ENT Pharm Flashcards
1
Q
What nasal spray is an antihistamine?
A
Azelastine HCl (Asteliln)
2
Q
What nasal spray is a corticosteroid?
A
Fluticasone Propionate (Flonase)
3
Q
What nasal spray is a anticholinergic?
A
Ipratropium Br (Atrovent)
4
Q
What nasal spray is a mast cell stabilizer?
A
Cromolyn Na (Nasalcrom)
5
Q
How long should patients use Oxymetazoline
A
3-5 days. Professor White said more like 5.
6
Q
What is the MoA for oxymetazoline?
A
Vasosconstriction (direct-acting alpha agonist)
7
Q
What are some SE/ADRs of oxymetazoline?
A
Rebound mucosal congestion & vascular irritation, stinging, burning, dryness, sneezing; hypertension in large dose; epistaxis, tachyphylaxis
8
Q
Contraindications for oxymetazoline?
A
Continuous use, glaucoma
9
Q
What should we monitor with oxymetazoline?
A
Length of use
10
Q
What class is oxymetazoline?
A
Topical Nasal Decongestant NS
11
Q
What class is Azelastine?
A
Nasal Spray-antihistamine
12
Q
When do you use azelastine?
A
allergic rhinits
13
Q
What is the MoA for azelastine?
A
H1 receptor blocker
14
Q
Side effects of azelastine?
A
Headache, bitter taste, rhinitis, cough, somnolence; Hypertension, tachycardia, anxiety, glaucoma
15
Q
Contraindicated for azelastine?
A
Hypersensitivity, glaucoma
16
Q
What kind of nasal spray is Oxymetazoline?
A
Decongestant
17
Q
Dx-Dx interactions for azelastine?
A
Other anti-cholinergic or sedating drugs
18
Q
What class is Fluticasone a part of?
A
Corticosteroid nasal spray
19
Q
When do you use Fluticasone?
A
Rhinitis (allergic, occupational, atrophic, vasomotor)
20
Q
What is the MoA of Fluticasone?
A
Anti-inflammatory with vasconstrictor activity
21
Q
SE/ADR of fluticasone?
A
Burning, irritation, dryness, headache, epistaxis; nasal septal perforation, epistaxis
22
Q
What should we monitor in patients who take fluticasone?
A
Epistaxis
23
Q
What class is Ipratropium Br a part of?
A
Anticholinergic (antimuscarinic) nasal spray
24
Q
When do we use Ipratropium?
A
Vasomotor rhinits
25
MoA for Ipratropium?
Blocks acetylcholine at muscarinic receptors in parasympathetic nervous system
26
SE/ADR for ipratropium?
Epistaxis, dryness, nausea; avoid with glaucoma
27
What is contraindicated for Ipratropium?
Hypersensitivity; caution in asthma, prostatic hypertrophy, angle-closure glaucoma
28
Dx-Dx, ipratropium?
other anticholinergics
29
What class is Cromolyn a part of?
Mast cell stabilizer nasal spray
30
When do you prescribe cromolyn?
Allergic rhinits
31
MoA for cromolyn?
Stabilizes mast cell membrane so mediators (histamine, leukotrienes, etc) not released
32
SE/ADR for cromolyn?
Local stinging, burning, unpleasant taste, sneezing, occasional epistaxis
33
H1 antihistamine receptors are?
smooth muscle, endothelium, brain
34
H2 antihistamine receptors are?
GI mucosa, cardiac muscle, mast cells, brian
35
H1 generation is sedating or no?
Sedating
36
H2 generation is sedating or no?
Not sedating
37
What kind of drug is diphenhydramine?
1st generation antihistamine
38
When do you use diphenhydramine?
Allergic rhinitis
39
MoA for diphenhydramine?
H1 blocker
40
SE/ADR for diphenhydramine?
drowsiness (frequently significant); anti-cholinergic side effects.
41
Contraindications for diphenhydramine?
Prostatic hypertrophy, dementia; caution in asthma, angle-closure glaucoma
42
What often happens when children take diphenhydramine?
They get cray cray. That means crazy.
ok, ok..hyperactivity/excitatory impact
43
Dx-Dx for diphenhydramine?
other sedating drugs, especially other anti-cholinergic
44
Is diphenhydramine is effective as nasal corticosteroids?
Nope
45
What class does Fexophenadine belong to?
2nd generation oral antihistamine
46
When do use fexophenadine?
allergic rhinits
47
How many things do we use to treat allergic rhinitis?
too many. moving on.
48
MoA for fexophenadine?
H1 receptor blocker
49
SE/ADR for fexophenadine?
Headache, somnolence, dizziness; increases any anticholinergic effect of other co-administered drugs
50
Does fexophenadine cross the blood brain barrier?
Nope
51
What class does Benzocaine Otic belong to?
Topical otic analgesic
52
When do we use Benzocaine Otic?
Otalgia with intact tympanic membrane
53
MoA for benzocaine otic?
Topical analgesic
54
SE/ADR for benzocaine otic?
Vertigo
55
How effective is this in children?
About 50 percent of the time. Lasts about 30-60 minutes
56
What is the pH or eye drops?
