Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHAR 153 > Colds & Allergic Rhinitis > Flashcards

Colds & Allergic Rhinitis Flashcards

1
Q

Common Cold Timeline (ie. Day 1 / 3 / 6)?

A

Day 1: Sore Throat (scratchy / tingly), Rhinorrhea, Sneezing

Day 3: Nasal Congestion, Sinus Headache, Plugged Ears, maybe Elevated Temp but rarer with cold (very low-grade fever)

Day 6: Coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens in terms of cold severity as the depth increases (ie. Head down into lungs)?

A

-Increasing severity as depth increases!
Head Cold < Bronchitis < Bronchiolitis < Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the three cough types.

A

1) Dry / Nonproductive - Cough IS NOT associated with chest congestion & no phlegm expelled.

2) Congested / Nonproductive - Cough IS associated with chest congestion, but little amounts of phlegm expelled. Will become productive!

3) Congested / Productive - Chest Congestion evident & lots of phlegm being expelled. This cough is VERY useful to the body!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do cold symptoms in Infants differ from those seen with kids & adults?

A

-May show early Fever
-GI distress / diarrhea
-Frequency… 8x / yr (compared to 1x / yr for adults)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In terms of relative frequency, order the following cold-like conditions from least likely to greatest likelihood to occur:

COVID-19
Strep Throat
Common Cold
Bronchitis / Sinusitis
Influenza

A

1) Strep Throat
2) COVID-19
3) Influenza
4) Bronchitis / Sinusitis
5) Common Cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What kind of differential questions can you ask a patient when distinguishing a common cold from influenza?

A

-How hard is illness hitting you?
-How quick did illness begin working?
-Any body aches?
-Chills? Fever?
-Any phlegm coming up with cough?
-Chest Congestion or Stuffy Nose?
-Runny Nose &/or Watery Eyes?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What group(s) of people are we most concerned with in terms of Influenza effects?

A

-Sr.’s (& little kids)!!! Very concerned with Sr.’s, as Influenza can deepen further & further into the lungs (& eventually kill them if left untreated).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Marg is an 85yr old resident at Luther Tower. She comes to your Pharmacy in October complaining about fatigue & systemic weakness (indicative of General Malaise). She presents a dry cough as well, but no fever. What are you thinking could be wrong with her [& what is the next step]?

A

-Could be Influenza!!! Malaise is much (MUCH) more common in the elderly than in adults presenting Influenza, & the dry / unproductive cough supports this rationale. Sr.’s also demonstrate Fever at a reduced rate compared to adults with Influenza.

-Next step should be a referral to a Dr. to make sure the potential Influenza gets treated ASAP & we prevent a possibly dangerous infection from occurring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are Pharmacists authorized to do when viral epidemics / pandemics are declared by the SHA?

A

-Prescribe Anti-Virals such as Oseltamivir or Zanamivir.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In terms of distinguishing COVID-19 from the Common Cold or Flu, what’s one major symptom that could help us in our screen?

A

-Shortness of breath!

-Much more common complaint than with the Common Cold or Flu. Fever & Aches are common with COVID too, but they’re also common with Flu. So, ask for shortness of breath & recommend testing for COVID if feverish symptoms or aches exist.

-Can also ask about loss of taste or smell (might help discern COVID).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Angie is a 24yr old patient who comes to your Pharmacy presenting a persistent cough & occasional wheezing. She tells you that her cough gets worse after she goes for long jogs, & the annoying cough has lasted about three months. She is otherwise healthy. What might Angie be presenting?

A

Asthma!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Johnny comes to your Pharmacy complaining about an irritated throat & heartburn, accompanied by an unproductive, dry cough that’s persisted for months. He tells you that laying down at night further exacerbates the symptoms. What might Johnny have?

A

GERD!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Andrew comes to your Pharmacy in late May & tells you that he can’t stop sneezing. He tells you that he’s started working a landscaping job planting flowers & other greenery for the City of Saskatoon. He tells you that his nose has also been super runny, and his eyes are “so damn red and itchy”! What condition might Andrew have?

A

Allergic Rhinitis! Exposure to pollen from flowering plants might be the root cause of irritation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What distinguishing factors differentiate a Smoker’s Cough from COPD?

