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pulmonary 684 > Allergic Rhinitis, Cough And Cold > Flashcards

Allergic Rhinitis, Cough And Cold Flashcards

1
Q

Sx of AR

A

Sneezing

Itchy nose, eyes or throat

Watery eyes

Rhinorrhea

Nasal congestion

Postnasal drip

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2
Q

What’s the main environmental control of allergic rhinitis?

A

Avoiding exposure to allergens

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3
Q

List nasal wetting agents

A

Saline

Propylene

PEG sprays

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4
Q

Nasal irrigation agents

A

Warm saline (isotonic or hypertonic)

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5
Q

What’s the first line tx for Chronic, Moderate-to-Severe rhinitis?

A

Intranasal corticosteroids

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6
Q

What’s the tx for milder, intermittent sx of hay fever?

A

Oral antihistamines

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7
Q

List Intranasal corticosteroids (1st line for chronic mod-to-severe hayfever)

A

Beclomethasone (Qnasi, Beconase AQ)

Budesonide (Rhinocort Aqua)

Ciclesonide (Omnaris, Zetonna)

Triamcinolone (Nasacort AQ)

Flunks oldie

Fluticasone (Flonase, Veramyst)

Fluticasone + Azelastine (Dymista)

Mometasone (Nasonex)

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8
Q

Remember “NASO” on a med name means nose

A

Ok

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9
Q

What’s the brand name for mometasone?

A

Nasonex

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10
Q

What’s the brand name for Triamcinolone?

A

Nasacort AQ

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11
Q

What’s the main warning ass. with Intranasal corticosteroids?

A

Delayed wound healing

AVOID use if recent nasal septal ulcers, surgery, trauma until healing has occurred

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12
Q

Effect of Intranasal corticosteroids on peds?

A

May cause red in growth

Use lowest possible dose

Monitor dose

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13
Q

Which is the preferred IC in pregnacy?

A

Budesonide (Rhinocort Aqua) - preg cat B

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14
Q

What’s the first line agents for mild-mod hayfever?

A

Oral antihistamine

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15
Q

What sx are oral antihistamines effective in reducing?

A

Itching

Sneezing

Rhinorrhea

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16
Q

What sx are oral antihistamines NOT effective in reducing?

A

Nasal congestion

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17
Q

What’s the main first gen oral antihistamines?

A

Diphenhydramine (Benadryl)

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18
Q

All first gen. oral antihistamines are safe for preg, but which is considered first line?

A

Chlorpheniramine (Chlor-Trimeton)

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19
Q

What’s the dose for diphenhydramine (Benadryl)?

A

25-50 mg PO Q4-6H (max. 300 mg/day)

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20
Q

Which first gen AH can’t be used in children < 2 years?

A

Carbinoxamine ER (Karbunak ER)

Promethazine (Phenergan)

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21
Q

What’s the main SE of first gen AH?

A

Sedation

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22
Q

List the 2nd gen AH agents

A

Cetirizine (Zyrtec, Zyrtec D)

Desloratadine (Clarinex, Clarinex D, Clarinex RediTabs)

Fexofenadine (Allegra, Allegra D 12H;24H, children’s Allegra ODT)

Levocetirizine (Xyzal)

Loratadine (Claritin, Claritin-D 24 hr, Claritin RediTabs, Alavert

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23
Q

What’s the brand name of cetirizine?

A

Zyrtec, Zyrtec D

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24
Q

What’s the brand name of desloratadine?

A

Clarinex, Clarinex D, Clarinex RediTabs

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25
Q

What’s the brand name of Fexofenadine?

A

Allegra, Allegra D 12H; 24H, children’s Allegra ODT

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26
Q

What’s the brand name of Levocetirizine?

A

Xyzal

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27
Q

What’s the brand name of loratadine?

A

Claritin, Claritin-D 24 hr, Claritin RediTabs, Alavert

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28
Q

Which 2nd gen AH is sedation most common in (still less than 1st gen)?

A

Cetirizine (Zyrtec)

Levocetirizine (Xyzal)

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29
Q

Which 2nd gen AH works the fastest of the group?

A

Cetirizine (Zyrtec)

Levocetirizine (Xyzal)

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30
Q

Name the agents/food that LOWER GI absorption of Fexofenadine (Allegra)?

What’s the timeframe for separation?

A

Orange juice

Grapefruit juice

Apple juice

Antacids containing Al or Mg

Separate by 2 hrs

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31
Q

Name the agents/food that INCREASE GI absorption of Fexofenadine (Allegra)?

What’s the timeframe for separation?

A

Ketoconazole

Erythromycin

No timeframe! AVOID this combo

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32
Q

What’s the age group oral AH is indicated for?

A

> 2 yrs

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33
Q

List agents for Intranasal AH?

A

Azelastine (Astelin, Astepro)

Azelastine + Fluticasone (Dymista)

Olopatadine (Patanase)

34
Q

What’s the brand name for Azelastine? (Intranasal AH)

A

Astelin

Astepro

35
Q

What’s the brand name for Azelastine + Fluticasone (Intranasal AH)?

A

Dymista

36
Q

Whats the age indicated for

Oloptadine

Azelastine

A

O - >= 6 yrs

A - >= 5 yrs

37
Q

MOA of decongestants

A

Alpha adrenergic AGONIST (sympathomimetics) that work by causing vasoconstriction

38
Q

If a pdt contains a D after the name eg. Mucinex D or Robitussin D, what does it usu contain?

