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Rx Prep > Allergic Rhinitis, Cough, Cold - Quiz 2 > Flashcards

Allergic Rhinitis, Cough, Cold - Quiz 2 Flashcards

1
Q

What is rhinorrhea?

A

Runny nose

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2
Q

What is allergic rhinitis?

A

Congestion, rhinorrhea, sneezing, and itchy eyes caused by exposure to an allergen

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3
Q

What are sx of a cold?

A
  1. Sneezing
  2. Runny nose
  3. Thick dark mucus
  4. Sore throat
  5. Body aches
  6. Sx about 3 days and last about a week
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4
Q

Sx of allergy?

A
  1. Sneezing
  2. Runny nose
  3. Thin, clear mucus
  4. Wheezing
  5. Red, watery eyes
  6. Sx lasts more days to months after contact with allergen
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5
Q

How can we test for allergies?

A

IGE-MEDIATED SKIN PRICK TEST

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6
Q

What are common allergies?

A
  1. Pollen
  2. Mold
  3. Dust mites
  4. Animal dander
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7
Q

Non pharm to avoid allergies?`

A
  1. Vacuuming
  2. Checking AQI
  3. Checking pollen counting
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8
Q

What are nasal gels?

A

Petrolatum (Allergen Block) that is applied around the nose to physically block pollen and allergens from entering the nose
* safe for chidren and pregnancy

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9
Q

Ex of wetting agents?

A
  1. Ocean Little Remedies
  2. Simply Saline
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10
Q

Ex of nasal irrigation?

A
  1. NeilMed Sinus Rinse
  2. Isotonic or hypertolic saline
  3. Homemade or store bought distilled, boiled and cooled saline mixure
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11
Q

What should you not do for nasal irrigation?

A

Tap water increases risk for infection

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12
Q

Counseling on how to use nasal irrigation?`

A

Prepared saline olution is placed in neti pot then poured into one nostril and drained out the other while breathing through the mouth

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13
Q

What is first line for chronic moderate to severe sx?

A

Intranasal steroids

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14
Q

What is tx for mild sx?

A

PO antihistamines

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15
Q

What is the purpose of IN sterois?

A

Decreases inflammation for oderate severe sx

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16
Q

Examples of IN steroids?

A
  1. Budesonide (Rhinocort Allergy)
  2. Fluticase (Flonase)
  3. Triamcinolone (Nasacort)
  4. Mometasone (Nasonex)
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17
Q

ADRs of IN steroids?

A

Epistaxis

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18
Q

How long can you use IN steroids for relief?

A

One week

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19
Q

What are the preferred IN steroids for pregnancy?

A

Budesonide and beclomethasone

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20
Q

Budesonide

A

Rhinocort

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21
Q

Flutiasone

A

Flonase

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22
Q

Triamcilone

A

Nasocort

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23
Q

MOA of antihistamine?

A

Blocks histamine release by binding to H1 recepotr site

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24
Q

Which antihistamines are more sedating?

A

First gen

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25
Q

Examples of first gen antihistamines?

A

Diphenhydramine (Benadryl)
Chlorpheniramine (Aller-Chlor)
Doxylamine (Unisom-SleepTabs)

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26
Q

Diphenhydramie

A

Benadryl

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27
Q

Chlorpheniramine

A

AllerChlor

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28
Q

Doxylamine

A

Unisom SleepTabs

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29
Q

Dosing of Benadryl in adults

A

25 mg PO Q4-6H or 50 mg PO Q6-8H (Max 300mg/day)

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30
Q

Avoid Benadryl is children under?

A

6

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31
Q

CI of first gen AH?

A
  1. Neonates (<2Y)
  2. Premature infants
  3. Breadfeeding
  4. Avoid in eldely
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32
Q

Patient populations cautioned for use of fist gen AH?

A
  1. BPH (prostate enlargement)
  2. Glaucoma
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33
Q

ADRs of first gen AH?

A
  1. Somnolence
  2. Cognitive impairment
  3. Anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation)
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34
Q

What disease states are worsened with first gen antihistamines?

A
  1. BPH
  2. Constipation
  3. Dementia
  4. Glaucoma
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35
Q

What are 2nd gen AH>

A
  1. Cetirizine (Zyrtec)
  2. Levocetirizine (Xyzal)
  3. Fexofenadine (Allegra)
  4. Loratadine (Claritin)
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36
Q

Examples of IN antihistamines?

A

Azelastine (Astepro Allergy)
Azelastin+Fluticasone (Dymista)
Olopatadine (Patanase)

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37
Q

Cetirizine

A

Zyrtec

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38
Q

Levocetirizine

A

Xyzal

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39
Q

Fexofenadine

A

Allegra
w/ Pseudophedrine (Allegra-D)

40
Q

Loratadine

A

Claritin
w/ Pseudophedrine (Claritin-D)

41
Q

Azelastine

A

Astepro
W/ Fluticasone (Dymista)

42
Q

Olopatadine

43
Q

What 2nd gen AH are preferred in pregnancy?

A

Loratidine and Cetirizine

44
Q

Which 2nd gen are more sedating?

A

Zyrtec and Xyzal

45
Q

0

What 2nd gens are least sedating?

A

Fexofenadine
Loratadine

46
Q

What 2nd gen have a faster onset for some patients?

A

Cetirizine and levocetirizine

47
Q

Counseling for Allegra

A

Take with water not fruit juice due to decreased absorption
* Avoid Aluminum or Mag products

48
Q

Can IN AH be used with IN steroids?

