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ENT Pharm > ENT Pharm > Flashcards

ENT Pharm Flashcards

1
Q

What nasal spray is an antihistamine?

A

Azelastine HCl (Asteliln)

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2
Q

What nasal spray is a corticosteroid?

A

Fluticasone Propionate (Flonase)

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3
Q

What nasal spray is a anticholinergic?

A

Ipratropium Br (Atrovent)

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4
Q

What nasal spray is a mast cell stabilizer?

A

Cromolyn Na (Nasalcrom)

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5
Q

How long should patients use Oxymetazoline

A

3-5 days. Professor White said more like 5.

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6
Q

What is the MoA for oxymetazoline?

A

Vasosconstriction (direct-acting alpha agonist)

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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

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8
Q

Contraindications for oxymetazoline?

A

Continuous use, glaucoma

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9
Q

What should we monitor with oxymetazoline?

A

Length of use

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10
Q

What class is oxymetazoline?

A

Topical Nasal Decongestant NS

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11
Q

What class is Azelastine?

A

Nasal Spray-antihistamine

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12
Q

When do you use azelastine?

A

allergic rhinits

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13
Q

What is the MoA for azelastine?

A

H1 receptor blocker

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14
Q

Side effects of azelastine?

A

Headache, bitter taste, rhinitis, cough, somnolence; Hypertension, tachycardia, anxiety, glaucoma

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15
Q

Contraindicated for azelastine?

A

Hypersensitivity, glaucoma

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16
Q

What kind of nasal spray is Oxymetazoline?

A

Decongestant

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17
Q

Dx-Dx interactions for azelastine?

A

Other anti-cholinergic or sedating drugs

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18
Q

What class is Fluticasone a part of?

A

Corticosteroid nasal spray

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19
Q

When do you use Fluticasone?

A

Rhinitis (allergic, occupational, atrophic, vasomotor)

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20
Q

What is the MoA of Fluticasone?

A

Anti-inflammatory with vasconstrictor activity

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21
Q

SE/ADR of fluticasone?

A

Burning, irritation, dryness, headache, epistaxis; nasal septal perforation, epistaxis

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22
Q

What should we monitor in patients who take fluticasone?

A

Epistaxis

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23
Q

What class is Ipratropium Br a part of?

A

Anticholinergic (antimuscarinic) nasal spray

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24
Q

When do we use Ipratropium?

A

Vasomotor rhinits

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25
Q

MoA for Ipratropium?

A

Blocks acetylcholine at muscarinic receptors in parasympathetic nervous system

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26
Q

SE/ADR for ipratropium?

A

Epistaxis, dryness, nausea; avoid with glaucoma

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27
Q

What is contraindicated for Ipratropium?

A

Hypersensitivity; caution in asthma, prostatic hypertrophy, angle-closure glaucoma

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28
Q

Dx-Dx, ipratropium?

A

other anticholinergics

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29
Q

What class is Cromolyn a part of?

A

Mast cell stabilizer nasal spray

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30
Q

When do you prescribe cromolyn?

A

Allergic rhinits

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31
Q

MoA for cromolyn?

A

Stabilizes mast cell membrane so mediators (histamine, leukotrienes, etc) not released

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32
Q

SE/ADR for cromolyn?

A

Local stinging, burning, unpleasant taste, sneezing, occasional epistaxis

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33
Q

H1 antihistamine receptors are?

A

smooth muscle, endothelium, brain

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34
Q

H2 antihistamine receptors are?

A

GI mucosa, cardiac muscle, mast cells, brian

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35
Q

H1 generation is sedating or no?

A

Sedating

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36
Q

H2 generation is sedating or no?

A

Not sedating

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37
Q

What kind of drug is diphenhydramine?

A

1st generation antihistamine

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38
Q

When do you use diphenhydramine?

A

Allergic rhinitis

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39
Q

MoA for diphenhydramine?

A

H1 blocker

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40
Q

SE/ADR for diphenhydramine?

A

drowsiness (frequently significant); anti-cholinergic side effects.

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41
Q

Contraindications for diphenhydramine?

A

Prostatic hypertrophy, dementia; caution in asthma, angle-closure glaucoma

42
Q

What often happens when children take diphenhydramine?

A

They get cray cray. That means crazy.

ok, ok..hyperactivity/excitatory impact

43
Q

Dx-Dx for diphenhydramine?

A

other sedating drugs, especially other anti-cholinergic

44
Q

Is diphenhydramine is effective as nasal corticosteroids?

A

Nope

45
Q

What class does Fexophenadine belong to?

A

2nd generation oral antihistamine

46
Q

When do use fexophenadine?

A

allergic rhinits

47
Q

How many things do we use to treat allergic rhinitis?

A

too many. moving on.

48
Q

MoA for fexophenadine?

A

H1 receptor blocker

49
Q

SE/ADR for fexophenadine?

A

Headache, somnolence, dizziness; increases any anticholinergic effect of other co-administered drugs

50
Q

Does fexophenadine cross the blood brain barrier?

A

Nope

51
Q

What class does Benzocaine Otic belong to?

A

Topical otic analgesic

52
Q

When do we use Benzocaine Otic?

A

Otalgia with intact tympanic membrane

53
Q

MoA for benzocaine otic?

A

Topical analgesic

54
Q

SE/ADR for benzocaine otic?

A

Vertigo

55
Q

How effective is this in children?

A

About 50 percent of the time. Lasts about 30-60 minutes

56
Q

What is the pH or eye drops?