A

Smoker’s Cough: Worse in morning & minimal sputum (but cough becomes more productive with time).

COPD: TONS of sputum & persistent cough for many many years. Effects usually rear their head around 20-30yrs post-smoking start.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute Bronchitis differs from the common cold how?

A

-Cough rate is increased & presents itself earlier.
-Cough is initially unproductive & becomes productive.
-Can last up to 3 weeks… Cold usually resolves itself around 7-10 days.
-Presence of Green Sputum (suggests bacterial / viral infection).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Greg is a 65yr old patient phoning into to your Pharmacy. He complains of a dry, raspy cough that’s been persisting for 6 weeks. You look at his patient history prior to the encounter and notice that he’s started to take Ramipril (an ACE Inhibitor) as of 6 weeks ago. Explain how the Ramipril that Greg is taking might be causing the dry, raspy cough.

A

-ACE (Angiotensin-Converting Enzyme) is responsible for degrading Substance P and Bradykinin.

-If we inhibit ACE, Substance P & BK accumulate in the lungs at higher concentrations, which induces bronchoconstriction, increasing coughing, & inflammation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some telltale signs of Strep Throat (vs. just a run-of-the-mill sore throat)?

A

-Increased rates of Fever & elevated pain when swallowing
-Often an absence of cough or runny nose
-Swollen Lymph Nodes / Glands / Tonsils
-Tonsil exudate
-Red Spotting on roof of the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What potentially fatal health condition most commonly arises in children with untreated Strep?

A

Rheumatic Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why are antibiotics prescribed for Strep?

A

-NOT to treat Strep itself!!!
-Are ACTUALLY prescribed to prevent bacterial spreading into vital organs such as the Heart or Kidneys (ie. Prevention of Rheumatic Fever).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes Tonsilitis?

A

Bacterial: 15-30% (most commonly Strep)
Viral: 70-85% (Epstein-Barr Virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What (usually) causes Laryngitis?

A

-Overuse of the voice box or viral infection
-Bacterial infections can cause Laryngitis (although less common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Angela brings her 4yr old child, Trey, into your Pharmacy. She lifts up his shirt and shows you a rash that has developed on his stomach. You investigate further and discover that Trey was in the Dr.’s office 6 weeks ago for virally-induced Acute Bronchitis. What is the name of Trey’s presented condition?

A

Fifth / Sixth Disease!

-Viral URTI’s cause ~40% of hive rashes in kids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the name of the virus most commonly responsible for causing Bronchiolitis?

A

Respiratory Syncytial Virus (RSV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T or F: Croup is treated with antibiotics.

