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Pre-pharmacology > Chapter 14 (ENT drugs) > Flashcards

Chapter 14 (ENT drugs) Flashcards

1
Q

decongestants

A

epinepherine-like drugs, alpha agonists; vasoconstrictors used to reduce upper airway congestion; often combined with anithistamines in many cold remedies
Can be taken as spray or orally (better locally b/c you avoid systemic side effects for the most part)

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2
Q

ENT

A

ear, nose, and throat

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3
Q

NeoSynephrine

A

phenylephrine; nasal spray decongestant (only lasts about 4 hours)
Ingredient in most oral decongestants nowadays, even though in oral form they are not better than placebo (even though they still produce sympathomimetic side effects)

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4
Q

Afrin

A

oxymetazoline; alpha agonist, very good decongestant that lasts about 12 hours

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5
Q

Sudafed

A

pseudoephedrine; good decongestant but abused so heavily its hard to find now (only behind counter in pharmacies as OTC)
*does increase BP though, so bad for those with HTN or CHF so best to use nasally

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6
Q

allergy treatment

A

one of hardest things to do in medicine b/c it is so widespread. Treatments don’t make people feel better instantly; prophylactic treatment is best:
Reduce exposure to allergen, and taken anti-histamines before allergy season begins

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7
Q

antihistamines

A

H1 rc blockers for cells of ENT so histamine cannot bind to them when mast cells respond to allergens
They are found in many cold remedies even though they have no proved cold benefits

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8
Q

histamine

A

released by mast cells in response to allergens; one part of the allergic response

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9
Q

first gen antihistamines

A

older, inexpensive antihistamines that cause drowsiness b/c they cross the BBB (a side effect used in OTC sleep aids now)
Some are used for their anti-nausea effects

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10
Q

Benadryl

A

diphenhydramine; first gen antihistamine that works very quickly
Also used for anti-nausea effects

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11
Q

Phenegran

A

promethazine; like a first gen antihistamine (technically a phenothiazine that works like an antihistamine)
Also used for anti-nausea effects

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12
Q

doxylamine

A

first gen antihistamine; found in many cold and cough medicines meant to induce sleepiness (like Nyquil)
Shorter 1/2 life than Benadryl

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13
Q

Chlor-Trimeton

A

chlorpheniramine; first gen antihistamine that works very quickly

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14
Q

Claritin

A

loratidine; only early second gen antihistamine still on market

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15
Q

second gen antihistamines

A

better tolerated than sedating first gen antihistamines and work better at treating hay fever
*should be used prophylactically

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16
Q

Allegra

A

fexofenadine; newer second gen antihistamine

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17
Q

Zyrtec

A

cetirizine; newer second gen antihistamine

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18
Q

leukotrienes

A

eicosanoids produced in the AA pathway from lipoxegenase; inflammatory mediates involved with asthma and allergies

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19
Q

Leukotriene rc blockers

A

approved for treatment of asthma and severe hay fever not responding to antihistamine therapy
Can be combined with antihistamines to get great allergy relief
*all -leukast

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20
Q

Singulair

A

montelukast; leukotriene rc blocker

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21
Q

Accolate

A

zafirlukast; leukotriene rc blocker

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22
Q

Ultair

A

pranlukast; leukotriene rc blocker that is in late stage trials in America

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23
Q

mast cell stabilizers

A

coat mast cells and prevent the release of their histamine granules; inert drugs b/c they are unchanged in the body and don’t do anything physiologically
Used for allergies and asthma
*only effective prophylaxis b/c it must be used before the mast cell degranulates

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24
Q

NasalCrom

A

cromolyn sodium; mast cell stabilizer prototype that is still used widespread
*used nasally but also as solution that can be nebulized (turned into mist and inhaled) for lungs

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25
Q

corticosteroids

A

Great drugs, but have terrible side e’s if used long term; better to use locally to avoid the side e’s
Used in upper airway to treat airway inflammation (like in allergic rhinitis)
All require Rx
Named with -one

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26
Q

Flonase nasal spray

A

fluticasone; corticosteroid used for upper airway

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27
Q

Nasacort nasal spray

A

triamcinolone; coritcosteroid used for upper airway

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28
Q

Orabase

A

triamcinolone; corticosteroid applied to canker sores in mouth although there is no proven benefit

29
Q

strep throat antibiotic treatment problem

A

people feel better after a couple days of antibiotics so they stop taking antibiotics and then rheumatic heart disease can develop (in 1% of untreated infections) which can lead to heart valve replacement that is necessary
Also antibiotic resistance is built

30
Q

antibiotics to treat oral conditions

A

pen VK, amoxicillin, Biaxin (clarithromycin), Cipro (ciproflaxacin)

31
Q

antibiotics in topical creams and ointments

A

Bactroban (mupirocin) and neosporin; used for things like impetigo or outer ear infections (too toxic for internal use)

32
Q

impetigo

A

“school sores” red sores on face, especially around child’s nose and mouth

33
Q

Bactroban

A

mupirocin; carboxylic acid type antibiotic that inhibits protein synthesis; used for things like outer ear infections (too toxic for internal use)

