Exam I Medications

Question 1

What should be prescribed for serious cases of Otitis Externa?

Answer 1

fluoroquinolones: ciprofloxacin or ofloxacin

Question 2

What are the most commonly prescribed medications for Otitis Externa?

Answer 2

ciprofloxacin/hydrocortisone

ciprofloxacin/dexamethasone

Question 3

Ciprofloxacin

Answer 3

Anti-Infective without Steroids

Treats: Otitis Externa

Route: Topical

Other: Fluoroquinolone; use in serious cases

Question 4

Ofloxacin

Answer 4

Anti-Infective without Steroids

Treats: Otitis Externa

Route: Topical

Other: Fluoroquinolone; use in serious cases

Question 5

Neomycin

Answer 5

Anti-Infective without Steroids

Treats: Otitis Externa

Route: Topical

Other: risk for oxotoxicity, causes contact dermatitis (itchy rash), never use with perforated eardrums or tubes in your ears

Question 6

Bacitracin

Answer 6

Anti-Infective without Steroids

Treats: Otitis Externa

Route: Topical

Question 7

Mupirocin

Answer 7

Anti-Infective without Steroids

Treats: Otitis Externa

Route: Topical

Question 8

polymyxin B/neomycin/bacitracin

Answer 8

Anti-Infective without Steroids

Treats: Otitis Externa

Route: Topical

Other: OTC; Neomycin - causes contact dermatitis (itchy rash), never use with perforated eardrums or tubes in your ears

Question 9

Ciprofloxacin/Hydrocortisone

Answer 9

Anti-Infective with Steroids

Treats: Otitis Externa

Route: Topical

Other: most commonly used medication for Otitis Externa, fluoroquinolone - serious cases

Question 10

Ciprofloxacin/Dexamethason

Answer 10

Anti-Infective with Steroids

Treats: Otitis Externa

Route: Topical

Other: most commonly used medication for Otitis Externa, fluoroquinolone - serious cases

Question 11

Hydrocortisone/Neomycin/Polymyxin B

Answer 11

Anti-Infective with Steroids

Treats: Otitis Externa

Route: Topical

Other: Neomycin - causes contact dermatitis (itchy rash), never use with perforated eardrums or tubes in the ears

Question 12

Hydrocortisone/Neomycin/Colistin

Answer 12

Anti-Infective with Steroids

Treats: Otitis Externa

Route: Topical

Other: Neomycin - causes contact dermatitis (itchy rash), never use with perforated eardrums or tubes in the ears

Question 13

Chloroxylenol/Pramoxine/Hydrocortisone

Answer 13

Anti-Infective with Steroids

Treats: Otitis Externa

Route: Topical

Question 14

Acetic Acid/Aluminum Acetate

Answer 14

Acid-Alcohol Solution

Treats: Otitis Externa; superficial infections of the external auditory canal

Route: Topical

Question 15

Acetic Acid/Propylene Glycol

Answer 15

Acid-Alcohol Solution

Treats: Otitis Externa; superficial infections of the external auditory canal

Route: Topical

Question 16

Acetic Acid/Propylene Glycol/ Hydrocortisone

Answer 16

Acid-Alcohol Solution

Treats: Otitis Externa; superficial infections of the external auditory canal

Route: Topical

Other: note presence of steroid - anti-inflammatory, antipruritis, and anti-allergenic

Question 17

Isopropyl Alcohol/Glycerine

Answer 17

Acid-Alcohol Solution

Treats: Otitis Externa; superficial infections of the external auditory canal

Route: Topical

Question 18

Isopropyl Alcohol/Propylene Glycol

Answer 18

Acid-Alcohol Solution

Treats: Otitis Externa; superficial infections of the external auditory canal

Route: Topical

Question 19

Amoxicillin

Answer 19

Antibiotic

Treats: Acute Otitis Media

Route: Oral

Other: drug of choice for Acute Otitis Media; tastes good (kids)

Question 20

Amoxicillin/Clavulanate

Answer 20

Antibiotic

Amoxicillin with B-lactamase coverage that is necessary if a patient has had Amoxicillin recently or has had a previous Amoxicillin resistance

