ENT Flashcards
management of allergic rhinitis?
nasal antihistamine is first line
others:
oral antihistamine for sneezing
intranasal corticosteroid for nasal blockage
sodium cromogliate can be used as an add on
example of an intranasal antihistamines?
azelastine
what do intranasal antihistamines (azelastine) interact with?
MAOi
contraindications to cetirizine?
acute porphyrias
be careful in epilepsy
SE and risks of cetirizine?
antimuscarinic - blurred vision/dry moth/urinary retention
GI disturbance
headache
angle closure glaucoma
arrhythmias
blood disorders
convulsions
EPS
liver dysfunction
hypersensitivity reactions
2 examples of oral antihistamines used for allergic rhinitis?
cetirizine
loratidine
when is fluticasone contraindicated/
after nasal surgery
in TB
in untreated nasal infections
what can fluticasone interact with?
live vaccines
NSAIDs
clarithromycin
examples of nasal corticosteroids used in allergic rhinitis?
beclometasone
fluticasone
SE of fluticasone?
raised IOP
headache
nasal septal perf
nasal irritation
throat irritation/taste distruabnce
hypersensitivity reactions
psychological effects in children
MOA of sodium cromoglicate?
mast cell stabiliser
SE of sodium cromoglicate?
transient bronchospasm
local irritation
what can be used in Menieres disease to help alleviate nausea and vertigo?
prochlorperazine or an antihistamine like cinnarizine
what can be given to help prevent recurrent attacks of Menieres disease?
betahistine
moa of prochlorperazine?
dopamine receptor antagonist - acts centrally on CTZ
contraindcatins to prochlorperazine?
phaeochromocytoma
cautions in elderly, Parkinsons, CVD, diabetes
pregnancy and breastfeeding
SE of prochlorperazine?
EPS - Parkinsonisms, akathisia, tadive dyskinesia, dystonia
hyperprolactinaemia and hyperglycaemia
arrhythmias
VTE
leucopenia/agranulocytosis
blurry vision, dry mouth, drowsy, urinary retention
what does prochlorperazine interact with?
alcohol
anti-muscarinics
levodopa
antihypertensives
CNS depressants
MAOi
lithium
moa of betahistine?
histamine analogue - H1 agonist
thought to improve microcirculation and reduce endoplymphatic pressure
CI for betahistine?
phaeochromocytoma
caution with asthma and PUD
SE of betahistine?
GI distruabnce
headaches
pruritus
rash
what does betahistine interact with?
antihistamines
what 4 drug groups can cause tinnitus?
Aspirin/NSAIDs
Aminoglycosides
Loop diuretics
quinine
what 3 drugs can cause gingival hyperplasia?
phenytoin
ciclosporin
CCB