A

False… Is VIRALLY caused!
-Croup clears on its own after 5-7 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Victor is a 17yr old patient who comes to your Pharmacy with a sore throat, fever, and he's complaining to you about being extremely tired. He tells you that his HS graduation party was three weeks ago, and that this was the only time he's left the house to intermingle with his friends. He also tells you that drinks were being shared amongst guests at the party. Given the length of time for symptoms to appear, what might you suscept Victor has?
Mono! -Symptoms present like the Flu or Strep Throat, but the onset is SLOWER!
26
What are some common signs & symptoms that patients with Lyme Disease demonstrate?
-Fever / Chills / Headache (similar to Flu). -Unlike the Flu, rash often appears at the site of a Tick bite. -"Bullseye Rash" in some patients. -Dizziness, Mental Confusion / Brain Fog, Nervous System Disorders.
27
When it comes to cold referrals, what age-based rules do we follow for Infants & young kids?
< 1yr: Automatic Referral 1-2yrs: Be very cautious 3-6yrs: Cautious
28
What's the youngest age in which we can use cold medicines?
6yrs... NEVER use cold medicines on kids < 6yrs of age!
29
When should you see a Dr. with regards to a persistent cold that's either worsening or staying the same (ie. No Improvements)?
14 days (generally)
30
Acute, Virally-Induced Sinusitis lasts roughly how long?
< 10 days
31
What is "Double-Sickening"?
-Indicative of Bacterial Sinusitis or Pneumonia... Cold-like symptoms for about a week, improvements for a few days, and then the cold comes back after a few days of improving conditions.
32
How long do we wait to make an MD referral for cough for the following age groups: < 1yr: 1-3yrs: 4-6yrs:
< 1yr: Automatic!!! 1-3yrs: 1 week (more cautious) 4-6yrs: 2 weeks (similar to adults)
33
The average cough length is what (how many days)? What is the expected / perceived normal length for a cough to persist?
Avrg Cough: Lasts 18 days! Patient: Thinks 7 days!
34
Three most common causes of chronic cough (account for 95% of cases): What are they?
1) Asthma 2) Post-Nasal Drip 3) GERD
35
Brain Centre that regulates body temperature... What is it?
Hypothalamus
36
Fever temperatures in the following bodily compartments: What are they? Rectum Mouth Armpit Ear
Rectum - 37.5 Celsius Mouth - 37 Celsius Armpit - 36.5 Celsius Ear - 37.5 Celsius
37
What are the ideal methods for each corresponding age group with regards to checking for Fever? 0-2yrs: 2-5yrs: > 5 yrs:
0-2yrs: 1 = Rectum, 2 = Armpit 2-5yrs: 1 = Rectum, 2 = Ear or Armpit > 5 yrs: 1 = Mouth, 2 = Ear or Armpit
38
Why aren't digital ear thermometers recommended for newborns?
-Size of a newborn's ear canal... Hard to position properly for an accurate reading b/c of the nature of how much smaller their ear canals are.
39
Procedurally, if you were planning to take an Otic temperature reading of a baby that's < 12 months, how would it differ from taking the temperature of an older child (say, 5yrs of age)?
< 12 months: Earlobe pulled DOWN & BACK for proper probe positioning. 5yrs: Earlobe pulled UP & BACK. -Shape & size (as seen before) of the baby's earlobe differs!
40
What is the "39 - 1 / 2 / 3 rule"?
-Describes Fever referrals (ie. When to see MD)... 1yr old: > 39 degrees for a day 2yr old: > 39 degrees for two days 3yr old: > 39 degrees for three days
41
What criticism does Jeff have with Pediatrician recommendations for treating Fever?
-They have a tendency to chase the number (39) rather than treat the child's discomfort... Should gauge how a child is feeling rather than simply treating when temps exceed 39 degrees.
42
Infant Tylenol vs. Advil Pediatric Drops... Which product is better for treating Fever?
-Either is good! Ace & Ibu can both be used, but Ibu does offer up more convenient dosing & slightly better anti-pyretic effects.
43
Administration Regiments for treating Child Fever with Ibu & Ace: What are they?
Ace: -10-15mg / kg Q4-6H... DO NOT EXCEED 5 DOSES IN 24hrs!!!! So, maximum of 75mg / kg / day. Ibu: -Kids < 6 months: 5 mg / kg Q8H -Kids > 6 months: 5-10mg / kg Q6-8H
44
Why do Dr.'s not recommend swapping between Ace & Ibu for Fever treatment?
-Can lead to dosing errors!
45
What OTC product should kids & teens not be given for Fever treatment due to its increased risk of developing Reye's Syndrome?