7
57
What is the pH of ear drops?
58
What class does Neomycin, Colistin, Hydrocortisone, Thonzonium (Corticosporin-TC Otic Solution/Suspension) belong to?
Antibiotic-hydrocortisone Otic solution/suspension
FYI just calling this drug Corticosporin from now on.
59
When do we use Corticosporin-TC?
Otitis externa with intact tympanic membrane
60
SE/ADR of corticosporin?
Mucosal irritation and edema with over use; Neomycin sensitivity can develop during course of use
61
What do we need to look out for with corticosporin?
Hypersensitivity--especially to neomycin
62
What class does Nystatin belong to?
Polyene Antifungal Antibiotic, topical use only, candida species only
63
When do we use Nystatin?
Thrush, oral candidiasis in immune intact host
64
MoA of nystatin?
Binds to fungal membrane, creates pores in membrane disrupting membrane integrity
65
SE/ADR of nystatin?
Unpleasant taste, NVD; Too toxic for systemic use (IV or IM)
66
Is the oral form absorbed systemically?
No. Swish/swirl/swallow 4 times a day
67
What class does Meclizine belong to?
Antiemetic, antihistamine
68
When do use Meclizine?
Prevent/treat vertigo, motion sickness
69
MoA of Meclizine?
Anticholinergic impact on chemoreceptor trigger zone; blocks conduction in middle ear vestibular-cerebellar pathway
70
Contraindications for meclizine?
Hypersensitivity; caution in asthma, prostatic hypertrophy, angle-closure glaucoma, dementia
71
SE/ADR of meclizine?
Sedation, thickening bronchial secretions
72
Dx-dx of meclizine?
Avoid ethanol, other anticholinergic medications
73
What class does acyclovir belong to?
Nucleoside Anti-herpes virus
74
When do you use acyclovir?
HSV-1, HSV-2, VZV, EBV, CMV (not as much(, HHV-6
75
MoA for acyclovir?
Block herpes virus nucleic acid synthesis
76
SE/ADR for acyclovir?
Nausea, diarrhea, headache; nephritis, tremors, delirium, seizures with overdose
77
What else should we know about acyclovir?
White wrote A LOT so....
PO, IV, topical formulations; requires viral kinase for activation so accumulates only in virus infected cells. Eliminated via glomerular filtration and tubular secretion; variability in viral sensitivity so varying dosing levels by virus; resistance may develop.
If any of you are still reading this, i love you.
78
What class does Betaxolol belong to?
Ophthalmic beta1 blocker anti-glaucoma drug
79
When do you use Betaxolol?
Chronic open-angle glaucoma; ocular hypertension
80
MoA of Betaxolol?
Reduces IOP by decreasing production of aqueous humor
81
SE/ADRs of Betaxolol?
Ocular discomfort, bradycardia, bronchospasm, depression, heart block, exacerbation heart failure
82
Contraindications for betaxolol?
Sinus bradycardia, heart block >1st degree
83
What should you monitor when patients are on betaxolol?
IOP
FYI, that's for every glaucoma drug so i'm only asking it once. Monitor IOP. Got it!?!?
84
What class of drug is Bimatoprost?
Ophthalmic prostaglandin anti-glaucoma drug
85
How does Bimatoprost work?
Synthetic analog of prostaglandin which deceases IOP by increasing outflow of aqueous humor
86
I want to make this clear... what does a prostaglandin do?
increases outflow of aqueous humor.
87
When do we use Bimatoprost?
Chronic open-angle glaucoma or ocular hypertension; hypotrichosis of eyelashes
88
SE/ADRs of Bimatoprost?
Ocular hyperemia, growth of eyelashes, ocular pruritus, headache, dry eyes, photophobia, brown pigmentation of iris and eyelid skin
89
Who shouldn't you prescribe this drug to?
People
90
What class does Brimonidine belong to?
Ophthalmic Alpha2 Agonist anti-glaucoma drug
91
When do you prescribe Brimonidine?
Chronic open-angle glaucoma, ocular hypertension
92
MoA for Brimonidine?
Selective agonism for alpha2-receptors causes reduced production of aqueous humor and increased outflow
AKA, this guy does both
93
SE/ADRs of Brimonidine?
Somnolence, allergic conjunctivitis, hyperemia, eye pruritus, HTN, xerostomia, CNS depression
94
Who don't we prescribe Brimonidine too?
Children
95
What class of drug does Dorzolomide belong to?
Ophthalmic Carbonic Anhydrous Inhibitor anti-glaucoma drug
96
When do you use Dorzolomide?
Chronic open-angle glaucoma or ocular hypertension
97
MoA for Dorzolomide?
Reversible inhibition of renal carbonic anhydrase causing increased renal excretion sodium, potassium, bicarbonate and water with decrease production of aqueous humor
98
SE/ADRs of Dorzolomide?
Eye discomfort, superficial punctate keratitis, ocular allergic reaction, blurred vision, photophobia, possible SJS
99
What happens when you co-administer verapamil and fexophenadine?
Increases the serum levels of fexophenadine
100
Who is going to rock this exam?
YOU ARE!
plus i was at 99 cards... needed one more.
but seriously. KILL IT!