A

Decongestants (Phenyephrine or Pseudoephedrine)

39
Q

List the systemic (oral) decongestants used in AH?

A

Phenyephrine HCL (Sudafed PE)

Pseudoephedrine (Sudafed)

40
Q

What’s the adult dose of systemic (oral) - Phenyephrine HCL?

Max dose?

A

10mg PO. Q4H PRN

Max. 60mg/d

41
Q

What’s the adult dose of systemic (oral) - Pseudoephedrine?

Max dose?

A

60mg PO Q4-6H PRN

240mg/d

42
Q

Brand name of Phenyephrine HCL?

A

Sudafed PE

43
Q

Brand name of Pseudoephedrine?

A

Sudafed

44
Q

Which is the more effective agent of the oral systemic decongestants?

A

Pseudoephedrine (Sudafed)

45
Q

List the agents used as topical (Intranasal) decongestants.

A

Naphazoline

Oxymetazoline 0.05% (Afrin)

Phenyephrine 0.25%, 0.5%, 1%

Tetrahydrozoline 0.5%, 0.1%

Xylometazoline 0.5%, 0.1%

46
Q

What’s the brand name of Oxymetazoline?

A

Afrin

47
Q

Which of the topical Intranasal decongestants is rx only?

A

Tetrahydrozoline (Tyzine)

48
Q

What’s the limit on the use of topical Intranasal decongestants? Why?

A

Limit use to less =< 3 days

To prevent rebound congestion

49
Q

List the additional allergy agents

A

Intranasal cromolyn (Nasalcrom)

Intranasal ipratropium bromide (Atrovent nasal spray)

Oral antileukotrienes (Montelukast - singular)

50
Q

Which of the additional allergy agents is used in young children and pregnancy (becuz of its safety panel)?

A

Intranasal cromolyn (Nasalcrom)

51
Q

What’s the main use of Atrovent Nasal Spray?

A

Rhinorrhea ONLY

used in combo with other agents when rhinorrhea

52
Q

What’s the maximum Pseudoephedrine that can be bought at once?

A

3.6 grams

OR

120 of the 30mg tablets

53
Q

What’s the maximum Pseudoephedrine that can be bought over a 30 day period?

A

9 grams (300 tablets)

54
Q

What’s the primary transmission method of colds and influenza?

A

Mucus secretions via patient’s hands

55
Q

What’s virus causes about half of all colds?

A

Rhinovirus

56
Q

List the natural cold pdts rated as possible effective?

A

Zinc

Vitamin C

Echinacea

57
Q

What form of zinc is to be avoided?

A

Zinc nasal swabs or sprays

58
Q

Both guaifenesin and Dextromethropan are preg cat. C. What’s the caveat to their use in preg?

A

Guaifenesin - do NOT recommend in 1st trimester

Dextromethropan - leave to dr to recommend use

59
Q

What should never be dispensed for a breastfeeding woman?

A

Codeine

Cold result in fatal respiratory depression in the infant nursed

60
Q

What’s the most commonly used cough suppressant?

A

Dextromethropan

61
Q

What’s the most common brand name for Dextromethropan?

A

Delsym

62
Q

A pdt that contains DM at the end of the name contains what?

A

Dextromethropan

63
Q

When taken in high doses, whats the concern with DM?

A

Risk of SEROTONERGIC syndrome, if taken with other serotonergic meds.

64
Q

Is DM a drug of abuse?

A

Yes. When taken in high doses

65
Q

MOA of DM as a drug of abuse (when taken in high doses)?

A

NMDA-receptor blocker which gives euphoric, hallucinogenic properties similar to PCP.

66
Q

At what dose is the toxic sx of Dextromethorphan usually observed?

A

> 10 mg/kg

67
Q

What’s used in the illicit combo “purple drink”?

A

DM

68
Q

MOA of guaifenesin?

A

Expectorant

DECREASES phlegm thickness in LOWER respiratory tract
INCREASES secretion in UPPER respiratory tract

69
Q

Most common brand name of guaifenesin?

A

Mucinex

70
Q

OTC cough and cold pdts should NOT be used in children under?

A

Age 4

71
Q

Combo cough and cold pdts should NOT be used in children under?

A

2 yrs (FDA)

6 yrs (AAP)

72
Q

Children should avoid combo cold & flu pdts. Why?

A

Severe skin rxns

73
Q

What should always be dispensed with the liquid meds for kids?

A

Calibrated oral syringe/ dosing cup/

74
Q

What should NOT be use to dispense liquid meds for kids?

A

Teaspoons

BC they come in diff sizes

75
Q

T/F? Advise pts to keep well hydrated?

A

TRUS

76
Q

Dose of acetaminophen in kids? (> 4yrs)

A

160mg/5ml Q4-6H PRN

77
Q

Dose of ibuprofen in infant?

A

50mg/1.25ml (10-15mg/kg) Q6-8H PRN

78
Q

Dose of ibuprofen in kids?

A

100mg/5ml Q4-6H PRN

79
Q

Pt counseling for Flonase b4 using?

A

Shake gently

Prime at 1st use or if not used in about 1week

80
Q

What is allergic rhinitis (hay fever)?

A

Inflammation of the membrane linings in the nose.

pulmonary 684 (14 decks)

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