EENT Pharm Flashcards
Inflammation and / or infection of the middle ear; most common in infant and children
Otitis media
Are most Otitis Media cases bacterial or viral infections?
40-75% acute cases are viral
What is the most common bacterial cause of Otitis media?
Streptococcus pneumoniae (20% - 50% of bacterial cases are caused by this)
Bacterial Otitis media commonly follows what kind of infection?
Viral Upper Respiratory Tract Infection
How can you visually determine whether an Otitis Media infection is bacterial or viral?
if pt is coughing with clear drainage = viral
What is the drug of choice for an acute bacterial Otitis Media infection?
Amoxicillin - ALONE
If a patient is diagnosed with bacterial acute Otitis Media and has had amoxicillin within the last 30 days or has a serious infection what do you prescribe?
amoxicillin + clavulanate
A patient diagnosed with bacterial Acute Otitis Media, failed to respond to amoxicillin + clavulanate , what do you prescribe them now?
a second or third generation cephalosporin
ceftriaxone, cefdinir, cefuroxime, cefpodoxime, etc.
A patient is diagnosed with bacterial Acute Otitis Media and has a penicillin allergy, what do you prescribe her?
a macrolide such as azithromycin or clarithromycin *z-pack - in class he said that these are pretty much almost not useful at this point because of increased resistance
A patient presents with an acute bacterial Otits Media infection, with trouble breathing, swelling of the tongue, hives and anaphylactic. What do you want to avoid in this patient?
cephalosporins because there is a 10% chance of cross reaction
inflammation of the nasal mucosa caused by IgE sensitization
Allergic rhinitis
allergic rhinitis with acute symptoms
seasonal (hay fever) allergic rhinitis
allergic rhinitis that is intermittent or persistent usually with more chronic, subtle symptoms
Perennial allergic rhinitis
What are the symptoms of allergic rhinitis?
- clear rhinorrhea
- sneezing
- nasal congestion
- post nasal drip
- allergic
- conjunctivitis
- itchy eyes
Which treatment for allergic rhinitis is more effective when taken prior to exposure but can blunt response after exposure?
Antihistimines
What is the difference in first and second generation antihistamines?
**H1 selective oral
first generation more lipophilic crosses the BBB and cause drowsiness
second generation doesnt
intranasal formulation - antihistamine used of allergic rhinitis
Azelastine
symptomatic treatment of allergic rhinitis?
Decongestants
What decongestants are of choice for systematically treating allergic rhinitis?
pseudo ephedrine or phenylephedrine
*pseudoephedrine in MS you HAVE to have a RX in order to get! NOT OTC like phenylephedrine
What is a decongestant given intranasally prescribed for allergic rhinitis?
Oxymetazoline
Patient education is important when prescribing Oxymetazoline intranasally?
Oxymetazoline is highly additive, patient should use the drug 3-5 days and then stay off of it.
What would you prescribe a patient with acute Otitis Media with associated inflammation?
*you wan to reduce the inflammation :)
intranasal corticosteroids
Beclomethasone, budesonide, flunisolide, fluticosone, triamcinolone are ________.
intranasal corticosteroids
T/F Intranasal Corticosteroids will blunt response after exposure immediately.
FALSE!!!
usually will respond in 2-3 days but CAN take up to 2-3 weeks. So if you know every May your nose starts running.. get your prescription early!! :)
Prophylactic treatment of Allergic rhinitis; mast cell stabilizer; less side effects than anithistimines
Cromolyn Sodium
T/F Cromolyn Sodium is most effective if taken a month in advance.
true
**take before the season :)
What two drugs are best for patients with allergic rhinitis and asthma?
Ipratropium & Leukotriene receptor antagonists
*NOT IMMEDIATE RESPONSES!!!
Which treatment for allergic rhinitis is no more effective than second generation antihistamines and less effective than intranasal corticosteroids?
Leukotriene receptor antagonists
***Montelukast
ocular disorder that leads to optic neuropathy, increased intraocular pressure, loss of visual sensitivity and field
glaucoma
type of glaucoma that is slowly progressive and asymptomatic, central vision acuity is maintained
open angle
intermittent prodromal symptoms, can have acute episodes, usually due to physical blockade of the trabecular meshwork
closed angle
goal of therapy for glaucoma -
decrease IOP to levels where no further damage occurs
dominant tone of the eye
para
iris radial is contracted by
alpha 1
iris circular is contracted by
m3
ciliary muscle is contracted by
m3
what type to applicaton is used first in treatment of ocular HTN and open angle glaucoma
topical
timolol, betaxolol and carteolol are in what class
beta blockers
latanoprost, bimatoprost and travoprost are in what class
prostaglandin analogs
carbachol and pilocarpine are in what class
cholinergic agonists
dipivefrin are in what class
nonspecific adrenegic agonists
apraclondine and brimonidine are in what class
alpha 2 agonist
what classes limit production of aqueous humor
Alpha 2 agonists
beta blockers
CA inhibitors
ABC
what classes promote drainage or increase absorption
Prostaglandin analogs
Cholinegic agonist
NS Adrenegic Agonist
how much of the aqueous humor drains in the trabecular meshwork
85%
treatment of closed angle
immediate IOP reduction
hole in iris to facilitate posterior to anterior flow
iridectomy
what drug therapy is used for an acute attack
mannitol and secretory inhibitor
osmotic agent
inflammation and/or infection of the membrane lining of the eyelids
conjunctivitis
what type of viral usually causes conjunctiviits
adeno
clear watery drainage is characteristic of
viral conjunctivitis
thick, yellow or greenish discharge is characteristic of
bacteria conjuctivits
gram + that cause conjunctivits
staph and strep
gram - that cause conjunctivitis
pseudo and haemoph…
treatment for viral conjunctivitis
NONE
treatment for bacteria conjunctivitis
aminoglyosides, fluoroquinolones or erythomycin
treatment for allergic conjunctivitis
systemic and/or opthalmic H1 antagonists and opthalmic corticosteriods
