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Pharm > Nose drugs > Flashcards

Nose drugs Flashcards

1
Q

drug classes for allergic rhinitis

A 
anti-histamines
decongestants
intranasal steroids
mast cell stabilizer
leukotriene inhibitors
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2
Q

nasal anithistamines (names and generations)

A 
1st: meclizine
   hydroxyzine
   dimenthydrinate
   diphenhydramine
   promethazine
   brompheniramine
   chloropheniramine
   doxylamine
2nd: loratadine
   desloratadine
   fexofenadine
   certizine
   levocetirizine
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3
Q

nasal decongestant (names)

A

pseudoephedrine

phenylephrine

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4
Q

intranasal steroids (names)

A 
beclomethasone
budesonide
ciclesonide
flunisolide
fluticasone
mometasone
triamcinolone
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5
Q

mast cell stabilizer (names)

A

cromolyn sodium

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6
Q

leukotriene inhibitors (names)

A

montelukast
zafirlukast
zileuton

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7
Q

histamine (actions, where it is and where it goes, what causes its release)

A
  • mediates allergic and inflamm rxns
  • gastric acid secretion
  • NT
  • in mast cells and basophils (released upon contact with allergen)
  • receptors H1 (smooth musc, brain, heart, CNS), H2 (gastric), H3 (CNS), H4 (immune)
  • released with ROTA (red-man [vancomycin], opioids, tubocurarine [anestehtic], amphoteicin [antifungal])
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8
Q

epinephrine class

A

?

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9
Q

epinephrine MOA

A 
functional antagonist to hist-induced bronchoconstriction
alpha agonist (decreas vasodilation)
B2 agonist (relax bronchial smooth musc)
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10
Q

epinephrine indications

A

emergency tx of type I allergic rxns

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11
Q

epinephrine cautions

A

elderly

heart conditions

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12
Q

epinephrine ADR

A 
anxiety
restlessness
tremor
weakness
palpitations
pallor
N/V
HA
respiratory probs
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13
Q

antihist (1st gen) class

A

antihist

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14
Q

antihist (1st gen) MOA

A 
block H1 receptor (nonselective)
inhibit hist effect on smooth musc
anticholinergic effects
alpha blocker effects
serotonin blocker effects
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15
Q

antihist (1st gen) indications

A 
allergies
motion sickness (meclizine/dimenhydrinate)
nausea (promethazine)
insomnia
block EPS (extra pyramidal side effects)
local anesthesia
itching (hydroxyzine)
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16
Q

antihist (1st gen) ADRs

A

increased sedation
decreased cognitive and psychomotor performance
increased appetite
stim CNS (restless, nervousness, insomnia, etc)

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17
Q

fexofenadine class

A

antihist (2nd gen)

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18
Q

fexofenadine MOA

A

still H1 blocker, but more selective (b/c 2nd gen)

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19
Q

fexofenadine indications

A

allergic rhinitis > 2 y/o

chronic urticaria > 6 mo

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20
Q

fexofenadine ADR

A 
HA
cough
URI
fever
back pn
dysmenorrhea
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21
Q

fexofenadine drug interactions

A

ketoconazole
erythromycin
P450
Al and Mg antacids

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22
Q

fexofenadine caution

A

renal dosing

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23
Q

cetirizine class

A

antihistamine

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24
Q

cetirtizine MOA

A

H1 receptor blocker (crosses BBB –> a little less selective for 2nd gen)

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25
Q

cetirizine indication

A

allergic rhinitis > 6 mo

chronic urticaria > 6 mo

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26
Q

cetirizine ADRs

A

somnolence
dizziness
HA
abd pn/nausea

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27
Q

cetirizine caution

A

dosing with renal probs

28
Q

antihistamine uses

A

tx of allergic rhinitis (ocular s/s, nasopharyng itch, sneeze, rhinorrhea)
not good for URI (except 1st gen for sedation)

29
Q

sympathomimetics

A

excite blood vessels, salivary/sweat glands
vasoconstrict
inhib gut
relax bronchial tree
increase HR and squeeze
increase gluc
CNS: awake, decrease appetite, increase NT

