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Pharmacology Unit 1 > EENT Medications > Flashcards

EENT Medications Flashcards

1
Q

Chemical messenger that mediates allergic and inflammatory reactions, gastric acid secretion, and neurotransmission in certain parts of the brain

A

Histamine

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2
Q

Histamine is primarily located in what type of cells?

A

Mast Cell granules

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3
Q

Where in the body are mast cells generally found?

A

nose
mouth
skin
internal body surfaces
blood vessels

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4
Q

Release of histamine is usually mediated by what?

A

Immune system

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5
Q

This receptor stimulates nerve endings that mediate itching, cause bronchoconstriction and increase mucus production, and increase capillary permeability leading to edema and vasodilation resulting in a decreased BP

A

H₁ Receptor

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6
Q

This receptor stimulates gastric acid secreting and increases capillary permeability and vasodilation, and slightly increases heart right and contractility

A

H₂ Receptor

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7
Q

First Generation Oral Antihistamines

A

Chloropheniramine (Chlor-Trimeton)
Diphenhydramine (Benadryl)
Doxylamine (Unisom)
Hydroxyzine (Vistaril)
Meclizine (Antivert)
Promethazine (Phenegran)

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8
Q

Second Generation Oral Antihistamines

A

Cetirizine (Zyrtec)
Desloratadine (Clarinex)
Fexofenadine (Allegra)
Loratadine (Claritin)
Levocetirizine (Xyzal)

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9
Q

What mechanism of action is used to block H₁ receptor-mediated responses to histamine in the GI tract, blood vessels, and respiratory tract?

A

Competitive binding

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10
Q

This generation of medication penetrates the CNS and causes sedation and can interact with other receptors besides H₁.

A

First-Generation Oral Antihistamine

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11
Q

This generation of medication has a minimal to negligible distribution to the CNS and is specific for H₁ receptors.

A

Second-Generation Oral Antihistamines

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12
Q

Second-generation are preferred to treat this due to less sedation and the reduction of sneezing, itching, and rhinorrhea

A

Allergic Rhinitis & Urticaria

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13
Q

These three drugs are second-generation antihistamines that are best for treating allergic rhinitis and urticaria

A

Loratadine (Claritin)
Desloratadine (Clarinex)
Fexofenadine (Allegra)

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14
Q

Doxylamine is the drug of choice and is used in combination with Vitamin B6 to treat what?

A

Pregnancy induced nausea and vomiting

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15
Q

These three drugs are used to prevent motion sickness but are less effective if it is already present

A

Diphenhydramine (Benadryl)
Meclizine (Antivert)
Hydroxyzine (Visatril)

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16
Q

These two drugs are used to treat insomnia and are commonly found it OTC sleep aids and night time cold and cough medicine. They are only intended for short-term use

A

Diphenhydramine (Benadryl)
Doxylamine (Unisom)

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17
Q

This drug can be used for its antiparkinsonism effect. It also suppresses extrapyramidal symptoms of certain antipsychotics.

A

Diphenhydramine (Benadryl)

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18
Q

Adverse drug reaction most common with first generation oral antihistamines such as diphenhydramine and hydroxyzine and seen slightly in chlorpheniramine and meclizine.

A

Sedation

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19
Q

This effect causes symptoms such as dry mouth, decreased tears and dry nasal passages, urinary retention, and tachycardia. This effect is also worse with diphenhydramine.

A

Anticholinergic effect

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20
Q

These drugs are more effective than oral agents for allergic rhinitis but are less effective than intranasal corticosteroids

A

Intranasal antihistamines

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21
Q

Adverse drug reactions of intranasal antihistamines

A

Bitter taste
Nasal irritation & epistaxis
Rarely sedation and anticholinergic

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22
Q

Examples of intranasal antihistamines

A

Azelastine (Astelin)
Olopatadine (Patanase)

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23
Q

This class of drugs reduce proinflammatory mediators, cause vasoconstriction of the nasal passage, and decrease sneezing, itching, rhinorrhea, and nasal congestion