Question 21

Cerumenolytics

Answer 21

cerumen softening agents

aimed at softening and removing ear wax from the external auditory canal

water based, oil based, nonwater/nonoil based

contraindications: perforated eardrums or tubes

Question 22

95% isopropyl alcohol and 5% anhydrous glycerin

Answer 22

solution to treat water-clogged ears

Auro Dri drops

FDA approved

Question 23

50:50 acetic acid (5%) and isopropyl alcohol (95%)

Answer 23

solution to treat water-clogged ears

recommended by American Academy of Otolaryngology

Question 24

Carbamide Peroxide 6.5% in Anhydrous Glycerin

Answer 24

Cerumenolytic

Treats: Cerumen Impaction

Route: Otic Drops

Other: bubbling sound can occur; could cause tympanic membrane damage if used for more than 4 days

Directions:
Children - 1-5 drops per ear twice daily (4 days max)
Adults - 5-10 drops per ear twice daily (4 days max)

Question 25

Triethanolamine Polypeptide Oleate

Answer 25

Cerumenolytic Treats: Cerumen Impaction Route: Otic Drops Directions: fill ear canal with drops, flush with water (ear wax should come out with water)

Question 26

1:1 solution of warm water and 3% hydrogen peroxide

Answer 26

Cerumenolytic not an effective drying agent

Question 27

Glycerin

Answer 27

emollient (softening and soothing to the skin), humectant (retains and preserves moisture) may facilitate the removal of ear wax

Question 28

Olive Oil aka Sweet Oil

Answer 28

Cerumenolytic

Question 29

Proparacaine 0.5% Solution

Answer 29

Ophthalmic Anesthetic (amino ester) Purpose: Numbs the Eye Route: Topical Excretion: bile Half-life: shortest of three Other: toxic if systemically absorbed

Question 30

Tetracaine 0.5% Solution

Answer 30

Ophthalmic Anesthetic (amino ester) Purpose: Numbs the Eye Route: Topical Excretion: bile Half-life: longest of three

Question 31

Lidocaine

Answer 31

Ophthalmic Anesthetic (amino amide) Purpose: Numbs the Eye Route: Topical Half-life: intermediate of three

Question 32

Sulfacetamide

Answer 32

Ophthalmic Anti-infective MOA: inhibits bacterial dihydrofolate synthesis, bacteriostatic Effective Against: E-coli, Klebsiella, Neisseria gonorrhoeae can cause irritation make sure patient doesn't have a sulfa allergy

Question 33

Tobramycin, Gentamicin

Answer 33

Ophthalmic Anti-infective MOA: aminoglycosides, bacteriocidal Effective Against: broad-spectrum aminoglycoside Other: gentamicin can cause irritation

Question 34

Bacitracin

Answer 34

Ophthalmic Anti-infective MOA: bacteriostatic, inhibits incorporation of amino acids and nucleotides Effective Against: many gram-positive and gram-negative bacteria

Question 35

Erythromycin

Answer 35

Ophthalmic Anti-infective (ointment) MOA: bacteriostatic, prevents protein synthesis in bacteria Effective Against: Strep pyrogenes, S. pneumoniae, S. Viridans, Corynebacterium diphtheriae Other: recommended for infants and children: good coverage, easier to administer than drops, and is well-tolerated

Question 36

Fluoroquinolones (ciprofloxacin, moxifloxacin, etc.)

Answer 36

Ophthalmic Anti-infective MOA: inhibit DNA synthesis of bacteria Effective Against: Staphylococci, S. pneumoniae, H. influenza, some Enterobacter, some Pseudomonas Other: recommended for contact wearers (broad-spectrum)

Question 37

Polymixin B

Answer 37

Ophthalmic Anti-infective MOA: high affinity for phospholipids in cell wall, causing cell wall permeability to increase, killing bacteria Effective Against: many gram-negative bacteria

Question 38

Nedocromil 2% Solution

Answer 38

Ophthalmic Mast Cell Stabilizer Route: Topical

Question 39

Cromolyn Sodium 4% Solution

Answer 39

Ophthalmic Mast Cell Stabilizer Route: Topical

Question 40

Iodoxamide 0.1% Solution

Answer 40

Ophthalmic Mast Cell Stabilizer Route: Topical

Question 41

Azelastine

Answer 41

Ophthalmic Antihistamine Treats: Allergic Conjunctivitis and Keratitis Route: Topical