30
Q

phenylephrine class

A

alpha agonist (decongestant)

31
Q

phenylephrine MOA

A

alpha 1 selective agonist

32
Q

phenylephrine indication

A

nasal decongestant
mydriatic
hemorroid treatment

33
Q

phenylephrine ADR

A 
increase HR
increase BP
HA
dizziness
sweats/shakes
34
Q

phenylephrine caution

A

HTN
heart dz
hyperthyroid (graves)
BPH

35
Q

pseudoephedrine class

A

alpha agonist (decongestant)

36
Q

pseudoephedrine indications

A

congestion due to rhinitis or URI

ET congestion

37
Q

pseudoephedrine ADRs

A

vasoconstriction
increase BP
arrhythmia

38
Q

pseudoephedrine drug interations

A

MAOIs
B-blockers
Digoxin

39
Q

pseudoephedrine caution

A

HTN
cardiac dz
hyperthyroid
taking after exercise (tachy)

40
Q

intranasal steroid class

A

steroid

41
Q

intranasal steroid MOA

A

decrease inflammation of nasal mucosa
block inflammatory mediators
antihist + decongest

42
Q

differences in intranasal steriod drug efficacy

A

they’re all the same!!

43
Q

intranasal steroid indication

A

allergic rhinitis (ocular s/s/, nasopharyng itch, sneezing, rhinorrhea, nasal congest)

44
Q

intranasal steroid caution

A

peds: different times for diff drugs

45
Q

intranasal steroid ADRs

A

epistaxis
HA
cough/URI/pharyngitis
some systemic (nasal septal perforation, candidia, glaucoma)

46
Q

Cromolyn sodium class

A

mast cell stabilizer

47
Q

cromolyn sodium indications

A

tx and prevention of allergic rhinits

48
Q

cromolyn sodium MOA

A

prevents mast cell degranulation and hist release

49
Q

cromolyn sodium ADRs

A

sneezing, stinging

50
Q

leukotriene inhib MOA

A 
leukotriene receptor antag -->
inhib leukotrienes that:
from arachadonic acid
produced by airway inflammatory cells
increase cap perm, WBC mvt, adhesion & aggreg.
51
Q

leukotriene inhibitor indications

A 
nasal congestion
rhinorrhea
conjunctivitis
bronchial symptoms
chronic asthma
52
Q

montelukast class

A

leukotreine inhibitor

53
Q

montelukast MOA

A

selective antag for leukotreine receptor (found in airway and inflammory cells)

54
Q

montelukast indications

A

asthma > 1 y/o
allergic rhinits > 6 mo
exercise-induced asthma > 15 y/o

55
Q

montelukast ADRs

A 
some GI discomfort
HA
fever
dizziness
neuropsych (rare) in peds (anxiety, agitate, depress, dreams, hallucinate)
56
Q

zafirlukast class

A

leukotriene inhibitor

57
Q

zafirlukast MOA

A

compeititive antag for diff leukotreine receptor.

prevent increased vasc perm

58
Q

zafirlukast indication

A

chronic asthma > 5 y/o (prevent and tx)

59
Q

zafirlukast CI

A

hepatic probs (includes cirrhosis)

60
Q

zafirlukast ADRs

A

neuropsych (insomia, depress)
liver damage (jaundice, n/v, abd pn…)
churg-strauss syndrome (syst vasculitis, asthma, rash, GI bleed, extremity pn)

61
Q

zileuton class

A

leukotriene inhibitor

62
Q

zileuton MOA

A

prevent leukotriene synthesis

63
Q

zileuton indications

A

asthma > 12 y/o (prevention and tx)

64
Q

zileuton CI

A

active liver dz

65
Q

zileuton drug interactions

A

increases warfarin levels

increases [propranolol]

66
Q

zileuton ADRs

A 
neuropsych (insomia, behavior)
hepatotoxicits
sinusitis
nausea
sore throat

Pharm (11 decks)

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