Aspirin
46
Ace or Ibu: Which one are we most concerned with in terms of toxicity risk?
Acetaminophen!!! Ibu is MUCH safer.
47
Types of Children's Acetaminophen formulations: What do we have?
-Infant Tylenol or Tempra Drops (less common than Tylenol) -Children's Tylenol Suspension -Children's Tylenol Fastmelts -ACET 120 / 160 Suppositories (very uncommon)
48
(Michael Pt. 1) Michael is a 3yr old boy who weights 36.9lbs. Calculate the maximum amount of Children's Tylenol that he can take in one week.
[10-15 mg / kg Q4-6H... Maximum of 5 doses / day!] Michael's Weight: (36.9lbs) x (1kg / 2.2lbs) = 16.8 kg Dose Calculations: (15 mg / kg) x (16.8kg) = 252 mg / dose (252 mg / dose) x (5 dose / day) = 1260 mg / day [Max] (1260 mg / day) x (7 days / week) = 8820 mg / week [Max]
49
(Michael Pt. 2) Use your calculation from Pt. 1 & determine how many Children's Tylenol Fastmelt tablets Michael can take in one week (round to the nearest whole tab). [160 mg / tab = Dose Strength of Children's Tylenol Fastmelts]
-Determined that Michael can take a maximum of 8820 mg / week... (8820 mg) / (160 mg / tab) = 55.125 tabs... Rounds down to 55 tabs in one week!
50
i) How long does Ibu take to initially relieve pain? ii) For how long does Ibu relieve pain?
i) 30mins ii) Up to 8hrs
51
Ibu s/e???
3-9%: Nausea, Epigastric Pain, Heartburn, Dizziness, Rash. < 1%: GI / Duodenal Ulcers. -At OTC concentrations, EXTREMELY UNLIKELY, but more likely occurrence at Rx levels for treatment of things like Rheumatoid Arthritis.
52
Ibu has historically been known to cause more s/e than Ace... Is this true?
-Kind of... At OTC concentrations (treatment of colds or Fever), both have similar s/e & incidence rates (ie. Nausea, Heartburn), so one isn't better than the other. However, at Rx levels for treating autoimmune conditions, Ibu is more likely to cause GI distress & ulcers or bleeds.
53
Which OTC Fever product brought about the dawn of safety capping on drug bottles?
ASA (Aspirin)... Good taste of flavored tablets caused OD's.
54
Jennifer is a patient at your Pharmacy wanting to simultaneously take Ibuprofen & Acetaminophen for her Fever. She's unsure how to space out her dosing. Provide a therapeutic dosage window for Jennifer to take her OTC medications.
***Ace: 4hrs apart. ***Ibu: 8hrs apart. 8am - Ace 12pm - Ibu & Ace 4pm - Ace 8pm - Ibu & ace
55
What is the OTC daily limit for Ace? For Ibu?
Ace: 4000mg Ibu: 1200mg (2400mg at Rx levels)
56
"Doubling Up" on Ace & Ibu for Pediatric Fever interventions is unfavorable... Why?
-Pediatricians are concerned with screwing up dosages! Combination Therapy is safe.
57
What are the two combination Ace & Ibu medications we discussed in class?
-Advil Dual Action w Ace -Combogesic *Both are safe & fairly low dosage, but dosing is only offered up for adults!
58
What are the six issues we discussed in terms of Fever Management?
1) Do we need to treat the fever? 2) Fever Phobia... Exaggerated Misconceptions (my kids will have seizures & suffer brain damage if I leave a fever untreated). 3) Alternating or using Ibu & Ace simultaneously... What are the dosage windows necessary to maintain safe drug usage? 4) Anti-Pyretics for vaccination pains... Evidence that they stunt effectiveness of a vaccine is inconclusive. 5) Febrile Seizures... Harmless (but scary) convulsions usually caused by viral Herpes infections, & infections are accompanied by Fevers. 6) Elderly Fevers... More likely associated with serious bacterial or viral infections.
59
Non-Drug Measures: Which ones are desirable for treating infants with bothersome cold symptoms such as a sore throat or nasal congestion?
-Saline Sol'ns & Drops... Are good for relieving sore throats. -Bulbous Suctioning (sometimes, but only if mucous is loose & runny). -Humidifier (to help a little bit with nasal or chest congestion).
60
What benefits would you get from a nasal mist like Rhinaris that you wouldn't get from something like Salinex?
-Presence of a lubricant... This provides soothing action that the regular saline product (ie. Salinex) wouldn't provide.
61
Nasal Strips: Good or Shitty products?
-Waste of money... Minimal (if any) therapeutic relief.
62
Vicks VapoInhaler: Good or Shitty product?
-More TLC than anything... Presence of Camphor & Menthol hits cooling receptors in airways to provide the sensation that cooler / better air is getting in. However, does nothing in terms of congestion.