Question 42

Epinastine

Answer 42

Ophthalmic Antihistamine Treats: Allergic Conjunctivitis and Keratitis Route: Topical

Question 43

Emedastine

Answer 43

Ophthalmic Antihistamine Treats: Allergic Conjunctivitis and Keratitis Route: Topical

Question 44

Ketotifen

Answer 44

Ophthalmic Antihistamine Treats: Allergic Conjunctivitis and Keratitis Route: Topical Other: prescribed often

Question 45

Levocabastine

Answer 45

Ophthalmic Antihistamine Treats: Allergic Conjunctivitis and Keratitis Route: Topical

Question 46

Olopatadine

Answer 46

Ophthalmic Antihistamine Treats: Allergic Conjunctivitis and Keratitis Route: Topical Other: prescribed often

Question 47

Phenylephrine

Answer 47

Ophthalmic Vasoconstrictor/Decongestant Treats: Allergic Conjunctivitis and Keratitis can precipitate angle-closure glaucoma

Question 48

Naphazoline

Answer 48

Ophthalmic Vasoconstrictor/Decongestant Treats: Allergic Conjunctivitis and Keratitis ocular decongestant of choice

Question 49

Tetrahydrozoline

Answer 49

Ophthalmic Vasoconstrictor/Decongestant Treats: Allergic Conjunctivitis and Keratitis less likely to alter pupil size, may cause stinging

Question 50

Oxymetazoline

Answer 50

Ophthalmic Vasoconstrictor/Decongestant Treats: Allergic Conjunctivitis and Keratitis is relatively free of ocular or systemic side effects

Question 51

Naphazoline + Pheniramine

Answer 51

Ophthalmic Vasoconstrictor/Decongestant and Ocular Antihistamine Treats: Allergic Conjunctivitis and Keratitis

Question 52

Naphazoline + Antazoline

Answer 52

Ophthalmic Vasoconstrictor/Decongestant and Ocular Antihistamine Treats: Allergic Conjunctivitis and Keratitis

Question 53

Cellulose Derivatives (Carboxymethylcellulose)

Answer 53

Artificial Tears Treats: Dry Eyes enhanced duration compared to other products tends to form eye crusts

Question 54

Polyvinyl Alcohol (glycerin, propylene glycol, polyethylene glycols, polysorbate 80)

Answer 54

Artificial Tears Treats: Dry Eyes shorter duration no crust formation

Question 55

Povidone and Dextran 70

Answer 55

Artificial Tears Treats: Dry Eyes can cause transient stinging and burning

Question 56

Lanolin, mineral oil, petrolatum, white ointment, white wax, yellow wax

Answer 56

Ocular Emollients Treats: Dry Eyes usually ointments, can be in liquid formulations can cause blurry vision, but remain in the eye longer more expensive versions last longer

Question 57

Cyclosporine

Answer 57

Restasis polycyclic peptide that inhibits interleukin-2 (needed for T-cell activity) - immunosuppressant Treats: Keratoconjunctivitis Sicca - suppressed tear production due to occular inflammation process adverse effects: burning sensation, eye discomfort expensive not first line; only prescribe under specialist recommendation

Question 58

Sodium Chloride (2-5%)

Answer 58

used to treat corneal adema

Question 59

Cyclopentolate 0.5, 1, or 2% Solution

Answer 59

Pupillary Dilation Agent 25-75 minutes for peak effect; lasts 6-24 hours

Question 60

Homatropine 1 or 5% Solution

Answer 60

Pupillary Dilation Agent lasts 24-72 hours

Question 61

Tropicamide

Answer 61

Pupillary Dilation Agent 20-30 minutes for peak effect; lasts 2-7 hours

Question 62

Fluorescein

Answer 62

used to detect corneal defects and abrasions yellow, water-soluble dibasic-acid xanthine dye does not stain cornea, but will appear bright green/yellow on corneal abrasion or defect (fluoresces under ultraviolet spectrum) not absorbed, can stain contacts

