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ENT Pharmacology Flashcards

1
Q

Viral Infection Therapy

A 
Symptomatic
Analgesics
Saline irrigation
Topical steroids
Topical decongestants
Oral Decongestants
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2
Q

Common Bacteria that Cause Sinusitis

A 
Strep pneumo
H. flu
Pseudomonas
Staph aureus
M. cat
Anaerobic bacteria
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3
Q

Antibiotics for Acute Sinusitis

A 
Amoxicillin
Augmentin
Doxycycline
Clarithromycin
Zithromax
Levofloxacin
Bactrim
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4
Q

Warnings for using Amoxicillin

A

Monitor blood, renal and hepatic function for long term use

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5
Q

Adverse Reactions for Amoxicillin

A 
GI upset
Hypersensitivity reactions (urticaria, rash, SJS, yeast infections)
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6
Q

Which antibiotic is first line for acute sinusitis?

A

Amoxicillin

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7
Q

What antibiotic is best for penicillin allergy in acute sinusitis?

A

Augmentin

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8
Q

Contraindications for Augmentin

A

Severe renal impairment

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9
Q

Adverse Reactions for Augmentin

A 
Diarrhea
Nausea
Abdominal pain
Rash
Urticaria
Vomiting
Vaginitis
Anaphylaxis
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10
Q

Augmentin Pregnancy Class

A

Class B

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11
Q

Warnings for Doxycycline

A 
Hepatotoxicity
Hypersensitivity
Photosensitivity
Tissue Hyperpigmentations
Peds: tooth enamel hypoplasia or permanemtn tooth discoloration
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12
Q

Can you use doxycycline during pregnancy and why?

A

No- reduced bone growth

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13
Q

Special Alerts for Azithromycin

A

Elderly
QT prolongation
Electrolyte disturbances

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14
Q

Adverse Reactions for Aithromycin

A 
Diarrhea
Abdominal pain
Anorexia
Cramping
Vomiting
Vaginitis
Acute renal failure
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15
Q

What is the drug of choice for acute sinusitis in penicillin allergic patients?

A

Azithromycin

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16
Q

How to treat uncomplicated acute sinusitis with mild symptoms?

A

Pseudoephedrine (Sudafed)
Oxymetazoline
NS nasal spray

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17
Q

Warnings for Psuedephedrine (Sudafed)

A

HTN
CVD
DM
Thyroid

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18
Q

Adverse Reactions for Psuedephedrine (Sudafed)

A

Nervousness
Dizziness
Insomnia

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19
Q

How long should antibiotics be prescribed for acute sinusitis?

A

5-7 days

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20
Q

Reasons for failure of treatment in acute sinusitis

A

Resistant pathogens
inadequate dosing
Structural abnormalities
Noninfectious etiology

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21
Q

When to refer sinusitis to ENT

A

Multiple episodes of acute bacterial rhinosinusitis (ABRS)
Chronic rhino sinusitis with exacerbations of ABRS
Allergic rhinitis who may be candidates for immunotherapy

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22
Q

Urgent referral to ENT

A

Severe infection

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23
Q

Symptomatic Treatment of OM

A

Ibuprofen/Motrin
Auralgan
Topical aqueous lidocaine

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24
Q

Antibiotics vs. Observation in OM

A
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25
Q

Base Antibiotics Treatment on:

A 
Clinical & microbiologic efficacy
Acceptability
SE & toxicity
Convenience of dosing schedule
Cost
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26
Q

Antibiotics for OM

A 
Amoxicillin
Augmentin
Azithromycin
Clarithromycin
Erythromycin/Sulfisoxazole
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27
Q

Alternative Antibiotic Options for OM

A

Cefdinir (Omnicef)

Cefuroxime (Ceftin)

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28
Q

Recommended Duration of Treatment

A
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29
Q

Prophylaxis can be given when

A

3 infections in 3 months
4 episodes in 6 months
6 episodes in 12 months

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30
Q

Pain Control in OM

A

Auralgan

Tylenol/Ibuprofen

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31
Q

Indications for Auralgan

A

Reduce pain and swelling

Remove or soften cerumen

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32
Q

OM Drug of Choice

A

Amoxicillin

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33
Q

Adverse Reactions of Amoxicillin

A 
GI upset
Hypersensitivity reactions
Hyperactivity
Blood dycrasias
Yeast infections
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34
Q

