P2 Spring Exam 1: Allergy

Question 1

Adverse Effects: Medrol

Answer 1

GI upset
Hyperglycemia
Osteoporosis
adrenocortical insufficiency
risk of infection

Question 2

Toxicity: Medrol & Deltasone

Answer 2

-hyperglycemia, osteoporosis, adrenocortical insufficiency, & infection
-freq & sev depend on length of tx and dose

Question 3

Patient counsel: Medrol & Deltasone

Answer 3

short-term: take w/ food to pvt GI upset
long-term: hyperglycemia, osteoporosis, adrenocortical insufficiency, infection
TAKE IN THE MORNING PVT INSOMNIA

Question 4

clinical pearls: Medrol

Answer 4

injection = fatal fungal inf

Question 5

besides, adrenocortical insufficiency & increased risk of infection, what are the two other rare but serious AE for Medrol & Deltasone?

Answer 5

Cushing synd.
decreased growth in children

Question 6

Adverse Effects: Spiriva

Answer 6

ANTICHOLINERGIC
Xerostomia, URT infection
Bowel obstruction, Cerebrovascular accident, Bronchospasm

Question 7

Toxicity: Spiriva

Answer 7

ANTICHOLINERGIC
bladder obstruction / urine retention
narrow-angle glaucoma
prostatic hyperplasia

Question 8

Patient Counsel: Spiriva

Answer 8

Not Rescue inhaler!
Caps = inhaled (Handihaler = cap twice)
Max benefit: 1-2 months
AE: increased HR, dry mouth, constipation, urine retention, RTI, sinusitis

Question 9

clinical pearls: Spiriva

Answer 9

paradoxical bronchospasm
-HandiHaler = COPD
-Respimat = COPD, Asthma

Question 10

COMMON Adverse Effects: Combivent Respimat/DuoNeb

Answer 10

Bronchitis, URT Infection

Question 11

Rare but Serious Adverse Effects: Combivent Respimat/DuoNeb

Answer 11

glaucoma
pneumonia
hypersensitivity
paradoxical bronchospasm

Question 12

Toxicity: Ipratropium/Albuterol

Answer 12

PARADOXICAL BRONCHOSPASM!!

Question 13

Patient counsel: Ipratropium/Albuterol

Answer 13

1. Wash mouthpiece
2. store room temp
3. use entire vial over 5-15 minutes

Question 14

clinical pearls: Ipratropium/Albuterol

Answer 14

anticholinergic effects
use caution w/ bladder obstruction, glaucoma, BPH

Question 15

AE: Hydroxyzine HCl (Atarax, Vistaril)

Answer 15

no common or rare but serious
less common: sedation/fatigue, headache, dry mouth

Question 16

toxicity: Vistaril

Answer 16

severe CNS toxicity

Question 17

patient counsel: Atarax

Answer 17

avoid mental alertness activities - dizziness, sedation

Question 18

clinical pearls: hydroxyzine

Answer 18

injectable - perioperative pain / sedation
reduce dose 50% for CrCl <50 ml/min

Question 19

AE: Meclizine

Answer 19

sedation, anaphylaxis

Question 20

toxicity: Antivert

Answer 20

CNS

Question 21

Patient counsel: Bonine

Answer 21

1. avoid driving
2. avoid alcohol
3. w/ food
4. caution w/ pts: asthma, glaucoma, BPH

Question 22

AE of Benzonatate

Answer 22

chewed caps = NUMBNESS
hypersensitivity

Question 23

toxicity: Benzonatate

Answer 23

HYPERSENSITIVITY
Rash, Itching, diff. breathing/swallowing, Confusion, Hallucinations

Question 24

patient counsel: Tessalon Pearles

Answer 24

1. do NOT CHEW
2. food/milk
3. CHILDREN <2 YEARS OLD = FATAL

Question 25

When did the FDA approve benzonatate?

Answer 25

1958