A

7

57
Q

What is the pH of ear drops?

A
58
Q

What class does Neomycin, Colistin, Hydrocortisone, Thonzonium (Corticosporin-TC Otic Solution/Suspension) belong to?

A

Antibiotic-hydrocortisone Otic solution/suspension

FYI just calling this drug Corticosporin from now on.

59
Q

When do we use Corticosporin-TC?

A

Otitis externa with intact tympanic membrane

60
Q

SE/ADR of corticosporin?

A

Mucosal irritation and edema with over use; Neomycin sensitivity can develop during course of use

61
Q

What do we need to look out for with corticosporin?

A

Hypersensitivity–especially to neomycin

62
Q

What class does Nystatin belong to?

A

Polyene Antifungal Antibiotic, topical use only, candida species only

63
Q

When do we use Nystatin?

A

Thrush, oral candidiasis in immune intact host

64
Q

MoA of nystatin?

A

Binds to fungal membrane, creates pores in membrane disrupting membrane integrity

65
Q

SE/ADR of nystatin?

A

Unpleasant taste, NVD; Too toxic for systemic use (IV or IM)

66
Q

Is the oral form absorbed systemically?

A

No. Swish/swirl/swallow 4 times a day

67
Q

What class does Meclizine belong to?

A

Antiemetic, antihistamine

68
Q

When do use Meclizine?

A

Prevent/treat vertigo, motion sickness

69
Q

MoA of Meclizine?

A

Anticholinergic impact on chemoreceptor trigger zone; blocks conduction in middle ear vestibular-cerebellar pathway

70
Q

Contraindications for meclizine?

A

Hypersensitivity; caution in asthma, prostatic hypertrophy, angle-closure glaucoma, dementia

71
Q

SE/ADR of meclizine?

A

Sedation, thickening bronchial secretions

72
Q

Dx-dx of meclizine?

A

Avoid ethanol, other anticholinergic medications

73
Q

What class does acyclovir belong to?

A

Nucleoside Anti-herpes virus

74
Q

When do you use acyclovir?

A

HSV-1, HSV-2, VZV, EBV, CMV (not as much(, HHV-6

75
Q

MoA for acyclovir?

A

Block herpes virus nucleic acid synthesis

76
Q

SE/ADR for acyclovir?

A

Nausea, diarrhea, headache; nephritis, tremors, delirium, seizures with overdose

77
Q

What else should we know about acyclovir?

A

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
Q

What class does Betaxolol belong to?

A

Ophthalmic beta1 blocker anti-glaucoma drug

79
Q

When do you use Betaxolol?

A

Chronic open-angle glaucoma; ocular hypertension

80
Q

MoA of Betaxolol?

A

Reduces IOP by decreasing production of aqueous humor

81
Q

SE/ADRs of Betaxolol?

A

Ocular discomfort, bradycardia, bronchospasm, depression, heart block, exacerbation heart failure

82
Q

Contraindications for betaxolol?

A

Sinus bradycardia, heart block >1st degree

83
Q

What should you monitor when patients are on betaxolol?

A

IOP

FYI, that’s for every glaucoma drug so i’m only asking it once. Monitor IOP. Got it!?!?

84
Q

What class of drug is Bimatoprost?

A

Ophthalmic prostaglandin anti-glaucoma drug

85
Q

How does Bimatoprost work?

A

Synthetic analog of prostaglandin which deceases IOP by increasing outflow of aqueous humor

86
Q

I want to make this clear… what does a prostaglandin do?

A

increases outflow of aqueous humor.

87
Q

When do we use Bimatoprost?

A

Chronic open-angle glaucoma or ocular hypertension; hypotrichosis of eyelashes

88
Q

SE/ADRs of Bimatoprost?

A

Ocular hyperemia, growth of eyelashes, ocular pruritus, headache, dry eyes, photophobia, brown pigmentation of iris and eyelid skin

89
Q

Who shouldn’t you prescribe this drug to?

A

People

90
Q

What class does Brimonidine belong to?

A

Ophthalmic Alpha2 Agonist anti-glaucoma drug

91
Q

When do you prescribe Brimonidine?

A

Chronic open-angle glaucoma, ocular hypertension

92
Q

MoA for Brimonidine?

A

Selective agonism for alpha2-receptors causes reduced production of aqueous humor and increased outflow

AKA, this guy does both

93
Q

SE/ADRs of Brimonidine?

A

Somnolence, allergic conjunctivitis, hyperemia, eye pruritus, HTN, xerostomia, CNS depression

94
Q

Who don’t we prescribe Brimonidine too?

A

Children

95
Q

What class of drug does Dorzolomide belong to?

A

Ophthalmic Carbonic Anhydrous Inhibitor anti-glaucoma drug

96
Q

When do you use Dorzolomide?

A

Chronic open-angle glaucoma or ocular hypertension

97
Q

MoA for Dorzolomide?

A

Reversible inhibition of renal carbonic anhydrase causing increased renal excretion sodium, potassium, bicarbonate and water with decrease production of aqueous humor

98
Q

SE/ADRs of Dorzolomide?

A

Eye discomfort, superficial punctate keratitis, ocular allergic reaction, blurred vision, photophobia, possible SJS

99
Q

What happens when you co-administer verapamil and fexophenadine?

A

Increases the serum levels of fexophenadine

100
Q

Who is going to rock this exam?

A

YOU ARE!

plus i was at 99 cards… needed one more.

but seriously. KILL IT!

ENT Pharm (1 decks)

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