Medication for severe otalgia or elevated temperature

A

Augmentin

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35
Q

Adverse Reactions for Augmentin

A 
GI upset
Diarrhea
Nausea
Abdominal pain
Rash
urticaria
Vomiting
Vaginitis
Anaphylaxis
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36
Q

Drugs can use if penicillin allergy without urticaria or anaphylaxis in OM

A

Cefdinir
Cefpodoxime
Cefuroxime
Ceftriaxone

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37
Q

Drugs can use if severe penicillin allergy in OM

A

Erythromycin + sulfisoxazole
Azithromycin
Clarithromycin
Bactrim

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38
Q

Define Malignant Otitis Externa

A

Invasive infection of the canal and skull base

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39
Q

Patients at high risk for malignant otitis externa

A

Elderly patients with DM

HIV

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40
Q

Antibiotics for Malignant Otitis Externa

A

ANTIPSUEDEMONALS
Ciprofloxacin
Levofloxacin

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41
Q

Initiating Events in Otitis Externa

A 
Moisture trapped in ear canal
Occurs after swimming or bathing
Hot, humid weather
Trauma
Cleaning the ear with cotton swab, paper clip, bobby pin, etc.
42
Q

Causative Agents of Otitis Externa

A 
Pseudomonas
Staph
Enterobacter aerogenes
Proteus mirabilis
Fungi
43
Q

Sings & Symptoms of Otitis Externa

A

Ear pain with movement of pinna

Erythematous auditory canal

44
Q

First step in treatment of Otitis Externa

A

Remove cerumen, desquamated skin, and purulent material

45
Q

Why do we clean the ear canal to treat otitis externa?

A

Facilitates healing

Enhances penetration of drops

46
Q

Description of Otics

A

Antibiotic or a mixture of antibiotic and cortisone

47
Q

Considerations Before Use of Cortisporin-Otic Suspension

A 
Allergies
Other ear infection
Perforated TM
Pregnancy (Cat C)
Breastfeeding
48
Q

Adverse Reactions of Cortisporin-Otic Suspension

A

Local reactions
Extended use can lead to resistant infections & thinning or atrophy of skin
Use with caution in perforated TMs

49
Q

Considerations Before Use of Cipro HC Otic Suspension, Ciloxan

A 
Allergies
Other ear infection
Perforated TM
Pregnancy (Cat C)
Breastfeeding
50
Q

Adverse Reactions for Ciprodex Otic Suspension

A

Ear discomfort/pain
Pruritis
Dysgeusia
Erythema

51
Q

What population can you not use ciprodex otic suspension?

52
Q

What population is Ofloxin 0.3% solution not recommended?

53
Q

Considerations Before Use of Ofloxin 0.3% Solution

A

Allergies
Other ear infection
Pregnancy (Cat C)
Breastfeeding

54
Q

Which medication is safe in the case of a perforated TM?

A

Ofloxin 0.3% solution

55
Q

Adverse Reactions of Ofloxin 0.3% Solution

A 
Pruritis
Local reactions
Taste changes if TM perforated
Dizziness
Ear pain
56
Q

Contraindications to Tobradex

A

Documented hypersensitivity

57
Q

Which ophthalmic medication is used off label as an otic preparation?

A

Tobradex (Tobramycin & dexamethasone)

58
Q

Pregnancy Category for Tobradex

A

Category B

59
Q

Precautions with Torbradex

A

Perforated TM- ototoxicity

60
Q

How does Acetic acid in aluminum acetate (Domeboro) work?

A

Acidifies ear canal
Exerts astringent
Bactericidal
Fungicidal

61
Q

What is a good alternative to an antibiotic solution for ear drops?

A

Acetic acid in aluminum acetate (Domeboro)

62
Q

When is Domeboro not recommended or contraindicated?

A 
TM perforation (C)
Children
63
Q

Adverse Reactions for Domeboro

A

Burning
Stinging
Irritation

64
Q

What does 5% Aluminum Acetate (Burow’s Solution) treat?