63
Pseudoephedrine is considered an Indirect-Acting Oral Decongestant... Explain its mechanism of action.
-Targets neurons next to blood vessels & kicks out Noradrenaline (which itself acts upon blood vessels).
64
Amphetamine Receptor type drugs: How do they work with regards to nasal congestion relief?
-Direct Acting... Target Alpha receptors & shrink vasculature, which relieves nasal congestion.
65
Two Oral Decongestants we discussed in class: What are they?
Pseudoephedrine Phenylephrine
66
Phenylpropanolamine (PPA) was an older Oral Decongestant that is no longer on the market... Why was it taken off?
-Induced cerebral bleeds & strokes in patients taking it in weight loss products.
67
Two Topical Decongestant agents discussed in class: What are they?
Xylometazoline Oxymetazoline
68
Which Decongestant Agent provides the longest duration of action?
Oxymetazoline (up to 12hrs)
69
i) Which decongestant is the active ingredient in Otrivin? ii) What s/e does this medication demonstrate?
i) Xylometazoline ii) Rebound Congestion
70
SudafedPE is a newer decongestant that was created in light of what scandal in the United States?
-People purchasing the original Sudafed OTC product & using it in Crystal Meth labs.
71
Why is the newer SudafedPE product inferior to its predecessor, Sudafed?
-Inconsistently absorbed & dependent upon one's Monoamine Oxidase levels.
72
Would a Topical or Oral Decongestant have a faster onset of action?
-Topical (much faster)! -However, Topical agents require the purchase of a second product, which makes Oral products much more practical.
73
What are the side effects of taking Topical Decongestants?
-Rebound Congestion -Localized Irritation
74
What are the side effects of taking Oral Decongestants?
-Stimulatory CNS effects -Increased HR & BP -Blood Glucose increases (minimal impact with diabetics... more caution w Type I than Type II) -Angle Closure Glaucoma (Extremely rare cases) -Urinary Retention / Prostate (reverses Prostatic relaxation effects seen with Alpha Antagonists such as Flomax) -Hyperthyroidism
75
Frankie is a 65yr old man coming to your Pharmacy looking for a decongestant to clear up his chest cold. His patient profile states that he has a genetic predisposition for heart failure (due to both of his parents & one set of grandparents dying from this condition) & he has elevated blood pressure readings. Based on this assessment, what decongestive agents would you avoid, and what decongestive agents might you choose to suggest instead?
-Avoid using Oral Decongestants such as Pseudoephedrine & Phenylephrine b/c of their stimulatory CNS effects & ability to raise HR & BP. -Use Topical Agents (such as Oxymetazoline & Xylometazoline) instead, as they DO NOT cause CV or CNS effects!
76
Dale is a 45yr old patient coming to your Pharmacy complaining of difficulties urinating. He has BPH (Benign Prostatic Hypertrophy) & began taking Flomax a year prior from this visit to make urinating easier. He says peeing became difficult about a week ago, which was when he started taking OTC Claritin D to alleviate his seasonal allergies. What might explain his sudden difficulties with urination?
-The decongestant ("D") present in this anti-histamine product may be causing the difficulties with urination. -Decongestants act as Alpha Receptor Agonists at the level of the Prostate, which causes Prostatic contraction & causes it to press up on the Bladder (thereby making bladder emptying / urination processes more challenging).
77
Georgina is a patient of yours taking Phenelzine [an old-school Monoamine Oxidase Inhibitor] for her depression. She comes in asking for a decongestant to treat a recent chest cold. What product(s) might you refrain from recommending to her?
***Drug-Induced Hypertensive Crisis*** -Avoid Indirect-Acting Oral Decongestants such as Pseudoephedrine or Phenylephrine! -MAO is an enzyme responsible for degrading neurotransmitters sitting in the synaptic cleft, so its inhibition would mean a surplus of NT's sitting in the cleft. By adding in the decongestant, we would be MASSIVELY increasing the amount of NT in the cleft (particularly Noradrenaline) due to the effects of PE & Pseudo!
78
Why do we recommend taking Topical Decongestants for only short durations of time (ie. 3-5 days)?
