Rhinitis, Coughs, Colds & Flu

Question 1

Rhinitis?

Answer 1

Inflammation of nasal mucous membranes

Question 2

What are the two different kinds of rhinitis?

Answer 2

1. Infectious
   -Viral(colds and flu)
   -Bacterial(sinusitis0
2. Non-infectious:
   -Allergic
   -Non-allergic(vasomotor)

Question 3

What is bacterial sinusitis treated with?

Answer 3

Treated with appropriate antibiotics & nasal irrigation(saline solution) sprays

Question 4

Which immunoglobulins mediate Rhinitis?

Answer 4

IgE

Question 5

Non-allergic rhinitis

Vasomotor or chronic?

Answer 5

Chronic

Question 6

Symptoms of non-allergic rhinitis?

Answer 6

-Sneezing & Congestion
-Rhinitis
-Postnasal drip
-Phlegm
-Cough

Question 7

Aetiology of non-allergic rhinitis?

Answer 7

Hyper-responsiveness of the nerve endings in the nostril

Question 8

Triggers of non-allergic rhinitis?

Answer 8

-Odours
-Irritation in the air(smoke)
-Changes in the weather
-Medication(aspirin, beta-blockers, sedatives and antidepressants)
-Foods & beverages(alcohol)
-Hormonal changes

Question 9

What is the treatment of non-allergic rhinitis?

Answer 9

-Nasal-corticosteriods
-Short-term decongestant

Question 10

Allergic rhinitis symptoms?

Answer 10

-Itching
-Sneezing
-Rhinorrhea & ocular symptoms
-Little effect on congetsion

Question 11

Which second generation antihistamines treat allergic rhinitis ?

Answer 11

Loratadine
Cetirizine
Fexofenadine
Rupatadine

Question 12

Which receptor (classification) does the Rupatadine receptor act on?

Answer 12

Antagonist at the PAF receptor-G-coupled receptor

Question 13

When is Rupatadine effective and what is its usage?

Answer 13

Early and late phase
&
Long lasting H1-antagonist

Question 14

Intranasal corticosteroids drugs antihistamines?

Answer 14

A Long Nose

-Azelastine
-Levocabastine
-intraNasal corticosteroids

Question 15

Cromoglyic acid?

Answer 15

Intermittent allergic rhinitis

Question 16

Intranasal corticosteroids uses?

Answer 16

-Anti-inflammatory action
-Decreased mucosal oedema
-Decreased number of mast cells

Question 17

Intranasal corticosteroids systemic effects?

Answer 17

Little Systemic effect

Question 18

Intranasal corticosteroids S/E?

Answer 18

-Dry nose
-Nasal bleeding
-Irritation of the throat
-Transient stinging
-Adrenal suppression(excessive use)

Question 19

Intranasal corticosteroids drugs?

Answer 19

BBF-CTM

Beclomethasone
Budesonide
Fluticasone
Ciclesonide
Triamcinolene
Mometasone

Question 20

Which antihistamines can not be used for children?

Answer 20

Intranasal corticosteroids
esp: Beclomethasone

Question 21

What are nasal preps?

Answer 21

1. Mesna(Mistabron)
   -Used for nasal obstruction dur to thick secretions

2.Sodium chloride(saline drops/spray)
-Safe to use in pregnancy, infants, babies and children under two

Question 22

Which drug is safe to use in children under two?

Answer 22

Sodium Chloride

Question 23

Types of influenza medication?

Answer 23

1. Neurominidase inhibitor(Influenza A & B)
2. NMDA-receptor antagonist
   (Influenza A only)

Question 24

Neurominidase inhibitor drugs?

Answer 24

Oseltamivir
Zanamivir

Question 25

Neurominidase inhibitor MOA?

Answer 25

Inhibit the neurominidase(sialidase) enzyme in both influenza A and B virus

Question 26

Neurominidase inhibitor indications?

Answer 26

-Used for prevention and treatment -Ability to limit the spread of the viral infection but only modest reduction in the symptoms duration

Question 27

Neurominidase inhibitor admin time?

Answer 27

Should be taken within 24-48hrs of the onset of symptoms

Question 28

NMDA-receptor antagonists drugs?

Answer 28

Amantadine Rimantadine

Question 29

NMDA-receptor indications?

Answer 29

-Influenza A only -Used for the prevention and treatment

Question 30

NMDA-receptor MOA?

Answer 30

M2 protein-selective ion channel of the influenza A but ineffective agonist influenza B

Question 31

What limits the usefulness of NMDA?

Answer 31

Widespread viral resistance and unwanted S/E limit the usefulness

Question 32

Vaccine S/E?

Answer 32

-Flu-like symptoms within 2-24hrs after vaccination -Pain and treatment at the site of the infection

Question 33

Vaccine ADR?

Answer 33

Allergic reactions

Question 34

Antitussive agents?

Answer 34

Cough suppressant mechanism to clear the throat of foreign particles and mucus

Question 35

Antitussive agents drugs?

Answer 35

Opiodanalgesics (dextromethaphan, codeine, pholcodeine)

Question 36

Antitussive agents S/E?

Answer 36

Sedation, constipation and nausea

Question 37

Demulgents?

Answer 37

Consists of sugar, lemon, honey and glycerol

Question 38

Demulgents increases what?

Answer 38

Saliva production and swallowing

Question 39

Demulgent indication?

Answer 39

Useful for a dry irritated throat?

Question 40

Expectorants?

Answer 40

Chesty coughs and increase the volume of bronchial secretions and reduces viscosity

Question 41

Expectorants drugs?

Answer 41

GAS Guaiphenesin Ammonium citrate Sodium Citrate

Question 42

Mucolytic agents?

Answer 42

Alters the structure of mucus and decreases viscosity

Question 43

Mucolytic agents drugs?

Answer 43

Nose Come Back Carbocisteine Bromhexine N-acetylcysteine

Question 44

Mucolytic agents S/E?

Answer 44

Nausea, vomiting and headaches

Question 45

Which mucolytic agent is used in cystic fibrosis?

Answer 45

Dornase alfaf

Question 46

Mucokinetics/Bronchodilators

Answer 46

Enhance mucocillary function

Question 47

Mucokinetics/Bronchodilators CI?

Answer 47

Cardiac arrhythmia Diabetes Hyperthyroidism Uncontrolled HT

Question 48

Mucokinetics/Bronchodilators drugs?

Answer 48

B2 adrenergic agonists: terbutaline, orciprenaline Xanthines: eg: theophylline

Question 49

Decongestants time uses and why?

Answer 49

Only short-term(4-5days) for periods of congestion DON'T USE OVER 5 days

Question 50

Local decongestants drugs?

Answer 50

Oxymetazoline Xylmetazoline Phenylephrine

Question 51

What are drug induced overuse of decongestant nasal sprays?

Answer 51

Pseudoephedrine

Question 52

Which mucolytic agent splits disulphide bonds into mucoproteins?

Answer 52

Acetylcysteine/N-acetylcysteine

Question 53

Which mucolytic agent is used in cystic fibrosis?

Answer 53

Acetylcysteine/N-acetylcysteine

Question 54

Dornase alfa side effect?

Answer 54

May cause voice alterations

Question 55

What is the durations the nasal decongestants?

Answer 55

Short duration: Phenylephrine Longer duration: Oxymetazoline & Xylometazoline

Question 56

MOA of nasal decongestants?

Answer 56

Alpha-1 adrenergic receptor: Phenylephrine, Oxymetazoline & Xylometazoline Mixed-action adrenergic agonist(alpha-1 and beta-2)- Ephedrine + Phenylpropanolaime