ENT Flashcards
What are the treatments for allergic rhinitis?
oral and intranasal antihistamines, intranasal corticosteroids, mast cell stabilizers, and leukotriene receptor antagonists
this oral antihistamine generation penetrates the CNS, interacts with receptors other than just H1, and has anticholinergic properties
first generation
this generation of oral antihistamine has minimal distribution in CNS and is specific for H1 receptors
second generation
are these 1st or 2nd gen oral antihistamines:
hydroxyzine
promethazine
chlorpheniramine
diphenhydramine
doxylamine
meclizine
1st generation
are these 1st or 2nd generation oral antihistamines:
desloratadine
cetirizine
fexofenadine
loratadine
levocetirizine
2nd generation
oral antihistamines used for allergic rhinitis
loratadine, desloratadine, fexofenadine
oral antihistamine that helps with pregnancy induced n/v
doxylamine in combo with vitamin B6
oral anithistamines for motion sickness prevention
diphenhydramine, hydroxyzine, meclizine
oral antihistamines for insomnia
diphenhydramine and doxylamine
oral antihistamine with antiparkinsonism effect
diphenhydramine
ADRs of oral antihistamines include..
sedation and anticholinergic effects
intranasal antihistamines for allergic rhinitis include…
Azelastine nasal (Astelin)
Olopatadine nasal (Patanase)
these are examples of __________ __________ used for allergic rhinitis
Beclomethasone nasal (Beconase AQ)
Budesonide nasal (Rhinocort Aqua)
Fluticasone propionate nasal (Flonase)
Mometasone nasal (Nasonex)
Triamcinolone nasal (Nasacort AQ)
intranasal corticosteroids
What is the main MOA of intranasal corticosteroids?
reduces proinflammatory mediators (PGs, LTRs, cytokines)
vasoconstriction of nasal passages
decreases sneezing, itching, rhinorrhea, nasal congestion
name a mast cell stabilizer used for allergic rhinitis
cromolyn inhaled (Intal)
mast cell stabilizer MOA
stabilizes mast cell and eosinophil plasma membranes, which prevents release of histamine
leukotriene receptor antagonist used for allergic rhinitis
motelukast (singulair)
what are the treatments for acute bacterial sinusitis?
NSAIDs, steam therapy, saline washes, intranasal corticosteroid
if abx are implicated for acute bacterial sinusitis, what is the first line tx?
augmentin
what are tx options for cough and cold?
oral and topical nasal decongestants, antitussives, expectorant
name the oral decongestants used for cough and cold
psedoephedrine, pseudoephedrine/ loratadine, phenylephrine
MOA of oral decongestants
stimulates adrenergic receptors and induces release of NE
ADRs of oral decongestants
increased BP, urinary retention, insomnia, HA, tachycardia, palpitations, anxiety, tremor, nausea
who should avoid oral decongestants
BPH and HTN
what two topical nasal decongestants are used for cough and cold
phenylephrine and oxymetazoline
MOA of topical nasal decongestants
alpha agonists
ADRs of topical nasal decongestants
same as oral, also rebound congestion
what are the three antitussives used for cough and cold?
dextromethorphan, benzonatate, codeine
how does dextromethorphan work?
depresses medullary cough center
how does benzonatate work?
local anesthetic, reduces sensitivity of stretch receptors
how does codeine work?
CNS cough suppressant
what is the main expectorant used for cough and cold?
guaifenesin
what does guaifenesin do?
thins airway mucus
what are the main treatments for glaucoma?
PGs, non-selective beta blockers, carbonic anhydrase inhibitors, cholinergic agonists
what are the 3 PGs used for glaucoma?
travoprost, bimatoprost, latanoprost
PG MOA
increases aqueous outflow
ADRs of PGs
changes in iris pigmentation, eyelash growth, redness, tearing, eye pain
what are 4 non-selective beta blockers used for glaucoma?
timolol, betaxolol, levobunolol, carteolol
non-selective beta blocker MOA
reduces aqueous humor production
ADRs of non-selective beta blockers
burning, stinging, itching, changes in vision, photosensitivity
what are 2 carbonic anhydrase inhibitors used for glaucoma?
brinzolamide, dorzolamide
carbonic anhydrase inhibitor MOA
reduces aqueous humor production
ADR of carbonic anhydrase inhibitors
bitter taste
what are 2 cholinergic agonists used for glaucoma?
pilocarpine and carbachol
cholinergic agonist MOA
increases aqueous outflow
what are 7 common treatments for allergic conjunctivitis
antihistamines
antihistamines/ nasal decongestant
antihistamine/ mast cell stabilizer
mast cell stabilizers
steroids
NSAIDs
moisturize with blink
what are the antihistamines used for allergic conjunctivitis?
ketotifen, levocetirizine, emedastine
what is an antihistamine/ decongestant used for allergic conjunctivitis?
naphazoline/ pheniramine
what antihistamines/ mast cell stabilizers are used for allergic conjunctivitis?
azelastine, epinastine, olopatadine
what 2 mast cell stabilizers are used for allergic conjunctivitis?
nedocromil, cromolyn
what NSAID is commonly used for allergic conjunctivitis
ketorolac
what 2 steroids are commonly used for allergic conjunctivitis?
dexamthasone, prednisolone
what are 4 common treatments of bacterial conjunctivitis?
polytrim
fluroquinolones
aminoglycosides
macrolides
what 2 fluroquinolones are commonly used for bacterial conjunctivitis?
moxifloxacin
ciprofloxacin
what 2 aminoglycosides are commonly used for bacterial conjunctivitis?
gentamicin
tobramycin
what 2 macrolides are commonly used for bacterial conjunctivitis?
azithromycin, crythromycin
