c39-mod6

Question 1

Diphenhydramine (Benadryl, others) classes

Answer 1

Therapeutic: Drug to treat allergies

Pharmacologic: H1-receptor antagonist; antihistamine

Question 2

Diphenhydramine (Benadryl, others) action + uses

Answer 2

treat minor symptoms of allergy and the common cold such as sneezing, runny nose, and tearing of the eyes.

• often combined with an analgesic, decongestant, or expectorant in OTC cold and flu products.
• administered topically to treat rashes, and intramuscular (IM) and intravenous (IV) forms are available for severe allergic reactions.

Other indications for diphenhydramine include Parkinson’s disease, motion sickness, and insomnia.

Question 3

Administration Alerts of Diphenhydramine (Benadryl, others)

Answer 3

increased risk of anaphylactic shock when this drug is administered parenterally.

When administering IV, inject at a rate of 25 mg/min to reduce the risk of shock.

Question 4

side effects of Diphenhydramine (Benadryl, others)

Answer 4

cause significant drowsiness, although this usually diminishes with long-term use. Occasionally, paradoxical CNS stimulation and excitability will be observed, rather than drowsiness.

Excitation is more frequent in children than adults.

Anticholinergic effects: dry mouth, tachycardia, and mild hypotension occur in some patients.

Diphenhydramine may cause photosensitivity

Question 5

contraindications of Diphenhydramine (Benadryl, others)

Answer 5

1) Hypersensitivity to the drug
2) benign prostatic hypertrophy (BPH)
3) narrow-angle glaucoma
4) gastrointestinal (GI) obstruction
5) used cautiously in patients with asthma or hyperthyroidism.

Question 6

classes of Fluticasone (Flonase, Veramyst, others)

Answer 6

Therapeutic Class: Drug for allergic rhinitis

Pharmacologic Class: Intranasal corticosteroid

Question 7

Actions and Uses of Fluticasone (Flonase, Veramyst, others)

Answer 7

acts to decrease local inflammation in the nasal passages, thus reducing nasal stuffiness.

1) treat seasonal allergic rhinitis (2 sprays in each nostril, twice daily, and decreases to 1 dose per day)

2) Veramyst: treatment of seasonal + perennial allergic rhinitis.
- once-daily dosing
- improvement of nasal + ocular symptoms associated with allergies.

3) Flovent
- administered by oral inhalation
- reduce bronchial inflammation for the therapy of asthma and COPD

4) Arnuity Ellipta: maintenance therapy of asthma
5) Topical fluticasone ointments and creams are applied to the skin for various inflammatory conditions, including atopic dermatitis, eczema, psoriasis, and contact dermatitis.

Question 8

adverse effects of Fluticasone (Flonase, Veramyst, others)

Answer 8

Swallowing large amounts increases the potential for systemic corticosteroid adverse effects.

Nasal irritation and epistaxis occur in a small number of patients.

When inhaled to treat asthma or COPD, the most frequent side effects are headache and nasopharyngitis.

Question 9

contraindications of Fluticasone (Flonase, Veramyst, others)

Answer 9

1) The only contraindication to fluticasone is prior hypersensitivity to the drug.
2) Because corticosteroids can mask signs of infection, patients with known bacterial, viral, fungal, or parasitic infections (especially of the respiratory tract) should not receive intranasal corticosteroids.

Question 10

Oxymetazoline (Afrin, others) classes

Answer 10

Therapeutic Class: Nasal decongestant

Pharmacologic Class: Sympathomimetic

Question 11

actions/uses of Oxymetazoline (Afrin, others)

Answer 11

1) activates alpha-adrenergic receptors in the sympathetic nervous system –> arterioles in the nasal passages constrict, thus drying the mucous membranes. Relief from nasal congestion occurs within minutes and lasts for 10 or more hours. Oxymetazoline is administered with a metered spray device or by nasal drops.

2) Oxymetazoline (Visine LR) is also available as eyedrops.
- vasoconstriction of vessels in the eye
- used to relieve redness and provide relief from dryness and minor eye irritations.

Question 12

Administration Alerts of Oxymetazoline (Afrin, others)

Answer 12

Wash hands carefully after administration to prevent anisocoria (blurred vision and inequality of pupil size).

Question 13

Adverse Effects of Oxymetazoline (Afrin, others)

Answer 13

1) Rebound congestion is common when oxymetazoline is used for longer than 3 to 5 days.
2) Minor stinging and dryness in the nasal mucosa may be experienced.
3) Systemic adverse effects are unlikely, unless a large amount of the medicine is swallowed.

Question 14

Dextromethorphan (Delsym, Robitussin DM, others) classes

Answer 14

Therapeutic Class: Cough suppressant

Pharmacologic Class: Drug for increasing cough threshold

Question 15

Actions and Uses of Dextromethorphan (Delsym, Robitussin DM, others)

Answer 15

1) nonopioid drug that is a component in many OTC severe cold and flu preparations.
2) available in a large variety of formulations, including tablets, liquid-filled capsules, lozenges, and liquids.
3) rapid onset of action, usually within 15 to 30 minutes. 4) acts in the medulla, but lacks the analgesic and euphoric effects of the opioids and does not produce dependence. 4) Patients whose cough is not relieved by dextromethorphan after several days of therapy should notify their health care provider.

Question 16

administration alerts of Dextromethorphan (Delsym, Robitussin DM, others)

Answer 16

Avoid pulmonary irritants, such as smoking or other fumes, because these agents may decrease drug effectiveness.

Question 17

adverse effects of Dextromethorphan (Delsym, Robitussin DM, others)

Answer 17

At therapeutic doses, adverse effects due to dextromethorphan are rare. Dizziness, drowsiness, and GI upset occur in some patients. In abuse situations, the drug can cause CNS toxicity with a wide variety of symptoms, including slurred speech, ataxia, hyperexcitability, stupor, respiratory depression, seizures, coma, and toxic psychosis.

Question 18

contraindications of Dextromethorphan (Delsym, Robitussin DM, others)

Answer 18

contraindicated in the treatment of chronic cough due to excessive bronchial secretions, such as in asthma, smoking, and emphysema. Suppressing the cough reflex is not desirable in these patients.

The U.S. Food and Drug Administration (FDA) has issued advisories that nonprescription cough and cold products (including those containing dextromethorphan) not be used in children under 6 years of age and that they be used with extreme caution in all children.

Question 19

Contraindications of Oxymetazoline (Afrin, others) classes

Answer 19

Patients with thyroid disorders, hypertension, diabetes, or heart disease should use sympathomimetics only on the direction of their health care provider.