A

Intranasal Corticosteroids

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24
Q

Adverse drug reactions of intranasal corticosteroids

A

Local irritation
Burning & stinging
Epistaxis

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25
Q

This class of drug stabilizes mast cell and eosinophil plasma membrane by preventing the degranulation of the mast cell and prevents release of histamines & leukotrienes

A

Mast Cell Stabilizers

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26
Q

These drugs are not first line for anything and are an alternative daily therapy for mild asthma. They also are not a therapy for an acute attack because they a very slow acting

A

Mast Cell Stabilizers

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27
Q

Name an example drug of a mast cell stabilizer

A

Cromolyn (Intal)

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28
Q

What are some adverse drug reactions from mast cell stabilizers?

A

Throat irritation & dry throat
Dysgeusia (bad taste in mouth)
Cough

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29
Q

What are two examples of intranasal antihistamines?

A

Azelastine (Astelin)
Olopatadine (Patanase)

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30
Q

What are some of the drug-drug interactions that can occur with oral antihistamines?

A

Potentiate CNS depression (including alcohol)
Potentiate anticholinergic effects
Worsen urinary retention in BPH
Decrease effectiveness of cholinesterase inhibitors in Alzheimer’s
Many are CYP2D6 and 3A4 Substrates or Inhibitors

31
Q

This class of drug decreases inflammation in the airways and is 2nd line for mild intermittent disease comorbid with mild asthma. Can also be used in children as young as 6 moths

A

Leukotriene Receptor Antagonists

32
Q

What drug is a Leukotriene Receptor Antagonist?

A

Montelukast (Singulair)

33
Q

What are the intial treatments for acute bacterial sinusitis?

A

NSAIDs
Steam therapy
Saline rinse
Intranasal corticosteroid

34
Q

When should you consider giving antibiotics for acute bacterial sinusitis?

A

Symptoms longer than 10 days
Facial or dental pain
Fever
Maxillary edema or puffiness

35
Q

What drug is first line for the treatment of acute bacterial sinusitis?

A

Augmentin for 10 days

36
Q

What drug should be given for acute bacterial sinusitis if the patient has a PCN allergy?

A

Clindamycin or Cefdinir

37
Q

This class of drug stimulates α & β adrenergic receptors. Induce the release of norepinephrine from nerve endings and act similar to epinephrine, but much less potent

A

Nasal decongestants

38
Q

What are some example drugs of nasal decongestants?

A

Pseudoephedrine (Sudafed)
Pseudoephedrine/loratadine (Claritin-D)
Phenylephrine

39
Q

What are the clinical uses of nasal decongestants

A

Allergic rhinitis
Common cold
Sinusitis

40
Q

What are some adverse effects of nasal decongestants?

A

↑ BP
Urinary retention
Insomnia
Tachycardia

41
Q

What drug can be used for patients who are experiencing the cold or flu and have high blood pressure?

A

Coricidin HBP

42
Q

Pseudoephedrine is a precursor to what illegal substance?

A

Methamphetamine

43
Q

These drugs are α agonists that cause vasoconstriction in the nasal mucosa and reduce airway resistance. They have a rapid onset of action and few systemic effects with aerosols

A

Topical nasal decongestants

44
Q

What are two examples of topical nasal decongestants?

A

Phenylephrine (Neo-synephrine)
Oxymetazoline (Afrin)

45
Q

Clinical use of topical nasal decongestants?

A

Allergic Rhinitis & Common Cold etc.
Short term (3 - 5 days)

46
Q

What are some adverse effects of topical nasal decongestants?

A

Rebound congestion (rhinitis medicamentosa)
↑ BP & Urinary retention
Insomnia
Tachycardia

47
Q

What class of drugs are structurally related to codeine & depresses the medullary cough center?

A

Antitussives

48
Q

This drug is an OTC antitussive that can be formulated alone or in combination with guaifenesin (Mucinex), phenylephrine, pseudoephedrine, or acetaminophen

A

Dextromethorphan

49
Q

Local anesthetic used to decrease the sensitivity of the airway stretch receptors and the drive to cough after a deep breath. Must be 10 years or older. Almost no side effects.