34
Q

Neosporin

A

antibiotic ointment; original formula is neomycin (aminoglycoside) and polymyxin B for gram negative bacteria, and bacitracin for gram positive bacteria

35
Q

Ocean Spray

A

salt water/saline; very good for use in irrigating nose when there is an infection

36
Q

swimmers ear

A

otitis externa; outer ear infection (which is a dermatitis)

37
Q

otitis externa treatment

A

anibiotic solutions and suspensions are used, often with combinations with corticosteroid (or antifungal in some cases)

38
Q

Floxin Otic

A

ofloxacin; otic solution of fluoroquinolone antibiotic; used for things like outer ear infections (too toxic for internal use)

39
Q

viral ENT infection

A

often saline nasal spray is helpful, otherwise symptomatic therapy is used (Afrin, tylenol, sleep aid, etc.); except when specific therapy can be used (influenza, RSV, herpes)
Secondary bacterial infections often complicate the primary viral therapy; usually manifested as worsening symptoms after a short period of recovery

40
Q

symptomatic therapy

A

therapy directed at symptoms of illness and not underlying cause of disease

41
Q

influenza treatment

A

Relenza (zanamivir) or Tamiflu (oseltamivir); IIV4 to prevent

42
Q

herpetic cold sore treatment

A

acyclovir type drugs

43
Q

RSV treatment

A

ribavirin; guanosine (ribonucleic) analog used to stop viral RNA synthesis and viral mRNA capping, thus, it is a nucleoside inhibitor

44
Q

antifungals for ENT use

A

nystatin, miconazole, and clotrimazole used as “swish and swallow” for oral thrush or some sinus infections

45
Q

antitussives

A

suppress cough by working on cough center in brain stem (medulla) or by anesthetizing the stretch receptors in the respiratory tract
*some coughs should not be suppressed though, like pneumonias where it is important to clear pooled mucous

46
Q

narcotic antitussives

A

best antitussive drugs we have; any opioid works

47
Q

codeine/morphine

A

classic narcotic antitussives

48
Q

Hycodan

A

hydrocodone; opioid used as an antitussive

49
Q

DM or DXM

A

dextromethorphan; used more commonly than opioids as an antitussive b/c it is not a pure opioid agonist (non-addicting opioid-like drug) and b/c it is OTC
*is often accidentally overdosed b/c of ubiquity in OTC medications, just like acetaminophen is

50
Q

expectorants

A

aka mucolytics; reduce thickness of mucous to make patients more easily cough it up

51
Q

guaifensin

A

expectorant; used in many OTC cough and cold medications (like Robitussin)
Used for centuries and is derived from the guaiac tree

52
Q

vertigo

A

disorder with equilibrium of the inner ear; often caused from a temporary viral infection or can be sign of more serious inner ear disease
Feeling of spinning and nausea produced is very disconcerting

53
Q

vertigo treatment

A

antihistamines and other anticholinergic drugs are used to treat vertigo and motion sickness

54
Q

Dramamine

A

dimenhydrinate; antihistamine used OTC to prevent motion sickness and treat vertigo

55
Q

Transderm Scop

A

scopolamine; belladonna anticholinergic drug used OTC to prevent motion sickness and treat vertigo

56
Q

Xylocaine

A

4-10% topical cocaine; our best decongestant and great local anesthetic (1-2% when injected for dental procedures)
*but is a controlled substance so rarely used; instead just use NeoSynephrine with lidocaine

57
Q

Beconase

A

beclomethasone; corticosteroid used for intranasal admin

58
Q

Nasonex

A

mometasone; corticosteroid used for intranasal admin

59
Q

Mycelex

A

clotrimazole; antifungal used as a “swish and swallow” liquid for thrush

60
Q

Mycostatin

A

nystatin; antifungal used as a “swish and swallow” liquid for thrush

61
Q

Chloromycetin Otic Drops

A

chloramphenicol; antibiotic used for things like outer ear infections (too toxic for internal use)

62
Q

Cerumenex ear drops

A

used to soften ear wax

63
Q

LAs for ENT

A

local anesthetics for ENT; sodium channel blockers to stop nerve transmissions
benzocaine and lidocaine

64
Q

silver nitrate

A

chemical cautery sticks used for cauterizing nosebleeds and cuts in shaving

65
Q

Vicks VapoRub

A

mentholated (eucalyptus oil) based petroleum jelly

66
Q

Allegra-D

A

combination product: fexofenadine (antihistamine) and pseudoephedrine (decongestant)
D for decongestant

67
Q

Claritin-D

A

combination product; loratadine and pseudoephedrine

68
Q

NyQuil

A

combination product; phenylephrine (decongestant), doxylamine (1st gen antihistamine), dextromethorphan (opioid-like antitussive), and acetaminophen (analgesic; antipyretic)

69
Q

Otobiotic Otic

A

combination product; hydrocortisone (corticosteroid) and polymyxin B (antibacterial)

Pre-pharmacology (27 decks)

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