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NAPLEx > allergic rhinits, cough & cold > Flashcards

allergic rhinits, cough & cold Flashcards

1
Q

budesonide

A

Rhinocort Allergy
OTC
age>=6
budesonide and beclometasone are preferred nasal steroids in prego
- intranasal steroid

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2
Q

Fluticasone

A

flonase
Rx and OTC
>=12 years 1-2 sprays per nostril
2-11 years 1 spray per nostril

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3
Q

fluticasone + azelastine

A

Dymista

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4
Q

triamcinolone

A

Nasacort
>=6years 1-2 sprays
2-5 years 1 spray

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5
Q

beclometasone

A

beconase
1-2 sprays BID

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6
Q

Diphenhydramine (it’s everywhere)

A
  • acute allergic reacting (+/- epi depends on severity)
  • prevent of allergic reactions
  • allergic rhinitis
  • cough (has antitussive properties)
  • sleep (sedating)
  • dystonic reactions (anticholinergic properties)
  • motion sickness

cause of wide range it can worsen disease states (BPH, constipation, dementia, glaucoma)

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7
Q

diphenhydramine

A

Benadryl
Rx and OTC
<6 years do not use OTC and major contra <2 years and elderly adults!
adults: max 300mg/day
6-11: max 150mg/day
- first-gen oral antihistamines

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8
Q

anticholinergic effects

A

dry mouth
blurred vision
urinary retention
constipation
seizures/arrhythmias at high doses

mad as a hatter, hot as hell, red as a beat, dry as a bone, and blind as a bat

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9
Q

chlorpheniramine

A

aller-chlor, chlor-trimeton
OTC
- first-gen oral antihistamines

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10
Q

doxylamine

A

unisome- for sleep
>12
OTC
- first-gen oral antihistamines

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11
Q

Safety/SE/ monitoring of
- first-gen oral antihistamines

A
  • warning in elderly and <2
  • can cause prostate enlargement, glaucoma, thyroid,
  • do not use w/ MOA, especially clemastine or carbinoxamine
  • somnolence, strong cognitive impairment, and strong anticholinergics effects
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12
Q

cetirizine

A

Zyrtec
OTC and Rx
- second-gen oral antihistamines

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13
Q

cetirizine + pseudoephedrine

A

Zyrtec-D
OTC
- second-gen oral antihistamines

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14
Q

levocetirizine

A

Xyzal
OTC
contra: end-stage renal disease CrCl<10, hemodialysis, 6-11 years w/ renal impairment
- second-gen oral antihistamines

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15
Q

fexofenadine
fexofenadine + pseudoephedrine

A

Allegra, Allegra-D
take w/ water (not fruit juice- decrease absorption)
avid amin w/ aluminum or mag containing products
OTC
- second-gen oral antihistamines

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16
Q

loratadine
loratadine + pseudoephedrine

A

Claritin, Claritin-D
OTC

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17
Q

Azelastine

A

Astepro
OTC and RX
+ flutcasone (dymista)
- intranasal antihistamiin

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18
Q

safety/SE/monitoring of
- second-gen oral antihistamines

A
  • in prego loratadine and cetirizine are preferred
  • cetirizine and levocetirizine have a fast onset
  • more sedating: cetirizine and levocetirizine
  • less sedating: fexofenadine and loratadine
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19
Q

pseudoephedrine, phenylpropanolamine and ephedrine
phenylephrine

A

max 3.6 g per day and 9 g per month

20
Q

decongestants

A

alpha-adrenergic agonist
vasoconstriction

21
Q

phenylephrine

A

Sudafed PE
low bioavailability, most times nasal spray version used by more SE so nasal spray oxymetazoline is preferred for nasal spra
- systemic decongestants