A

Bacterial external otitis

Fungal external otitis

65
Q

Alcohol Vinegar Otic Mix

A

Pregnancy Cat. A
Prevention of OE
Flushing solution for fungal infections
Avoid with perforated TM

66
Q

Indications for Auralgan

A

Analgesic-anesthetic

Cerumen removal adjunct

67
Q

Otic dosage for ear pain caused by infection

A

Enough medicine to fill ear canal every 1-2 hours until pain is relieved

68
Q

Otic dosage for softening earwax before removal

A

Enough medicine to fill ear canal 3 times a day for 2 or 3 days

69
Q

SE of Auralgan

A

Itching
Burning
Redness

70
Q

Indications for Debrox

A

Cerumen removal

71
Q

Contraindications for Debrox

A

Perforated TM
Ear drainage or discharge
Ear pain or irritation
Dizziness

72
Q

Prevention of Otitis Externa

A

Wearing ear plugs when swimming or showering
Drying ear with hair dryer
Avoid removing ear wax mechanically

73
Q

Why would one use an ear wick?

A

Helps topical mediation penetrate a severely swollen ear canal

74
Q

Treatment for Mild Otitis Externa

A

Acetic acid/Hydrocortisone

75
Q

Treatment for Moderate and Severe Otitis Externa

A

Cipro HC

Cortisporin

76
Q

What are Vertigo Syndromes?

A

Subtype of dizziness in which a patient inappropriately experiences the perceptions of motion due to dysfunction of the vestibular system

77
Q

Treatment of Vertigo Syndromes

A

Symptomatic treatment until cause is determined

78
Q

Treatment of Labrynthitis

A

Prochlorperazine (Compazine)
Meclizine (Antivert)
Diazepam

79
Q

Indications for Prochlorperazine (Compazine)

A

Severe N/V

80
Q

Adverse Reactions for Prochlorperazine (Compazine)

A 
Drowsiness
Dizziness
Blurred vision
Anticholinergic effects
Lowered seizure threshold
81
Q

Indications for Meclizine (Antivert)

A

N/V

Vertigo of vestibular origin

82
Q

Adverse Reactions of Meclizine (Antivert)

A

Drowsiness
Sedation
Dry mouth
Blurred vision

83
Q

Indication for Diazepam

A

Suppress the vestibular system

84
Q

Adverse Reactions for Diazepam

A

CNS depression
Ataxia
Memory impairment

85
Q

Medications for Meniere’s Disease

A 
Diuretics
Antiemetics
Anxiolytis
Antihistamines
Scopolamine
86
Q

Types of Diuretics for Meniere’s Disease

A

Hydrochlorothiazide (HCTZ)
Hydrochlorothiazide and triamterene (Maxzide)
Acetazolamide (Diamox)

87
Q

Contraindications for Hydrochlorothiazide (HCTZ)

A

Sulfonamide allergy

88
Q

Warnings for HCTZ

A

Renal or hepatic impairment
DM
Gout

89
Q

Adverse Reactions for HCTZ

A

Hypokalemia

Hyperglycemia

90
Q

Contraindications for HCTZ and triamterene (Maxzide)

A

Sulfonamide allergy

91
Q

Antiemetics for Meniere’s Disease

A

Prochlorperazine (Compazine)

Meclizine (Antivert)

92
Q

Indications for Meclizine (Antivert)

93
Q

Adverse Reactions for Meclizine (Antivert)

A

Drowsiness
Sedation
Dry mouth
Blurred vision

94
Q

Types of Anxiolytics for Meniere’s Disease

A

Valium/Diazepam

Atarax (Hydroxyzine)

95
Q

Adverse Reactions of Atarax (Hydroxyzine)

A

Drowsiness

Dry mouth

96
Q

Medications for Allergic Rhinitis

A

Intranasal glucocorticoids (topical)

97
Q

Mechanism of Action of Topical Intranasal Glucocorticoids

A

Inhibit allergic inflammation

98
Q

First Generation of Topical Intranasal Glucocorticoids

A

Beclomethason (Beconase AQ)
Flunisolide (Nasalide)
Budesonide (Rhinocort Aqua)

99
Q

Second Generation of Topical Intranasal Glucocorticoids

A

Fluticasone (Fonase)

Mometasone (Nasonex)

100
Q

Adverse Reactions for Topical Intranasal Glucocorticoids

A

Headache
Pharyngitis
Epistaxis

101
Q

Warnings of Topical Intranasal Glucocorticoids

A

Adrenal suppression
Delayed wound healing
Immunosuppression
Risk vs. benefit

ENT (10 decks)

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