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pharm ENT Module > Test#3: random tid bits > Flashcards

Test#3: random tid bits Flashcards

1
Q

what do you use for allergic rhinitis in a person with glaucoma?

A

cromolyn sodium; only nasal spray that can be used in glaucoma

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2
Q

what happens when you use diphenhydramine in children? what would you want to switch them to?

A

makes them crazy, “aggitated” and restless.

Switch to: flexophenadine, makes them less excitatory, follow up in 24 hours for craziness

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3
Q

what causes vasomotor rhinitis? treatment for that?

A

thinning of the membrane causes clear rhinnoreah that doesn’t stop.

SYMPTOMATIC TX

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4
Q

what causes rhinnoreah in pregnant women? treatment?

A

increase levels of estrogen

SYMPTOMATIC TX

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5
Q

what do you do for a man who has been using oxymatazolone for years and what do you want to put him on instead?

A

ween him off slowly otherwise will get medicamatosa, slowly transition him to fluticasone corticosteroid, have him use the oxymetazalone first and then the steroid so it can get in there, take away oxymetazalone when steroids at full dose!

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6
Q

how long does fluticasone or corticosteroids take to show their effects? whats their bioavaliavility?

A

7-14 days, only 1-2% which is why it takes so long

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7
Q

what is the DOC for a 1 year old with acute ottitis media? what if they were already prescribed that in the last month?

A
  • amoxicillin

- augmentin

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8
Q

how long does it take to seen abx relief?

A

48-72 hours

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9
Q

when CAN benzocain ottic be used? what is the efficacy in children and for how long?

A

when TM is intact

effective in 50% of children for 30-60 mins

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10
Q

what is the DOC for ottitis externa? If they are sensitive to this drug what is the next one you should use?

A
  • Cortasporin, if sensitive to neomycin use 2nd.

- cipro-ottic: thin so can be absorbed by an earwick

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11
Q

if someone is sensitive to neomycin what would you typically see? what percent of people are sensitive to neomycin?

A

15%

creates symptoms of ottis externa and a rash

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12
Q

what should you use instead of otic drops if the TM is perforated?

A

opthalmic drops that are PH neutral

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13
Q

Caution: what do over the counter sleep aids contain? why is this a problem is someone is taking ipratropium bromide?

what can they switch to?

A

sleep aids contain diphenhydramine, this has a sedrating effect that is increased with other anticholerengic drugs.

Ipratropium bromide has anticholergenic properties so it increase the sedation and confusion!!!

melatonin safer instead, observe for 48 hours!

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14
Q

what should you use to treat BPPV? how should it be prescribed? what should you watch for?

A

meclazine, scheduled not PRN because then you have to wait for symptoms to present

BRONCIAL SECRETIONS/SEDATION SINCE ANTICHOLERGNCI. NO ALCOHOL OR DRIVING!!

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15
Q

what is the DOC for dental pain/abcess? how is it prescribed?

A

penicillin, prescribed for as long as it takes them to get in a see a dentist because the infection will come back if it isn’t treated untill seen by a dentist

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16
Q

what can make glaucoma even worse and you would definitely want to treat?

A

diabetes

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17
Q

tramadole and codeine are what type of drugs?

A

PRODRUGS

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18
Q

what populations of people specifically are slow metabolizers of prodrugs? what system effects a persons ability to break down prodrugs?

A

Asians! 20% chance of being a slow metabolizer, substitute with tylenol or injections instead! P450 highlight

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19
Q

what populations (2) can be hypermetabolizers of prodrugs?

A

moms who are breastfeeding and post op children (especially when tonsils are removed!) can lead to DEATH

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20
Q

when can you use a ottic-analgesic?

A

when pain in the ear when TM is intact

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21
Q

what things can set a person up for thrush?

A

T2DM, corticosteroids, antibiotics, symbicort inhaler for COPD

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22
Q

what should you use to treat oral thrush and how long for healthy and unhealthy individuals?

A

nystatin, swish, swirl, and swallow

7 days in healthy, 10 in unhealthy

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23
Q

what is the appearance of thrush in children and adults?

A

children: white patches
adults: BRIGHT RED with SMOOTH tongue, make sure to look under the dentures

24
Q

if someone is flying on a plane and has congestion, what can you suggest they use?

A

oxymetazalone 20 mins before taking off and landing, one spray and then one more time, will decongest and allow the eutachian tube to work properally

25
if someone has post nasal drip with bilateral nasal polys that look like peeled grapes what should they take?
use oxymatazalone first to get the fluticasone into the nose, and then taper the oxymatazalone
26
what is the difference between unilateral and bilateral nasal polys?
bilateral. ..probally chronic allergies | unilateral. ..more likely cancerous GET TO ENT
27
Explain the DOC methodology for strep throat!!
DOC: 1. penicillin 2. allergic to penicillin->clindamycin (sadly expensive and also causes c.diff) so may also choose 3. macrolides (erythromycin, azithromycin, clarithromycin) IF clinda is too expsenive or if there is resistance in the community!!
28
strep throat contact spread is _______. ______ of cases aren't infectious after 24 hours of antibiotic
strep throat contact spread is 35%. 80% of cases aren't infectious after 24 hours of antibiotic
29
what is the only nasal spray you can/should use in glaucoma?
cromolyn sodium, mast cell stabalizer
30
what should you avoid in gluacoma?
1. ALL ANTIHISTAMINES (azelastine, diphenhydramine, fexophenadine) 2. All nasal sprays except cromolyn sodium
31
when you are taking oxymatazalone it is important to stop______
taking oral decongestants like pseudophedrine and phenylephrine
32
which drug can cause anxiety?
azelastine HCL, nasal antihistamine spray
33
which drug should you worry about nasal septum perforation in and avoid using in people with cataracts?
fluticasone
34
whats is the systemic bioavaliability of fluticasone
1-2%
35
fluticasone is avaliable as _______ for asthma
Flovent
36
what percent of strep is resistant now
20%
37
what is the maximum dose you can prescribe to a obses child?
the max dose is the max dose for an adult. NEVER GO OVER THIS!!!
38
what are the percentages for ipratropium bromide for children and adults?
.03% for children | .06% for adults
39
what drug is good for children and pregnant women and has a bad taste?
cromolyn sodium
40
if a patient is taking diphenhydramine and is confused...what do you always want to do?
take a UTI culture because UTIs cause confusion too
41
Fexophenadine's effects are increased by which drug specifically?
Verapamil ( Heart med)
42
Don't use antihistamines in dementia patients!f
FUN FACT
43
which drug is too toxic for systemic use
nystatin, oral form is NOT absorbed systemically.....thank god!
44
which drug causes bronchial secretion thickening?
anti-vertigo meclizine
45
how soon does BVVP ususally resolve?
30 days
46
which is the only drug on our list that causes delirium and seizures in OD and is renally cleared?
acyclovir
47
what increases the renal and neuro toxicity of acyclovir?
probenicid cimetadine
48
why does acyclovir only work on viruses and not our cells?
it requires viral kinases, we don't have those so it acculates 40-100x in infected cells
49
what is the oral bioavaliability of acyclovir? what happens when you increase the dose?
10-30%, increasing dose decreases bioavaliability. HUH.......
50
Valcyclovir is the.....
prodrug for acyclovir
51
how long can you use acyclovir and how much does it decrease viral shedding and transmission
1-10 years decreases shedding 90% decreases transmission 50%
52
Betaxolol has a half life of
12 hours
53
bimatoprost has a halflife of ______, and this is why it is a first line drug, its QUICK!
45 mins!
54
dorzolomide has a halflife of _________. don't use with a eGFR ______
dorzolomide has a halflife of 4 months! what? | don't use with a eGFR
55
what glaucoma med can cause steve johnson syndrome and superficial punctinate keratitis?
dorzolomide
56
what gluacoma med causes an increase in HTZ and CNS deprsesion?
brimonidine
57
first line drug for glaucoma is______. second line drug is ______.
1st-bimatoprost | 2nd-beta blocker

pharm ENT Module (2 decks)

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