A

Yes, but increases ost and risk for side effects

49
Q

MOA of decongestants

A

Alpha-adrenergic agonist that cause vasoconstriction of sinus vessels and decreases engorgement and mucosul edema

50
Q

What are the APIs of decongestatns?

A

D: phenylephrine or pseudophedrine

51
Q

What is the difference between phenylephrine and pseudoephrine?

A

Phenylephrine: poor PO absorption that comes in a nasal spray and lasts for a shorter amount of time
Pseudophedrine: effective systemic decongestants that is a precursor to methamphetamine

52
Q

i

Federal max amount of pseudoephedrine?

A

3-6 grams/day
9 grams/30 day

53
Q

Systemic decongestants?

A
  1. Phenylephrine (Sudafed PE)
  2. Pseudoephedrine (Sudafed, Nexafed, Zephrex-D)
54
Q

Topical decongestants?

A

Oxymetazoline (Afrin)

55
Q

CI of systemic decongestants?

A
  1. Don’t use with MAOI
  2. Avoid in children <2Ys (FDA), <4Ys (package labeling)
  3. First trimester in pregnancy
56
Q

ADRs of systemic decongestants?

A
  1. Tachycardia
  2. Palpitations
  3. Increased BP
  4. Insomnia
  5. Decreased appetite
57
Q

Warning of using Afrin? ADRs?

A

Warning: BPH
ADR: Rhinitis medicamentosa (rebound congestion) if used longer than 3 days

58
Q

Phenylephrine

A

Sudafed PE

59
Q

Pseudoephedrine

A

Sudafed, Nexafed, Zephrex-D

60
Q

OTC mast cell stabilizer

A

IN cromolyn (Nasal Crom)

61
Q

Indications for Cromolyn?

A

Used regularly not prn
* Safe in children ≥2Y and in pregnancy

62
Q

What is used for the treatment of both allergic rhinitis and asthma?

A

Montelukast (Singular)

63
Q

What medication is know to cause nasal dryness?

A

IN ipratropium

64
Q

Montelukast

65
Q

What is used for prevenative tx for allergies?

A

Immunotherapy by slowly increasing exposure to the allergen

66
Q

What is the minimum tx for allergies usign immunotherapy

67
Q

How is ht SL immunotherapy initiated?

A

First dose is given in a medical office where the patient can be monitored for 30 minutes
* If tolerated, patient can take doses at home
* Epinephrine auto injector shoul be given to patients on SL immunotherapy

68
Q

How are colds transmitted?

A

Mucus secretions

69
Q

How is cold transmission prevented?

A

Hand washing

70
Q

What are natural products used for colds?

A
  1. Zinc
  2. Vitamin C
  3. Echinacea
  4. Airborne
  5. Emergen-C
71
Q

What are expectorants?

A

Used for productive cough to thin out mucus moving secretions out of respiratory tract

72
Q

Examples of expectorants?

A

(Mucinex, Robitussin Mucus, RObafen Coughcongestion)
W/ Dextromethrophan (Robafen DM, Robitussin DM)

73
Q

Guaifenesin

A

(Mucinex, Robitussin Mucus, RObafen Coughcongestion)
W/ Dextromethrophan (Robafen DM, Robitussin DM)

74
Q

MOA of dextromethorphan?

A

Serotonin reuptake inhibitor but at high doses it acts as an NMDA-receptor blocker (euphoria and hallucinations)

75
Q

What are cough suppressants?

A

Suppresses the cough reflex

76
Q

Because of its abuse potential, who is not allowed to purchase Dextromethorphan or codiene?

77
Q

Examples of cough suppressants?

A
  1. Dextromethorphan (Delsym, Robafen Cough, Robitussin Cough)
    W/ Guaifenesin (Robafen DM, Robitussin DM)
  2. Codiene
  3. Benzonatate (Tessalon Pearles)
  4. Diphenhydramine (Benadryl)
78
Q

What are the types of schedules for codiene?

A

CII: pain
CV: combo for cough and cold

79
Q

CI for Dextromethorphan?

A
  1. Don’t use within 14 days of MAOI
  2. Serotonin syndrome
80
Q

Products that contain dextromethorphan have what in their product name?

81
Q

BBW of codiene?

A
  1. Respiratory depression and death in children with tonsillectomy and adenoidectmy and ultra-rapid metabolizers from CYP2D6 polymorphism
  2. Nursing infants
82
Q

CI of codiene?

A

Children <12 of any indication
<18 Y after tonsillectomy and/or adenoidectomy

Avoid codien-containing cough and cold products for <18Y

83
Q

Dextromethrophan

A

Delsym, Robafen Cough, Robitussin Cough

84
Q

Benzonatate

A

Tessalon Perles

85
Q

Brompheniramine/PE/D

A

Bromfed DM

86
Q

What schedule is Promethazine/Codiene?

87
Q

Chlorpheniramine/Hydrocodone? Schedule?

A

TussiCaps

C-II

88
Q

D

A

Decongestant (phenylephrine or pseudophedrine)

89
Q

PE

A

Phenylephrine

90
Q

DM

A

Dextromethorphan

91
Q

AC

92
Q

Cold products that should be avoided in <18Y?

A

Codient and hydrocodone

93
Q

Cold products that should be avoided in <4Y?

A

OTC cough and cold products

94
Q

Cold products that should be avoided in <2Y?

A
  1. OTC cough and cold products
  2. Promethazine
  3. Topical menthol and comphor
95
Q

Menthol

A

Vicks Vaporub

96
Q

Don’t use phenylalanine if patient has ___?

A

Phenylketonuria

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