A

Benzonatate (Tessalon Perles)

50
Q

Moderate opioid agonist with antitussive effects. Suppresses the response of the CNS cough center at doses that don’t cause analgesia

A

Codeine

51
Q

Side effects of Codeine

A

Nausea and Vomiting
Constipation
Sedation
Potential addiction

52
Q

Prodrug that that needs converted to morphine by CYP2D6 to produce analgesia

A

Codeine

53
Q

Drug that thins airway mucus (expectorant) making it easier to bring up. No antitussive effects and lack clinical efficacy data.

A

Guaifenesin (Mucinex)

54
Q

Side effects of Guaifenesin (Mucinex)

A

May cause nausea and vomiting at high doses
Rarely: Uric acid nephrolithiasis (Kidney Stones)

55
Q

This type of glaucoma is treated in the hospital and is a medical emergency

A

Closed-angle glaucoma

56
Q

This type of glaucoma is a chronic disease state and is treated with eyedrops

A

Open-angle glaucoma

57
Q

Often used as 1st line treatment for glaucoma. Works by increasing aqueous flow.

A

Prostaglandins

58
Q

Clinical Pearls of Prostaglandins

A

Take at night
Cannot be administered with contact lenses

59
Q

Adverse drug reactions of Prostaglandins

A

Changes in iris pigmentation
Eyelash growth
Eye redness, tearing, eye pain, or lid crusting

60
Q

Examples of Prostaglandins

A

Travoprost (Travatan Z)
Bimatroprost (Lumigan)
Latanoprost (Xalatan)

61
Q

Class of drugs that can be used to treat glaucoma. Works by reducing aqueous humor production.

A

Non-selective Beta-blockers

62
Q

Examples of Non-selective Beta Blockers

A

Timolol
Betaxolol
Levobunolol
Carteolol

63
Q

Clinical pearls of Non-selective beta blockers

A

Can exacerbate respiratory conditions
Timolol is typically an eye drop but can be a gel

64
Q

Adverse drug reactions of non-selective beta blockers

A

burning, stinging, or Itching of eyes & eyelids
changes in vision
photosensitivity

65
Q

Not commonly used to treat glaucoma but works by reducing aqueous humor production. Must be used 3x a day. Can produce a bitter or unusual taste.

A

Carbonic Anhydrase Inhibitors

66
Q

Examples of Carbonic Anhydrase Inhibitors

A

Brinzolamide (Azopt)
Dorzolamide (Trusopt)

67
Q

Lowers interocular pressure by increasing aqueous outflow. Also called Miotics.

A

Cholinergic Agonists

68
Q

Examples of Cholinergic Agonists

A

Pilocarpine
Carbachol

69
Q

Clinical Pearls of Cholinergic Agents

A

4x daily for Glaucoma
Used in acute angle closure
Use with caution of history of retinal detachment or corneal abrasion

70
Q

Allergic Conjunctivitis Treatments

A
  • Antihistamine (Ketotifen)
  • Moisturize with Blink
  • NSAID (Ketorolac)
  • Mast Cell Stabilizer (Cromolyn)
  • Steroids (Dexamethasone or Prednisolone)
71
Q

Bacterial Conjunctivitis Treatments

A
  • Polytrim (Trimethoprim & Polymyxin B)
  • Fluoroquinolones (Ciprofloxacin)
  • Aminoglycosides (Gentamicin)
  • Macrolides (Azithromycin & Erythromycin)
72
Q

Drug class that is used shortly after birth for prevention of ophthalmic neonatorum due to gonococcal infection

A

Macrolides

73
Q

Otitis Externa Treatments

A

Ciprodex (Ciprofloxacin & Dexamethasone)
Neomycin

74
Q

Used to treat cerumen impaction. Release hydrogen peroxide and foaming action helps soften the wax.

A

Carbamide peroxide (OTC)

Pharmacology Unit 1 (5 decks)

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