast cell stabilizer

31
Q

What is MOA of ipratropium nasal spray?

What is time limit use for this drug?

A

anticholinergic

-no more than 4 days

32
Q

What is MOA for H2 receptor antagonist?

A

competitive inhibitor of receptors on parietal cells to stop acid secretion.

33
Q

When do you use H2 receptor antagonist? Name drug (1)?

A

-in combo with H1 receptor antagonist in allergic rxn and urticaria
Ex Cimetidine

34
Q

Which H2 receptor antagonist has the fewest side effects?

A

Ranitidine

35
Q

What is MOA for hydrocodone/codeine?

A

-direct central action in the medulla

36
Q

Name 3 Hydrocodone/Codeine medications?

A
  1. Codeine/Guaifenesin-Robitussin
  2. Codeine/Promethazine- Phenergan
  3. Hydrocodone/Chloramephenrine
37
Q

What are adverse effects of this hydrocodone/codeine?

A
  • drug dependency
  • Nausea
  • CNS depressant (cross blood brain barrier)
38
Q

What is MOA of benzonatate?

A
  • topical anesthetic action of respiratory stretch receptors

- relative to tetracaine

39
Q

What is a contraindication of Benzonatate?

A

-increase risk of death in children under 10 y/o

40
Q

What is MOA of Dextromethorphan?

A
  • reduced sensitivity of cough receptors

- suppresses medullary cough center

41
Q

Contraindications of Dextromethorphan?

A

MAOI within two weeks

42
Q

What are adverse effects of DXM (2)?

A
  • confusion

- potential serotonin syndrome

43
Q

Drug interactions with Dextromethorphan?

A

-SSRI can increase serotonergic effects

44
Q

T/F Dextromethorphan is similar in structure to codeine?

A

True

45
Q

Name dextromethorphan drug?

A

-Delsym DXM Polistirex

46
Q

What is MOA for Guaifenesin?

A
  • irritating gastric mucosa and stimulating respiratory tract secretions
  • increases respiratory fluid volume and
  • decreases mucous viscosity
47
Q

Adverse rxns to Guaifenesin (4)?

A
  • nausea
  • vomiting
  • headache
  • dizziness
48
Q

What should you monitor for a person taking Guaifenesin?

A

hydration status

pharmacology (47 decks)

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