AllergicRhinitisFC Flashcards
What is the most effective class in controlling symptoms of allergic rhinitis?
intranasal corticosteroids
what is the doc for moderate to sever allergic rhinitis? What if it is more moderate?
mild to moderate: oral antihistamines, if more mod-sever use intranasal corticosteroids
fluticasone - intranasal name and asthma name?
nasal = Flonase and Veramyst
asthma = Flovent
Triamcinolone for intranasal brand name?
nasacort
Budesonide - intranasal and asthma name?
nasal - Rhinocort
asthma - Pulmicort
dose of pormethazine for alleric rhinitis?
12.5 to 25mg po q 4-6 h prn max 100mg/day
Flunisolide - brand
Nasarel
Mometasone - nasal and asthma name
nasal - nasonex
asthma - Asmanex
benadryl
diphenhyramine
What are the first generation anti-histamines?
chlorpheniramine, bropheniramin (mod sedation)
diphenhydramine, doxylamine promethazine (most sedating)
What is dosing for diphenhydramine for allergic rhinitis ? Max dose?
25-50 mg Q4-6H (max 300 mg/day)
What are some side effects of 1st generation antihistamine?
sedation, anticholinergic effects, consitpation, urinary retention
What are the second generation antihistamines?
cetirizine, desloratadine, fexofenadine, levocetirizine, loratadine
cetirizine - Brand and dosing
Zyrtec 5-10 mg daily
benefits of zyrtec and zyzal/disadvantages
zyrtec and zyzal(levocetirizine) work FASTER than other 2nd gen onset w/in 1 hr but also makes u more sleepy. Ceterizine day time and zyzal only at night taken.
Astelin, astepro generic, MOA
azelastine , intranasal antihistamine
desloratadine - Brand and dosing
Clarinex - 5 mg daily
fexofenadine - Brand and dosing
Allegra - 60 mg BID or 180 mg/day
levocetirizine - brand and dosing
Xyzal - 5 mg QHS
Loratadine - Brand and dosing
Claritin - 10 mg daily or 5 mg q12h
What is the MOA of decongestants?
alpha adrenergic agonists that cause nasal vasoconstriction
What pts should avoid decongestants?
HTN, cardiovascular condition, glaucoma, hyperthyroidism, diabetes, prostate enlargement,
How can you tell if a product contains a decongestant?
if it has a D after the name - Mucinex D
Sudafed dosing, generici and max
pseudoephedrine 30 mg 1-2 tablets Q12H
max is 3.6 mg or 9g in 30 days
sudafed PE dosing, generic and max
phenylephirne HDL, 10mg q 4h prn max 60mg per day
what are some common topical decongestants?
neo-synephrine (phenylephrine), oxymetazoline (Afrin), xylometazone (Otrivin)
what is the benefit of oxymetazoline?
generally causes less side effects than phenylephrine and lasts 12 hours
what makes a flu diff from a cold
boyd aches and extreme tiredness
-generally flu causes fever
-cough in cold is not as bad as the flu
-colds have more nasal symptoms
What is the problem with topical decongestants?
If used longer than 3 days, they can worsen congestion
Delsym
dextromethorphan
How can you tell if a product contains dextromethorphan?
usually will contian DM added to the name
what is the concentration of childrens APAP?
160 mg/5ml
what is concentration of ibuprofen infant drops?
50 mg/1.25 ml
wha is concentration of infants APAP?
80 mg/0.8 ml
what is the concentration of childrens ibuprofen?
100 mg/5ml
inhaled antibiotics are often used to treat which infection in CF?
pseudomonas
what are common side effects of inhaled Tobramycin?
ototoxicity, tinnitus, dizziness, bronchospasm
psuedophed max dose
maximum of 3.6 grams or 120 of the 30 mg tablets, and 9 grams (300 tablets) in a 30-d period.)
triamcinolone for allergies
nasacort AQ
FDA says dont use otc cough and cold products for children under age of 4
lil kids use for cold/cough
nasal irrigation, nasap spray, non med stuff.
vicks and vapor rub not for kids
promethazine w/ codeine not for kids younger than 6
FDA no products for younger than 2 (b/c ingestion) do not appy to noase esspecialy.
intransal cromolyn
nasal crom- takes 4-7 days tosee sxs relief. up to 2 weeks for max effects. (consider for young children and pregnancy)
intranasal ipratropium bromide
only for rhinorrhea.
singular dosing
10 mg daily for 15 and up
6-14: 5 mg chewable tablets
2-5: 4 mg chewable tablets.
6 months to 5 years: 4 mg oral granules.
influenza vs cold
influenza has body aches
promethazine w/ codeine is not for kids younger than?
6 years old
what is the main problem in cystic fibrosis?
problem w/ a gene tha regulates movemnt of chloride ans soduium ions across epithelials membraes and mutations
what are the three most common infections that CF patients can get/
S.A , HI, PSEUDOMONAS
if a patient is taking PPX abx and a brochodilator or mucyolytic, when should he takes the abx?
after the bronchdilator or mucyolitic, not before !!
what two abx used for ppx for CF pts? What does it prevent?
tobramycin INHALED SOLUTION (>= 6 yo) and aztreonam INHALED SOLUTIOn if >= 7 years old if pt is colonized with pseudomonas in the lungs
SE tobramycin
ototoxicity, tinnitus, dizziness, bronchospasm
what broncho dilator to use for CF/
albuterol 2-4 x /day prn
hypersal
hypertonic sailine
mucomyst
acetylcysteine
pulmozyme
dornase alfa
most common SE of pulmozyme
chest pain, fever, rash, rhinitis, laryngitis, voice alteration, throat irration
dose of pulmozym
2.5 mg daily, STORE INF refrigerantor
order of meds for CF pateitns
broncho dilator first, then chest physiotherpay, then other hinaled medications, then antibiotics
what is the MOA of pancrealipase?
acts as amylase, lipase and protease
when should pt take pancrealipase?
before any meals or snacks , full dose w/ meals, 50% dose w/ sakcks , more fat= higher dose
do you ned to refrigeralte pancrealipase?
NO
what kinds of foods must pts on pacnrealipase avoid?
products w/t a hih ph like dairy