Question 63

Latanoprost

Answer 63

Prostaglandin Analogue Treats: Glaucoma - increase outflow of aqueous humor (1st line) Route: Topical Adverse Reactions: Iris pigmentation, eyelid darkening, lengthening eyelashes, intraocular inflammation, keratitis, macular edema, hyperemia Most Common Side Effect: Hyperemia expensive most commonly prescribed

Question 64

Bimatoprost

Answer 64

Prostaglandin Analogue Treats: Glaucoma - increase outflow of aqueous humor (1st line) Route: Topical Adverse Reactions: Iris pigmentation, eyelid darkening, lengthening eyelashes, intraocular inflammation, keratitis, macular edema, hyperemia Most Common Side Effect: Hyperemia

Question 65

Tafluprost

Answer 65

Prostaglandin Analogue Treats: Glaucoma - increase outflow of aqueous humor (1st line) Route: Topical Adverse Reactions: Iris pigmentation, eyelid darkening, lengthening eyelashes, intraocular inflammation, keratitis, macular edema, hyperemia Most Common Side Effect: Hyperemia

Question 66

Travoprost

Answer 66

Prostaglandin Analogue Treats: Glaucoma - increase outflow of aqueous humor (1st line) Route: Topical Adverse Reactions: Iris pigmentation, eyelid darkening, lengthening eyelashes, intraocular inflammation, keratitis, macular edema, hyperemia Most Common Side Effect: Hyperemia

Question 67

Unoprostone

Answer 67

Prostaglandin Analogue Treats: Glaucoma - increase outflow of aqueous humor (1st line) Route: Topical Adverse Reactions: Iris pigmentation, eyelid darkening, lengthening eyelashes, intraocular inflammation, keratitis, macular edema, hyperemia Most Common Side Effect: Hyperemia

Question 68

Timolol

Answer 68

Beta Blocker Treats: Glaucoma - decrease aqueous humor production Adverse Reactions: bradycardia, stinging, bronchospasm (hard to breath), depression, fatigue, ocular dryness systemic absorption may lower blood pressure and heart rate

Question 69

Carteolol

Answer 69

Beta Blocker Treats: Glaucoma - decrease aqueous humor production Adverse Reactions: bradycardia, stinging, bronchospasm (hard to breath), depression, fatigue, ocular dryness systemic absorption may lower blood pressure and heart rate

Question 70

Levobunolol

Answer 70

Beta Blocker Treats: Glaucoma - decrease aqueous humor production Adverse Reactions: bradycardia, stinging, bronchospasm (hard to breath), depression, fatigue, ocular dryness systemic absorption may lower blood pressure and heart rate

Question 71

Metipranolol

Answer 71

Beta Blocker Treats: Glaucoma - decrease aqueous humor production Adverse Reactions: bradycardia, stinging, bronchospasm (hard to breath), depression, fatigue, ocular dryness systemic absorption may lower blood pressure and heart rate

Question 72

Betaxolol

Answer 72

Beta Blocker Treats: Glaucoma - decrease aqueous humor production Adverse Reactions: bradycardia, stinging, bronchospasm (hard to breath), depression, fatigue, ocular dryness systemic absorption may lower blood pressure and heart rate LEAST LIKELY TO CAUSE ADVERSE EFFECTS - CARDIOSELECTIVE

Question 73

Brimonidine

Answer 73

Alpha-2 Adrenergic Agonist Treats: Glaucoma - decreases aqueous humor production, maybe increases outflow Adverse Reactions: ocular allergy, somnolence, bitter taste, dry mouth, systemic hypotension, irregular heart rate taken 2-4 times a day - can be difficult to remember to take

Question 74

Apraclonidine

Answer 74

Alpha-2 Adrenergic Agonist Treats: Glaucoma - decreases aqueous humor production, maybe increases outflow Adverse Reactions: ocular allergy, somnolence, bitter taste, dry mouth, systemic hypotension, irregular heart rate taken 2-4 times a day - can be difficult to remember to take

Question 75

Acetazolamide

Answer 75

Carbonic Anhydrase Inhibitor Treats: Glaucoma - deceases aqueous humor production Route: TABLET (systemic side effects) - used less often Adverse Reactions: ocular irritation, sour taste Contraindication: sulfa allergy Reacts with: aspirin, cyclosporine, lithium, and phenytoin