22
Q

pseudoephedrine

A

Sudafed, Nexafed, Zephrex-D
Rx and behind the counter
- systemic decongestants

23
Q

safety/SE/monitoring of
- systemic decongestants

A

for phenylephrine and pseudoephedrine
- DO NOT USE within 14 days of MOA
- avid in children <2 (FDA), package label <4 years
- cardio SE- tachy, palpitation increased BP
- SE- BPH, urinary retention, glaucoma risk, insomnia, hallucinations… decreased appetite

24
Q

oxymetazoline

A

Afrin
>6
OTC
do not use more than 3 days, or rebound congestion will occur (rhinitis medicamentosa)
warning do not use w/ MOA, BPH risk…
- intranasal topical decongetant

25
montelukast
singular tx of both allergic rhinits and ashtma but remember neuropsychiatric side effects
26
intranasal ipratropium
decreasing rhinorrhea by causing nasal dryness not effect for other symptoms
27
oralair grastek ragwitek Odactra
5 different grass pollens extract timothy grass pollen extract ragweed pollen extract house dust mite allergen extract
28
natural products for colds
zinc vitamin c echinacea AirBone and Emergen-C- include vitamin C, vitamin E, zinc and echinacea
29
Guaifenesin Guaifenesin + dextromethorphan
Mucinex, Robitussin, Rabafan Rabafen DM, Robitussin DM do not use ER tabs in pt <12 years expectorant- for productive cough, think mucus
30
cough suppressants
dextromethorphan and opioids (codeine and hydrocodone) have high affinity for several regions of the brain including medullary cough center, suppressing cough. Bezonatate suppresses cough by topical anesthetic action on the respiratory stretch receptor. do not use in <10 years
31
abuse potential: Dextromethorphan acts as...
SRI- it does not have addictive properties, but at high doses, it acts as an NMDA- receptor blocker leading to euphoria and hallucinations similar to PCP- "robo-tripping"
32
abuse potential: codeine
codeine products contain one or more non-codeine active ingredients (guaifenesin) and no more than 200 mg/ 100ml are scheduled as C-V drugs. abused w/ promethazine a lot street name- "purple drank" and "lean"
33
dextromethorphan dextromethorphan + guaifenesin
Delsym, rabafen, robitussim DM in name indicates dextromethorphan contra: do not use 14 days of MOA inhibitors risk: Serotonin syndrome, CNS depression OTC do not use <4 years - cough suppressants
34
Codeine
C-II (for pain) C-V (combo products for cough and cold) risk of respiratory depression! keep in mind CYP450 2D6! rapid metabolizers contra: <12 years or 18years of age after tonsillectomy and/or adenoidectomy FDA contra <18 yrs - cough suppressants
35
Benzonatate
tessalon perles do not use in children <10yrs
36
tussiCaps
CII chlorpheniramine/hydrocodone cap: 8/10mg Q12h PRN suspension 8/10mg ER per 5ml (10 ml/day max)Q12hrs PRN
37
promethazine/codeine
C-V 6.25/10mg per 5ml (max60ml/day) q4hrs
38
Bromfed DM
brompheniramine/ pseudoephedrine/ dextromethorphan 2/30/10mg per 5ml max 60ml/day
39
dextromethorphan/ promethazine
15mg/ 6.5mg per 5 ml max 30 ml
40
cough and cold comb names D
decongestant
41
cough and cold comb names PE
phenylephrine
42
cough and cold comb names DM
dextromethorphan
43
cough and cold comb names AC
contains codeine
44
cough and cold comb names Guaifenesin
mucolytic thins out mucus
45
cough and cold comb names analgesic
combo w/ cough and cold usually is acetaminophen
46
cough and cold comb names antihistamines
diphenhydramine, chlopheniramine, brompheniarmine common and cause sedation; night time products
47
children < 18years < 4 < 2
<18 yrs: avoid codeine and hydrocodone containing cough and cold products (FDA) <4: avoid OTC cough and cold products (package label) <2: avoid OTC cough and cold products (FDA), avoid promethazine (FDA), avoid topical methol and camphor (package label)

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