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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
Q

What is the prescriptive antitussive?

A

Codeine

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26
Q

If someone with a narcotic addiction needs an antitussive what should we give them?

A

The over the counter version

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27
Q

What is Dextromethorphan Hydrobromide?

A

Over the counter antitussive

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28
Q

What pregnancy category is Dextromethorphan Hydrobromide?

A

Pregnancy category C

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29
Q

How is Dextromethorphan Hydrobromide given?

A

PO

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30
Q

How does Dextromethorphan Hydrobromide work?

A

Temporarily suppresses a non productive cough, and reduces viscosity of tenacious secretions

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31
Q

What are contraindications for Dextromethorphan Hydrobromide?

A

COPD, chronic productive cough, hypersensitivity, MAOIs, children < 2

32
Q

What are side effects of Dextromethorphan Hydrobromide?

A

N/D, drowsiness, sedation

33
Q

What are adverse effects of Dextromethorphan Hydrobromide?

A

Hallucinations at high doses

34
Q

What are drug interactions of Dextromethorphan Hydrobromide?

A

Increased toxicity with MAOIs, narcotics, sedatives, barbiturates, alcohol, antidepressants

35
Q

What are the trade names for Dextromethorphan Hydrobromide?

A

Vicks 44, Benylin, Sucrets cough control, Robitussin

36
Q

How do Topical Nasal Decongestants work?

A

Sympathomimetic, affect the SNS to cause vasoconstriction, cause less inflammation of the nasal membrane

37
Q

What are the indications for Topical Nasal Decongestants?

A

Relieve the discomfort of nasal congestion that comes with the common cold, sinusitis, and allergic rhinitis

38
Q

How are Topical Nasal Decongestants absorbed, metabolized, and excreted?

A

Generally not absorbed systemically, any portion that is, is metabolized by the liver and excreted in the urine

39
Q

What are the contraindications of Topical Nasal Decongestants?

A

Lesion/erosion in the mucous membrane

40
Q

What can Topical Nasal Decongestants cause?

A

CVA, HTN, Renal failure

41
Q

What are adverse effects of Topical Nasal Decongestants?

A

Local stinging and burning, rebound congestion, rebound vasodilation

42
Q

What are drug interactions of Topical Nasal Decongestants?

A

Cyclopropane and halothane

43
Q

What is Ephedrine?

A

Topical nasal decongestant

44
Q

What are the indications for Ephedrine?

A

Relief of nasal congestion, and adjunctive therapy for middle ear infections to decrease congestion around the eustachian ostia

45
Q

How does Ephedrine work?

A

Has sympathomimetic effects, vasoconstriction lead to a decrease in edema and inflammation of the nasal membranes

46
Q

How is Ephedrine given?

A

Nasal spray

47
Q

What is the onset of Ephedrine?

A

Immediate

48
Q

What is the duration of Ephedrine?

A

4-6 hours

49
Q

What is the half life of Ephedrine?

A

0.4-0.7 hours

50
Q

What are the adverse effects of Ephedrine?

A

Disorientation, confusion, lightheadedness, N/V, fever, rebound congestion

51
Q

How do Oral decongestants work?

A

Shrink the nasal mucus membrane by stimulating the alpha-adrenergic receptors in the nasal mucous membranes

52
Q

What are the indications for Oral decongestants?

A

Promote drainage of the sinuses and improve air flow

53
Q

How are Oral decongestants absorbed, metabolized, and excreted?

A

Well absorbed, widely distributed throughout the body, metabolized in the liver, excreted in the urine

54
Q

What are contraindications of Oral decongestants?

A

Any condition that might be exacerbated by sympathetic activity (MI, CAD, history of CVA)

55
Q

What are the adverse effects of Oral decongestants?

A

Rebound congestion, sympathetic effects

56
Q

What are the drug interactions of Oral decongestants?

A

Over the counter products that contain pseudoephedrine, concurrent use can cause serious side effects

57
Q

What version of the Oral decongestants should diabetics take?

A

The bottle labeled for them because it has the sugar removed

58
Q

What are the indications for Nasal steroid Decongestants?

A

Seasonal allergic rhinitis and inflammation after the removal of nasal polyps

59
Q

How is Nasal steroid Decongestants absorbed?

A

Not systemically

60
Q

What is a contraindication for Nasal steroid Decongestants?

A

Acute infection

61
Q

What should we take caution with regarding Nasal steroid Decongestants?

A

Active infections and avoid exposure to airborne infections like the flu

62
Q

What are the adverse effects of Nasal steroid Decongestants?

A

Local burning and stinging dryness of the mucosa, headache, and suppression of healing can occur for pts who recently had surgery/trauma

63
Q

What is Flunisolide?

A

A nasal steroid decongestant

64
Q

How is Flunisolide given?

A

Nasal spray

65
Q

What is the onset of Flunisolide?

A

Immediate

66
Q

What is the peak of Flunisolide?

A

10-30 minutes

67
Q

What is the duration of Flunisolide?

A

4-6 hours

68
Q

What are the actions of Expectorants?

A

Thins and loosens secretions so it’s easier to cough up and clear the lungs

69
Q

What is the best natural expectorant?

A

Hydration

70
Q

What are the indications for Expectorants?

A

Symptomatic relief of respiratory conditions characterized by a dry and nonproductive cough

71
Q

What is Guaifenesin?

A

Expectorant

72
Q

How is Guaifenesin given?

A

PO

73
Q

What is the onset of Guaifenesin?

A

30 minutes

74
Q

What is the duration of Guaifenesin?

A

4-6 hours

75
Q

What are the adverse effects of Guaifenesin?

A

N/V, dizziness, HA, rash

PHARM EXAM 2 (10 decks)

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