ENT cont'd Flashcards
Two classes of Sympathomimetic Decongestants
Pseudoephedrine
Phenylephrine
both Alpha Agonists
Three Ocular Decongestants (classes?)
Oxymetazoline (Afrin) - Direct acting, non selective, alpha agonist
Naphazoline
Xylometazoline
O and N are both Alpha Agonists
Areas that are inhibited by Sympathomimetics
Gut, bronchial tree, skeletal muscles
Mechanisms of sympathomimetics which results in decongestion
Vasoconstriction:
- reduced capillary hydrostatic pressure / blood flow / volume
- decreases edema, reduces “leakage”
Cardiac effects of sympathomimetics
Increased heart rate (positive chronotropic) and contractility (positive inotropic)
Metabolic effects of sympathomimetics
“stress - like” effects
- increased glycogenloysis
- free fatty acid liberation from tissues
CNS effects of sympathomimetics
- Respiratory stimulation
- Wakefulness
- Anxiety
- Appetite reduction
Phenlyephrine found in which products?
- Sudafed PE
- Tylenol Cold “day time”
- Hemorrhoidal suppositories
3 ADR’s of Phenylephrine
- Increase BP and compensatory decrease HR (dose-dependent)
- Arrhythmia, tachycardia
- Shaking
Phenylephrine drugs are contraindicated for which patients?
- HTN
- heart disease
- hyperthyroid
- BPH (benign prostate hyperplasia)
Pseudoephedrine
** Mixed-acting agonist **
same effects as Phenylephrine
Onset of action 15-30 mins, peak effect <60 mins
“behind” the counter, can be reduced to methamphetamine
3 Intranasal Steroids
1ST LINE, MOST EFFECTIVE TREATMENT
FOR ALLERGIC RHINITIS
1. Fluticasone (Flonase) for 12 yrs and up only
2. Mometasone (Nasonex)
3. Triamcinolone (Nasocort) for 12 years and up only
Intranasal Steroids for Peds 2+
- Fluticasone furoate (veramyst)
2. Mometasone
3 ADRs of Intranasal Steroids
- Epistaxis
- Candida infection
- Nasal septal perforation
Mast Cell Stabilizer
Cromolyn Sodium (Nasalcrom) - Allergic rhinitis (ocular, nasal, bronchial preps)