-Rebound Congestion risk... Taking for long periods of time causes blood vessels to dilate beyond their dilatory capacity. -Vessels then press on nasal tissues & the drug itself now causes demonstrated congestion.
79
Provide examples of various antitussive agents.
Centrally Acting: DM, Codeine, Hydrocodone, Diphenhydramine Locally Acting: Camphor, Menthol, Honey
80
When would be appropriate times to give antitussive agents? C/P C/NP D/NP
C/P: Don't give right away (cough is productive & expelling shit) C/NP: Don't give right away (as cough will become productive) D/NP: Sure... Cough is not removing crud & is irritating [ie. PND / Influenza patients]
81
i) What agent is often counterintuitively added to antitussive medications (in combination with DM)? ii) What does this agent do?
i) Guaifenesin ii) Loosening agent that aids in crud removal & does nothing in terms of cough suppression... DM suppresses cough (so the effects of both agents offset one another).
82
What major advantage does DM have in comparison to Codeine?
-Onset of action... Works basically from the start of administration (within 15-30mins). -Codeine is a prodrug that requires CYP2D6 conversion to its active form (Morphine). OOA = 1-2hrs.
83
Codeine side effects...?
Serotonin Syndrome (if patient is on SSRI's) Constipation (with repeated use) Sedation & Dizziness Nausea
84
Explain why Codeine is now avoided for use in pregnant / lactating women.
-One case of a woman who was a CYP2D6 "Ultra-Metabolizer"... High levels of Morphine were believed to have passed through her breast milk & killed her infant child.
85
What is the minimum OTC dose of Codeine that acts as an analgesic / cough suppressant?
10mg
86
Dosing regimens for Codeine & DM: What are they?
Codeine: 10-20mg Q4-6H DM: 10-20mg Q4H or 30mg Q6-8H... Cut doses in half for kids 6-11yrs.
87
What is the criteria for Codeine to get into an OTC product like Calmylin or Benylin?
-Must be present with two other ingredients & at [< or = 3.3mg / 5mL]!
88
T or F: Camphor, Menthol & Honey all act as great analgesic / antitussive agents at sites originating away from pain sources.
False... All are LOCALLY acting agents that work in the throat.
89
What therapeutic agent is often present in nighttime cough and cold medications, yet is absent in daytime cough and cold medications?
Diphenhydramine (1st gen AH with minor sedative effects)
90
i) Guaifenesin's primary role in cough & cold medications is to act as what? ii) Provide an example of a Guaifenesin product.
i) An Expectorant... Stimulates Trachea & loosens / thins mucous. ii) Mucinex
91
Regular Robitussin / GF or Extra Strength: Which one do you recommend?
-Extra Strength Robi / GF... Closer to therapeutically useful dose (200-400mg Q4H)... Robi Syrup is 200mg / 5mL in extra strength form, 100mg / 5mL in regular form.
92
Which are better for colds: 1st Gen or 2nd Gen Anti-Histamines?
-1st Gen (although neither are great). -1st gen may have subtle sedating effects that can aid one's sleep (in cases where cough is disrupting one's sleep), but 2nd Gen are useless.
93
Zinc has been suggested to help with immune system functioning & phagocytic processes within 24hrs of the onset of a cold. What was the estimated Q2H dosing strength that we discussed in class that might be of benefit?
20mg Elemental Zinc Q2H... Is merely an estimation (ACTUAL values are still unknown).
94
List a few of the bullshit cold remedies that were discussed in class.
-Sambucol -Vitamin C -Kids 0-9 Cough & Cold -Stodal Honey -Coryzalia Cold (Bear Products seen many times) -Homeopathic Medicines
95
What was the off-label common cold recommendation that Jeff suggested in class for congestive relief? Hint: Low potential side effects, excellent for seasonal allergies.
Topical Nasal Steroids
96
Topical Decongestants should be utilized with what kinds of patients?
-Post Myocardial Infarction -Prostate Issues -High BP Patients
97
T or F: The addition of an Anti-Histamine to Advil Cold & Flu products is a justifiable decision.
False... AH does nothing for treating Common Cold or Flu (Histamine is NOT a big player)!
98
Although Combination Products are more convenient in nature, what problem do they bring along with them?
