Module 7 Flashcards
Which anti-inflammatory drug is used for prophylaxis of chronic asthma?
Glucocorticoids
Glucocorticoids reduce asthma symptoms by what?
suppressing inflammation
budesonide and fluticasone are glucocorticoids used in what?
long term control of airway inflammation
Serious adverse effect with inhaled glucocorticoids
adrenal suppression
oropharyngeal candidiasis and dysphonia are common adverse effects with which drug?
inhaled glococorticoids
How can a patient minimize side effects of inhaled glucocorticoids?
rinse mouth with water and gargle after each administration
Long-term use of inhaled glucocorticoids may promote what?
bone loss
Using the lowest dose that controls symptoms, ensure adequate intake of calcium and vitamin D, and participate in weight-bearing exercises are all ways to minimize what with long term glucocorticoid use
bone loss
Most important patient education point for inhaled glucocorticoid use
intended for preventative therapy-not for aborting an ongoing attack
must administer on regular schedule NOT PRN
What possible side effect of glucocorticoids is seen in children but not adults?
growth suppression
When would you increase dose of glucocortioids?
in times of stress
bronchodilators, glucocorticoids, and PDE-4 inhibitors are used in management of what?
stable COPD
Ipratropium is an anticholinergic drug that improves lung function by which mechanism of action?
blocking muscarinic receptors in the bronchi, thereby reducing bronchoconstriction
What is the onset and peak of anticholinergic drug Ipratropium?
30 seconds, reach 50% of max in 3 mins, and lasts about 6 hours
Side effects of Ipratropium?
dry mouth and irritation of the pharynx
glaucoma
cardiovascular events
small, hand-held, pressurized devices that deliver a measured dose of a drug with each actuation
metered-dose inhalers
Patient education with metered dose inhalers
patient must begin to inhale before activating the device
Phenylephrine is a sympathomimetic that is indicated for what?
to reduce nasal congestion
Sympathomimetics only relieve stuffiness associated with what conditions?
sinusitis and colds
What are some ways to discontinue Phenylephrine
discontinue drug one nostril at a time
use intranasal glucocorticoid for 2-6 weeks–starting 1 week before discontinuing
Which leukotriene modifier is the only one approved for children aged 1-5 years?
Montelukast
Montelukast has 3 approved indications:
(1) prophylaxis and maintenance thearpy of asthma in patients at least 1 year old
(2) prevention of EIB in pts at least 15 years old
(3) relief of allergic rhinitis
Montelukast has been linked with which neuropsychiatric side effects?
mood changes and suicidality
Patient education for dosing of Montelukast
once a day in the evening with or without food
No additional dose should be taken for at least 24 hours
Which expectorant medication renders cough more productive by stimulating the flow of respiratory tract secretions?
Guaifenesin [Mucinex]
Why are decongestant drops preferred for young children?
Because children are susceptible to toxicity and the number of drops can be precisely controlled, and drops allow better control of dosage than do sprays
Why are non-selective beta blocker glaucoma drops contraindicated in patients with COPD?
Blockade of beta2 receptors in the lungs can cause bronchospasms
What is the only ophthalmic beta blocker that can be used in patients with asthma and COPD and why?
betaxolol because it is beta1 selective
This drug is applied topically to lower IOP in patients with open-angle glaucoma and ocular hypertension
Latanoprost (analog of prostaglandin F2 alpha)
Latanoprost lowers IOP by what action?
facilitating aqueous humor outflow and by relaxing the ciliary muscle
Most significant side effect seen with Latanoprost drops?
harmless heightened brown pigmentation of the iris
How do sunscreens protect against sunburn, photoaging of the skin, and photosensitivity reactions to certain drugs?
They impede penetration of UV radiation to viable cells of the skin
What type of sunscreen absorbs UV radiation and then dissipates it as heat?
Organic screens (chemical screens)
Minoxidil is a direct-acting vasodilator used primarily for severe hypertension but has topically can be used for what?
promoting hair growth in pts with baldness.
open comedones (blackheads) are the most common lesion in this skin disorder?
mild acne
nonpharmacologic therapy for for mild acne includes what?
cleansing with a gentle nonirritant soap 2x a day
avoid vigorous scrubbing or abrasives
avoid oil-based make-up or moisturizing products
Drug therapy for mild acne
topical antibiotics and topical retinoids
Moderate acne can be treated with what?
oral antibiotics and comedolytics
In young women whose acne is unresponsive to other drugs, the provider can order what?
combination OCs and spironolactone
Why is the topical vitamin D analog Calcitriol used to treat mild to moderate Psoriasis?
It slows the growth of new cells
Inflammation of the EAC caused by bacterial infection. Rapid-onset ear pain.
Otitis externa (swimmers ear)
How can you prevent otitis externa (swimmers ear)?
don’t put anything in ear
dry EAC after swimming and showering
don’t remove ear wax
don’t use earplugs except when swimming
Treatment otitis externa include keeping the ear dry and using what?
analgesics for pain
topical antimicrobials
oral antibiotics
Why is quinolone Ciprofloxacin preferred treatment for otitis externa?
safe for perforated tympanic membranes
Keflex has to be used instead of Cipro in children under 18 for which condition?
otitis externa with infection beyond the EAC involving the pinna
Inflammation of the middle ear caused by bacterial or viral infection or noninfectious causes.
Otitis media
What are some ways to prevent otitis media in children?
breastfeed first 6 months avoid childcare centers eliminate exposure to smoke reduce pacifier use avoid supine bottle feeding
If 3 or more episodes of acute otitis media occur in the past 6 months or 4 times in the past year what is recommended treatment?
tympanostomy tubes
Why are oral fluoroquinolones contraindicated for use in children under 18?
can cause tendon rupture
inflammation of the conjunctiva in response to an allergen-may be seasonal or chronic
allergic conjunctivitis
Mast cell stabilizers, antihistamines, NSAIDs, glucocorticoids, and ocular decongestants are all forms of treatment for what?
allergic conjunctivitis
This is the most common form of glaucoma, characterized by progressive optic nerve damage with eventual impairment of vision
Primary open angle glaucoma
Painless, insidious disease, develops over years. Elevated IOP is seen. No symptoms until significant and irreversible optic nerve injury has occurred
Primary open angle glaucoma
What are the 3 classes of first line drugs for glaucoma
beta blockers
alpha2-adrenergic agonists
prostaglandin analogs
What is the goal of glaucoma treatment?
To reduce elevated IOP
decreased aqueous humor formation is what glaucoma drugs mechanism?
beta blockers
increased aqueous humor outflow is what glaucoma drugs mechanism?
prostaglandin analogs
decreased aqueous humor formation is what glaucoma drugs mechanism?
Alpha2-adrenergic agonists