Question 76

Dorzolamide

Answer 76

Carbonic Anhydrase Inhibitor Treats: Glaucoma - deceases aqueous humor production Adverse Reactions: ocular irritation, sour taste Contraindication: sulfa allergy

Question 77

Brinzolamide

Answer 77

Carbonic Anhydrase Inhibitor Treats: Glaucoma - deceases aqueous humor production Adverse Reactions: ocular irritation, sour taste Contraindication: sulfa allergy

Question 78

Methazolamide

Answer 78

Carbonic Anhydrase Inhibitor Treats: Glaucoma - deceases aqueous humor production Route: TABLET (systemic side effects) - used less often Adverse Reactions: ocular irritation, sour taste Contraindication: sulfa allergy

Question 79

Dichlorphenamide

Answer 79

Carbonic Anhydrase Inhibitor Treats: Glaucoma - deceases aqueous humor production Adverse Reactions: ocular irritation, sour taste Contraindication: sulfa allergy

Question 80

Pilocarpine

Answer 80

Direct-Acting Cholinergic Treats: Glaucoma - opens canal of Schlemm by activating parasympathetic response, which makes pupils smaller Adverse Reactions: blurred vision, poor night vision, eye pain, headache

Question 81

Carbachol

Answer 81

Direct-Acting Cholinergic Treats: Glaucoma - opens canal of Schlemm by activating parasympathetic response, which makes pupils smaller Adverse Reactions: blurred vision, poor night vision, eye pain, headache

Question 82

Echothiophate

Answer 82

Indirect-Acting Cholinergic Treats: Glaucoma - opens canal of Schlemm by activating parasympathetic response, which makes pupils smaller - prevents breakdown of acetylcholine Adverse Reactions: blurred vision, poor night vision, eye pain, headache long half-life; irreversible

Question 83

Timolol + Dorzolamide

Answer 83

Beta Blocker + Carbonic Anhydrase Inhibitor Treats: Glaucoma use twice daily

Question 84

Mannitol, Glycerin

Answer 84

Short-term Emergent Glaucoma Treatment hyperosmotic causes blood to be hypertonic compared to intraocular and spinal fluids; pulls water from the intraocular and spinal areas to the bloodstream can be used to interrupt acute attack of close-angle glaucoma or hypertensive crisis severe side effects: headache, back pain, diuresis, circulatory overload, pulmonary edema, and cerebral hemorrhage

Question 85

Beclomethasone

Answer 85

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation

Question 86

Budesonide

Answer 86

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation

Question 87

Ciclesonide

Answer 87

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation

Question 88

Flunisolid

Answer 88

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation

Question 89

Fluticasone Fluroate

Answer 89

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases more common Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation (NO ALCOHOL IN THIS)

Question 90

Fluticasone Propionate

Answer 90

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases more common Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation (NO ALCOHOL IN THIS)

Question 91

Mometasone

Answer 91

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases more common Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation

Question 92

Triamcinolone Acetonide

Answer 92

Intranasal Corticosteroid reduce ocular symptoms, nasopharyngeal itching, sneezing, and rhinorrhea decrease influx of inflammatory cells, inhibit release of cytokines, which reduce inflammation of mucosa onset is less than 30 minutes need to be taken for 2-4 weeks for max efficacy more effective than antihistamines in persistent and more severe cases more common Adverse Effects: bitter aftertaste, burning, epistaxis, headache, nasal dryness, possible systemic absorption, stinging, throat irritation (NO ALCOHOL IN THIS ONE)

Question 93

Chloropheniramine

Answer 93

First Generation Antihistamine Treats: Allergic Rhinitis causes sedation older dosed more often more effective than 2nd generation

Question 94

Brompheniramine

Answer 94

First Generation Antihistamine Treats: Allergic Rhinitis causes sedation older dosed more often more effective than 2nd generation

Question 95

Diphenhydramine

Answer 95

First Generation Antihistamine Treats: Allergic Rhinitis causes sedation older dosed more often more effective than 2nd generation

Question 96

Clemastine

Answer 96

First Generation Antihistamine Treats: Allergic Rhinitis causes sedation older dosed more often more effective than 2nd generation

Question 97

Loratidine

Answer 97

Second Generation Antihistamine Treats: Allergic Rhinitis newer lasts 24 hours non-sedative

Question 98

Cetrizine

Answer 98

Second Generation Antihistamine Treats: Allergic Rhinitis newer lasts 24 hours can cross BBB and cause sedation in 1/10 most effective 2nd generation

Question 99

Fexofenadine

Answer 99

Second Generation Antihistamine Treats: Allergic Rhinitis newer lasts 24 hours non-sedative

Question 100

Desloratadine

Answer 100

Second Generation Antihistamine Treats: Allergic Rhinitis newer lasts 24 hours non-sedative more expensive

Question 101

Azelastine

Answer 101

Intranasal Antihistamine treat symptoms of conjunctivitis, rhinitis, and congestion blocks H1 receptors 15 min onset BID dosing Adverse Reactions: bitter aftertaste, headache, nasal irritation, sedation, epistaxis (fewer due to topical administration)

Question 102

Olopatadine

Answer 102

Intranasal Antihistamine treat symptoms of conjunctivitis, rhinitis, and congestion blocks H1 receptors 15 min onset BID dosing Adverse Reactions: bitter aftertaste, headache, nasal irritation, sedation, epistaxis (fewer due to topical administration)

Question 103

Azelastine/fluticasone

Answer 103

Intranasal Antihistamine/Corticosteroid combination expensive

Question 104

Phenylephrine

Answer 104

"Oral Decongestant" cheap version of sudafed (Sudafed PE) that is sold OTC low bioavailability - doesn't really work BUT GOOD TOPICAL DECONGESTANT

Question 105

Pseudoephedrine

Answer 105

Oral Decongestant relieves rhinorrhea real Sudafed - have to get from pharmacist, not OTC

Question 106

Oxymetazoline

Answer 106

Topical Decongestant relieves rhinorrhea

Question 107

Cromolyn

Answer 107

Intranasal Mast Cell Stabilizer prevent and treat allergic symptoms: itching, sneezing, and rhinorrhea prevent mast cells from releasing histamine dosed 4-6 times a day (not first choice) side effects: nasal irritation, nasal burning, stinging, sneezing, cough, unpleasant taste, epistaxis

Question 108

Ipratropium

Answer 108

Intranasal Anticholinergic reduce rhinorrhea block acetylcholine receptors 15 minute onset adverse effects: epistaxis, headache, nasal dryness dosed 2-3 times a day prevent parasympathetic response -> less mucous

Question 109

Montelukast

Answer 109

Leukotriene Receptor Antagonist reduce ocular symptoms, sneezing, rhinorrhea block leukotriene receptors adverse reactions: elevated levels of alanine transaminase, aspartate transaminase, bilirubin may be useful for patients with asthma - reduces bronchospasm and attenuates inflammatory response

Question 110

Codeine

Answer 110

Antitussive Treats: Cough Route: Oral narcotic centrally mediated (medulla of the brain) suppression of the cough; binds to opioid receptors, producing analgesia, sedation, and cough suppression for night cough - causes sedation side effects: sedation, nausea, constipation avoid alcohol converted to active form (morphine) by CYP2D6; rapid metabolizers could overdose prodrug

Question 111

Hydrocodone

Answer 111

Antitussive Treats: Cough narcotic suppresses medulla of the brain - binds to opioid receptors, producing analgesia, sedation, and cough suppression for night cough side effects: sedation, respiratory depression, constipation avoid alcohol do not use for children under 12

Question 112

Dextromethorphan

Answer 112

Antitussive (OTC) Treats: Cough centrally mediated (at medulla) suppression of cough - elevates threshold of cough reflex for nonproductive cough side effects: drowsiness, GI effects drug interactions - MAO inhibitors crosses BBB prodrug

Question 113

Guaifenesin

Answer 113

Exporant Treats: Cough thins mucus to enhance clearance side effects: GI discomfort increase fluid intake

Question 114

Sore Throat/ Cough Remedies

Answer 114

saline gargle sprays, lozenges (benzocaine, dyclonine, phenol, menthol) honey lots of water