-May be taking a product with an unnecessary therapeutic agent for longer than necessary... Ex. Advil Cold & Sinus (for Decongestion purposes)... Ibuprofen is an added agent in this decongestive product, so you'd be taking Ibu for potentially 2-3 days longer than the 1 day necessary for headache relief.
99
Kids 6-12yrs: What are the dosing regimens for Pseudoephedrine, DM, & Phenylephrine?
Pse: 30mg Q6H PE: 5mg Q4H DM: 5-10mg Q4H
100
Decongestant options for pregnant women... Which way do we want to go?
Oxymetazoline or Xylometazoline... Go Topical! Less side effects than with Orals (BUT avoid in 1st Trimester if you can).
101
Which of the following cough & cold agents impact Blood Glucose readings of Diabetics? Oral Decongestants Topical Decongestants Antihistamines Antitussives Expectorants
-Oral Decongestants (impact is minimal)... Other four do nothing in terms of BG impact.
102
What agent discussed in class induces Rhinitis Medicamentosa?
Topical Decongestants... Not caused by Orals!
103
Nasal Congestion... More common with Seasonal or Perennial Allergies?
Perennial... Inflammatory response is involved!
104
Rhinorrhea... More common with Seasonal or Perennial Allergies?
Seasonal... Variable with Perennial.
105
Approaches to Allergic Therapies?
1) Allergen / Trigger Avoidance 2) Nasal Irrigation (via Saline) / Relief (via Lubricant) 3) Usage of Antihistamines
106
T or F: Green Phlegm... Indicative of bacterial infection?
False... Can be viral infection as well, but green color is more indicative of INFLAMMATION!
107
T or F: H1 & H2 receptors are both localized to the nose & lungs.
False... H1 = Nose & Lungs, H2 = Stomach!
108
We hear 'congestion' as a primary allergy symptom... AH or Topical Steroid?
Topical Steroid... AH better for rhinorrhea / sneezing / itchiness.
109
1st Gen AH... What are the classes & provide examples?
Promethazine (stand-alone) Ethanolamines (more sedating)... Diphenhydramine, Doxylamine, Clemastine Alkylamines (less sedating)... Chlorpheniramine, Brompheniramine, Dexbrompheniramine, Triprolidine
110
Sedating 1st gen agent most commonly used in Day/Night products?
Chlorpheniramine
111
Anticholinergic effects such as drowsiness, dry mouth & constipation are most commonly seen with what 1st Gen AH's?
Promethazine & Ethanolamines such as Diphenhydramine... Lesser effects with Alkylamines.
112
2nd Gen AH's > 1st Gen AH's... Why?
1) Safer... Has much better H1 Receptor affinity than 1st gen (MUCH less Anticholinergic effects). 2) Dosing = More Convenient (OD vs. TID or QID). 3) Onset of Action = Equivalent to 1st gen (~1hr).
113
Why is Diphenhydramine often favored by HC providers over 2nd Gen Antihistamines such as Claritin / Allegra / Reactine for use in kids & infants?
-Because of dosing criteria present on the packaging... Is NOT the best option (go 2nd Gen whenever).
114
If 2nd Gen AH's don't work, what product do we revert to?
Topical Steroid... Offers up better decongestive effects!
115
What's a better option than taking combo 'Allergy & Sinus' products?
-Take regular 2nd Gen AH by itself & use Decongestant SPARINGLY... Decongestant when used chronically loses its effectiveness!
116
Provide an example of a useful Intranasal AH product.
Dymista (Fluticasone & Azelastine) -Fluticasone = Corticosteroid -Azelastine = 2nd Gen AH
117
Benefits of using an Intranasal Steroid vs. a Topical Steroid?
-No rebound congestion (huge). -No mucosal thinning & no addictive potential.
118
New Intranasal Steroid products...?
Fluticasone Ciclesonide Mometasone
119
What bad rap do newer Intranasal Steroid products such as Flonase get with regards to child altering effects?
-Stunt Growth... VERY minimal chance or risk of this happening b/c the bioavailability of the drug is much much lower than older agents (ie. 30% for Budesonide, Flunisolide, Triamcinolone, Beclomthasone).
120
How do Ophthalmic allergy products such as Cromolyn work?
-Stabilize Mast Cells so they don't rupture & release Histamine!
121
What makes Cromolyn an unpopular product (even though its safety & efficacy have proven to be good)?
-Dosing Regimen... Up to 6x / day (inconvenient).
122
Jeff's defacto choice for treating Ophthalmic Allergic Rhinitis???
Patanol... Has both Mast Cell stabilization effects & is Antihistamine!!!
123
Montelukast... What's it used for?
Allergy-Based Asthma & AR add-on!
124
Ipratropium... Used in what?
Vasomotor Rhinitis (via Anti-Cholinergic mechanisms).

PHAR 153 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions