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PHARM EXAM 2 > upper respiratory diseases > Flashcards

upper respiratory diseases Flashcards

1
Q

What are the upper respiratory diseases?

A

Common cold, Acute rhinitis, Sinusitis, Acute pharyngitis

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2
Q

What is the common cold caused by?

A

Rhinovirus, contracted by touching contaminated surfaces

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3
Q

When does the incubation period occur?

A

1-4 days before the onset of symptoms

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4
Q

How long is the period of infection?

A

21 days, 7 days to start, 7 days during, and 7 days for it to go away

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5
Q

What is acute rhinitis?

A

Acute inflammation of the mucus membranes, accompanies the common cold

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6
Q

What is sinusitis?

A

Inflammation of the sinuses

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7
Q

What is acute pharyngitis?

A

Inflammation of the throat

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8
Q

What are sinusitis and acute pharyngitis typically caused by?

A

Viral infections

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9
Q

What are antihistamines?

A

H1 or H1 antagonists, block nasal secretions, they compete with histamine for receptor sites preventing the histamine response

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10
Q

What are the two types of histamine receptors?

A

H1 - when stimulated, the extravascular smooth muscle in the nasal cavity are constricted; H2 - when stimulated there is an increase of gastric secretions

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11
Q

What are the antihistamine generations and their side effects?

A

1st gen - drowsiness (significant), dry mouth, and other anticholinergic effects (med example: Benadryl); 2nd gen - nonsedating antihistamines, have fewer anticholinergic effects (med example: Allegra (fexofenadine), and loratadine (Claritin))

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12
Q

What antihistamine generation is Diphenhydramine (Benadryl)?

A

1st generation

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13
Q

What are the indications for Diphenhydramine (Benadryl)?

A

Treat allergic rhinitis and itching, prevent motion sickness, sleep aid, antitussive

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14
Q

What are contraindications for Diphenhydramine (Benadryl)?

A

Acute asthma attack, severe liver disease, lower respiratory disease, Neonate, MAOIs

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15
Q

What are drug interactions of Diphenhydramine (Benadryl)?

A

Increased CNS depression with alcohol, narcotics, hypnotics, barbiturates, MAOIs

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16
Q

What are side effects of Diphenhydramine (Benadryl)?

A

Drowsiness, fatigue, dizziness, urinary retention, constipation, dry mouth, decreased secretions

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17
Q

What is the paradoxical effect that can occur in children?

A

Excitation

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18
Q

What are the adverse effects of Diphenhydramine (Benadryl)?

A

Life threatening agranulocytosis, thrombocytopenia, and hemolytic anemia

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19
Q

How do antitussives work?

A

Act directly on the medullary cough center of the brain to inhibit the cough reflex

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20
Q

What are the indications for antitussives?

A

Control nonproductive cough

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21
Q

How are antitussives metabolized and excreted?

A

Metabolized in the liver, excreted in the urine

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22
Q

What are contraindications of antitussives?

A

Patients who need to cough to maintain airways, head injury and impaired CNS

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23
Q

In what patients should we take caution with when giving antitussives?

A

Hypersensitivity or history of narcotic addiction

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24
Q

What are the adverse effects of antitussives?

A

Drying effect on the mucous membranes, CNS effects (drowsiness and sedation), GI upset

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25
What is the prescriptive antitussive?
Codeine
26
If someone with a narcotic addiction needs an antitussive what should we give them?
The over the counter version
27
What is Dextromethorphan Hydrobromide?
Over the counter antitussive
28
What pregnancy category is Dextromethorphan Hydrobromide?
Pregnancy category C
29
How is Dextromethorphan Hydrobromide given?
PO
30
How does Dextromethorphan Hydrobromide work?
Temporarily suppresses a non productive cough, and reduces viscosity of tenacious secretions
31
What are contraindications for Dextromethorphan Hydrobromide?
COPD, chronic productive cough, hypersensitivity, MAOIs, children < 2
32
What are side effects of Dextromethorphan Hydrobromide?
N/D, drowsiness, sedation
33
What are adverse effects of Dextromethorphan Hydrobromide?
Hallucinations at high doses
34
What are drug interactions of Dextromethorphan Hydrobromide?
Increased toxicity with MAOIs, narcotics, sedatives, barbiturates, alcohol, antidepressants
35
What are the trade names for Dextromethorphan Hydrobromide?
Vicks 44, Benylin, Sucrets cough control, Robitussin
36
How do Topical Nasal Decongestants work?
Sympathomimetic, affect the SNS to cause vasoconstriction, cause less inflammation of the nasal membrane
37
What are the indications for Topical Nasal Decongestants?
Relieve the discomfort of nasal congestion that comes with the common cold, sinusitis, and allergic rhinitis
38
How are Topical Nasal Decongestants absorbed, metabolized, and excreted?
Generally not absorbed systemically, any portion that is, is metabolized by the liver and excreted in the urine
39
What are the contraindications of Topical Nasal Decongestants?
Lesion/erosion in the mucous membrane
40
What can Topical Nasal Decongestants cause?
CVA, HTN, Renal failure
41
What are adverse effects of Topical Nasal Decongestants?
Local stinging and burning, rebound congestion, rebound vasodilation
42
What are drug interactions of Topical Nasal Decongestants?
Cyclopropane and halothane
43
What is Ephedrine?
Topical nasal decongestant
44
What are the indications for Ephedrine?
Relief of nasal congestion, and adjunctive therapy for middle ear infections to decrease congestion around the eustachian ostia
45
How does Ephedrine work?
Has sympathomimetic effects, vasoconstriction lead to a decrease in edema and inflammation of the nasal membranes
46
How is Ephedrine given?
Nasal spray
47
What is the onset of Ephedrine?
Immediate
48
What is the duration of Ephedrine?
4-6 hours
49
What is the half life of Ephedrine?
0.4-0.7 hours
50
What are the adverse effects of Ephedrine?
Disorientation, confusion, lightheadedness, N/V, fever, rebound congestion
51
How do Oral decongestants work?
Shrink the nasal mucus membrane by stimulating the alpha-adrenergic receptors in the nasal mucous membranes
52
What are the indications for Oral decongestants?
Promote drainage of the sinuses and improve air flow
53
How are Oral decongestants absorbed, metabolized, and excreted?
Well absorbed, widely distributed throughout the body, metabolized in the liver, excreted in the urine
54
What are contraindications of Oral decongestants?
Any condition that might be exacerbated by sympathetic activity (MI, CAD, history of CVA)
55
What are the adverse effects of Oral decongestants?
Rebound congestion, sympathetic effects
56
What are the drug interactions of Oral decongestants?
Over the counter products that contain pseudoephedrine, concurrent use can cause serious side effects
57
What version of the Oral decongestants should diabetics take?
The bottle labeled for them because it has the sugar removed
58
What are the indications for Nasal steroid Decongestants?
Seasonal allergic rhinitis and inflammation after the removal of nasal polyps
59
How is Nasal steroid Decongestants absorbed?
Not systemically
60
What is a contraindication for Nasal steroid Decongestants?
Acute infection
61
What should we take caution with regarding Nasal steroid Decongestants?
Active infections and avoid exposure to airborne infections like the flu
62
What are the adverse effects of Nasal steroid Decongestants?
Local burning and stinging dryness of the mucosa, headache, and suppression of healing can occur for pts who recently had surgery/trauma
63
What is Flunisolide?
A nasal steroid decongestant
64
How is Flunisolide given?
Nasal spray
65
What is the onset of Flunisolide?
Immediate
66
What is the peak of Flunisolide?
10-30 minutes
67
What is the duration of Flunisolide?
4-6 hours
68
What are the actions of Expectorants?
Thins and loosens secretions so it's easier to cough up and clear the lungs
69
What is the best natural expectorant?
Hydration
70
What are the indications for Expectorants?
Symptomatic relief of respiratory conditions characterized by a dry and nonproductive cough
71
What is Guaifenesin?
Expectorant
72
How is Guaifenesin given?
PO
73
What is the onset of Guaifenesin?
30 minutes
74
What is the duration of Guaifenesin?
4-6 hours
75
What are the adverse effects of Guaifenesin?
N/V, dizziness, HA, rash

PHARM EXAM 2 (10 decks)

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