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Pharmacotherapy 2 - Final Exam > Otitis & Sinusitis > Flashcards

Otitis & Sinusitis Flashcards

1
Q

Contraindicated Meds in AOM & Sinusitis

A

Decongestants & Antihistamines d/t thickened mucous

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2
Q

Tx of AOM in Infants <6mo

A

Always tx if suspected

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3
Q

Tx of AOM in Infants 6mo - 2 yr

A

Tx if diagnosis is certain or systemic symptoms present (fever, lymphadenopathy)

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4
Q

Tx of AOM in Kids > 2 yr

A

Tx if systemic symptoms present (fever, lymphadenopathy

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5
Q

MC AOM Pathogens

A

S. pneumoniae; H. flu; M. cat

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6
Q

1st line tx for AOM

A

Amoxicillin x 7 d

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7
Q

2nd line tx for AOM (Amoxil failed)

A

Augmentin (preferred); Macrolides (Azithro or Clarithro); Bactrim DS

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8
Q

3rd line tx for AOM

A

Cefdinir (Omnicef)

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9
Q

AOM tx for PCN allergic

A

Macrolides (Azithro or Clarithro) or Bactrim DS

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10
Q

Clarithromycin (Biaxin XL) Unique AE

A

Metal taste in mouth

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11
Q

Cefdinir (Omnicef) Unique AE

A

Red stools

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12
Q

ABX requiring refrigeration

A

Augmentin

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13
Q

ABX requiring room temp

A

Azithromycin & Clindamycin & Cefdinir

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14
Q

Clindamycin drawback

A

Tastes terrible

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15
Q

Azithromycin drawback

A

Resistance; dosing packs (requires 2)

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16
Q

When to switch tx in AOM

A

No response within 72 hours of initiating tx

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17
Q

Aurodex

A

Pain relief ear drops (contain benzocaine)

18
Q

OM with Effusion - Signs of Severity

A

Lasts > 3 mo; Sustained hearing or speech impairment; recurrent AOM

19
Q

Tx of OM with Effusion

A

Tympanostomy tubes

20
Q

OE - Signs of Severity

A

Periauricular Erythema; Lymphadenopathy; Fever

21
Q

OE tx

A

Remove cerumen, desquaminated skin & purulent material; topical abx

22
Q

1st line tx for OE

A

Ofloxacin 0.3% sol’n (Floxin Otic); Ciprofloxacin & Hydrocortisone (Cipro HC otic); Tobramycin & Dexamethasone (Tobradex) x 7 - 14 days

23
Q

Contraindications for Ear Drops & Aural Irrigation

A

Ruptured TM

24
Q

2nd line tx for OE or Severe OE

A

Oral FQs (Cipro/Levo)

25
Q

OE Pathogens

A

Pseudomonas; S. aureus; Polymicrobial (1/3 of all cases)

26
Q

How many days should a patient have s/sx of sinusitis before ABX are administered?

A

10 days

27
Q

Tx for Sinusitis with 1-10 days of symptoms

A

Intranasal glucocorticoids (Flonase); Mucolytics (Mucinex)

28
Q

1st Line ABX for Bacterial Sinusitis

A

Amoxicillin x 10 - 14 d

29
Q

PCN Allergic Tx for Bacterial Sinusitis

A

Macrolides (Azithro or Clarithro); Bactrim DS; or 3rd Gen Cephalosporins (Cefdinir or Cefixime)

30
Q

2nd Line ABX for Bacterial Sinusitis (Amoxil failed)

A

Augmentin; 2nd/3rd gen Ceph (Cefuroxime or Cefdinir); Levo or Moxifloxacin (avoid FQs in peds d/t bone/joint problems)

31
Q

Adjuntive Tx to Avoid in Peds with Sinusitis

A

Decongestants & Antihistamines & Nasal corticosteroids

32
Q

Rhinitis medicamentosa

A

Rebound congestion d/t prolonged use of Afrin or nasal corticosteroids

33
Q

Safe Length of Use for Afrin

A

72 h

34
Q

Pseudoephedrine MoA

A

Alpha-adrenergic stimulation&raquo_space; Vasoconstriction of resp mucosa; Beta stimuation&raquo_space; ^ Rate & contractility of heart; bronchorelaxation

35
Q

Pseudoephedrine Side Effects

A

Cardio (tachy, palpitations, arrhythmia, ^BP); CNS (Dizzy, HA, Insomnia, Nervous, CNS stimulation)

36
Q

Nasal Corticosteroids

A

Fluticasone Propionate (Flonase); Mometasone (Nasonex); Fluticaone furae (Veramyst); Budesonide (Rhinocort); Triamcinolone (Nasacort)

37
Q

Nasal Corticosteroids Tx Length

A

1-2 sprays/nostril qd x 10-14 d; May take 3 days for noticable effect

38
Q

Viral causes of Pharyngitis

A

Rhinovirus; Coronavirus; Adenovirus

39
Q

MCC of Bacterial Pharyngitis

A

S. pyogenes

40
Q

1st Line Tx for Bacterial Pharyngitis

A

Amoxicillin x 10 d

41
Q

2nd Line Tx for Bacterial Pharyngitis (Amoxil fail)

A

Augmentin

42
Q

PCN Allergic Tx for Bacterial Pharyngitis

A

Cefdinir (Omnicef); Cefuroxime (Ceftin); Azithro; Clarithro

Pharmacotherapy 2 - Final Exam (10 decks)

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