Pharm ENT module Flashcards
Oxymatazoline HCL
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
Nasal decongestant spray
MOA: vasoconstriction, alpha agonist
SHORT TERM NASAL DECONGESTION (max 3 days)
XGLUCOMA, CONTINUED USE, ORAL DECONGESTANTS PSEUDOPHED
Interesting:
- can be used 3-5 days if a bridge to corticosteroid use
- rebound nasal congestion so switch to corticosteroid fluticasone proprionate
- causes RHINITIS MEDICAMETOSA
Azelastine HCL
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
Nasal Antihistamine Spray
H1 receptor blocker
ALLERGIC RINHITIS
Xglaucoma, <3, anticholingeric/sedating drugs
Interesting:
- bitter taste
- SYSTEMIC ABSORPTION
- WILL RELIEVE ALL SYMPTOMS EXCEPT NASAL CONGESTION
fluticasone propionate
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
corticosteroid nasal spray
MOA: anti-inflammatory with vasoconstriction
all forms of rhinitis
Caution: cause nose bleeds, nasal septum perforation
X:epitaxis, glaucoma, catarracts
Interesting:
- 1-2% systemic bioavaliability
- delayed impact 7-14 days
- avaliable as flovent for inhaler in asthma
Ipratropium Bromide
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
Nasal antimucarinic spray
MOA: blocks acetylcholine at muscarinic receptors in PNS
vasomotor rhinitis
Xother anticholinergic, glucoma, epitaxsis
Interesting:
- inhalation form Atrovent MDI
- not for allergies but good for rhinnoreah
.03% solution children and .06% for adults
which drug do you not what to combine with OTC sleep aids or diphenylhydramine?
ipratropium bromide, causes increased drowsiness and confusion in adult patients
vasomotor rhinitis means
nonallergic rhinitis
what percent of strep throat is resistance?
20%
what is the first and second and third DOC for strep? the second would be used if…? the third would be used if?
DOC:
- penicillin
- clindmycin (if pen allergy, but $$$ and causes c. diff)
- macrolide (azithromycin, erythromycin, and clarithromycin) if resistance in community
what should you never do in children, especially obese children, when dosing drugs?
Never give more than the maximum adult dose for a child, adult dose is the MAXIMUM DOSE
Cromolyn sodium
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
mast cell stablizer nasal spray
stabalizes mast cell membranes so histamine leukotrienes aren’t released
allergic rhinitis
ONLY NASAL SPRAY THAT CAN BE USED IN GLUACOMA!! good for kids and preggo
Interesting:
- bad taste
- 3-14 days
- inhalation and opthalmic form
what is the only nasal spray that is safe to use in gluacoma???
cromolyn sodium
mast cell stabalizer
Diphenhydramine
1st generation oral antihistamine
MOA: H1 blocker
allergic rhinitis
ANTICHOLENERGIC EFFECT, drowsiness
Xasthma, angle closer glaucoma dementia
INTERESTING:
1. DO NOT USE WITH OTHER ANTICHOLERNERGIC DRUGS LIKE IPRATROPIUM BROMIDE NASAL SPRAY=DROWSINESS CONFUSION
- Elderly it causes confusion and children causes excitatory effect
- always do a urine test in elderly when showing confusion because it can be indicative or a UTI
antihistamines (diphenhydramine, fexophenadine, azelastine) all have the same MOA. They work on the_____
H1 receptor
fexophenadine HCL
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
2nd generation antihistamine
Allergic rhinitis
MOA: blocks H1 receptor
X: Increases cholerginic effect of other drugs, asthma, angle closure gluacoma dementia
interesting:
- Verapamil increases the [conc] of this drug
- dimishes the impact of actetlycholinesterases in dementia
3. does not cross BBB, caution in lactation
benzocaine otic
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
topical otic analgesic, intact TM
may cause vertigo
effective in about 50% of children for 30-60 min
Neomycin +
colistin, hydrocortisone, Thonzonium
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
topical antibiotic/antinflammatory (steroid)
ottisis externa with intact TM
caution in hypersensitivitiy
Interesting:
- can be very sensitive and CREATE otitis media externa symptoms in patient with a RASH
many people are very sensitive to NEOMYCIN. If sensitive what happens? This happens in what percent of people?
causes otitis externa like symptoms and a rash, people take more of it and then it gets worse
15% of people have sensitivity
what should you use for ear drops if there is a perforated TM? why?
opthalmic
otic drops are acidic like the ear canal but if there is a perforation then it can get into the middle ear which is NOT ACIDIC, therefore you need to use a neutral PH drug, which include opthalmolgoy drops.
Use these in the ear instead!
Nystatin
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
oral antifungal med
creates pores in the membrane the fungus causing death
candidiasis
1. oral form not absorbed systemically
2. SWISH SWIRL SWALLOW
what is it important to do during oral candidiasis? What is the presentation of thrush in children and elderly?
need to swish, swirls, and swallow to get rid of any infection that may have gotten into the esophagus
In children: white patches
In elderly: bright bright red, need to look under the dentures and encourage good oral hygiene
meclizine
Drug class?
MOA?
What do you use it for?
Don’t use in?
Intresting?
anti-vertigo drug
MOA: anticholinergic impact on chemoreptor, blocks conduction in middle ear vestibular-cerebral pathway
X: ALCOHOL and other cholingeric drugs
DO NOT DRIVE OR DRINK ALCOHOL WITH THIS DRUG
why is it important to presribe meclazine regullary instead of PRN?
want to prescribe regular does and then taper it because PRN you have to wait for the symptoms to come before taking it. Presribe and then taper it off because benign Paryoxymal Postional Vertigo BPPV usualy resolves within 30 days!
acyclovir
anti-viral agent
MOA: blocks viral nucleic acid synthesis
Herpes simplex, varicella zoster, EBV, CMV
XCrCl, need to monitor kidney function!!
neuro and renal toxicity increased with probenicid cimetadine
why does acyclovir only accumulate in viral cells? how long can a person use this drug for? what is the ratio of accumulation vs regular cell?
-requires viral kinases for activation so it only occures in viruses
40-100X acculmination in infected cell compared to regular cell
they can use this drug from 1-10 years
