URI Case Flashcards
5 classes of meds used for URI
decongestants
pain/fever relievers
cough suppressants
cough expectorants
vitamins/supplements
2 classes of meds used for allergic rhinitis
antihistamines
intranasal corticosteroids
decongestants activate __ alpha and beta receptors
adrenergic
effect of decongestants on alpha adrenergic receptors
stimulate respiratory mucosa -> vasoconstriction -> reduced mucosal swelling -> improved ventilation
effect of decongestants on beta adrenergic receptors
bronchial relaxation
2 major s.e of decongestants include __,
which can lead to __ (6)
vasoconstriction, tachycardia
-angina
-HTN
-worsening CVD
-increased glycogenolysis and gluconeogenesis -> labile blood sugars
-CNS stimulation -> nervous, insomnia, dizzy, drowsy
-urinary retention
3 contraindications for decongestants
HTN
< 6 yo
first trimester pregnancy
only FDA approved decongestant for pt’s w. HTN
coricidin
1st line decongestant
pseudoephedrine (sudafed)
phenylephrine = garbage
7 cough suppressants
dextromethorphan
opiates
benzonate (tessalon)
lozenges
viscous preparations
menthol
camphor
where in the body do cough suppressants/antitussives work (2)
centrally -> medullary cough center
locally -> site of irritation
what 4 cough suppressants/antitussives work centrally on the medullary cough center
codeine
dextromethorphan
opiates
benzonate (tessalon)
what 2 cough suppressants/antitussives work locally at the site of irritation
lozenges
viscous preparations
menthol
camphor
which cough suppressant is an isomer of codeine but has a lower addiction profile
dextromethorphan
3 s.e of antitussives
nausea
dizzy
drowsy
t/f: dextromethorphan is safe in pregnancy
t!
contraindication for dextromethorphan
MAOIs
caution in w. SSRI
which antitussive can cause serotonin syndrome
dextromethorphan
sx of serotonin syndrome
confusion
agitation
tachycardia
HTN
twitching
muscle rigidity
diaphoresis
fever
sz
which cough suppressant is a common allergen
codeine
t/f: codeine is safe in pregnancy
f!
class C
t/f: benzonate is safe in pregnancy
f!
how do expectorants/antimucolytics work (3)
dissolve thick mucous
enhance airway clearing
promote cough
s.e of expectorants
n/v
rash
2 expectorants
mucinex
robitussin
active ingredient in expectorants
guaifensin
contraindication for expectorants
< 6 yo
t/f: guaifensin is safe in pregnancy
t!
what condition might guaifensin exacerbate
nephrolithiasis
what is robitussin DM
dextromethorphan/guaifensin
3 vitamins/supplements that might be supportive for URI
vitamin C
echinacea
zinc
tx for mild-mod bacterial sinusitis
augmentin 875 mg PO bid x 7 days
alt: doxycycline
tx for bacterial sinusitis if risk for resistance or abx failure
augmentin 2000 mg po bid x 10-14 days
alt: levofloxacin, moxifloxacin
tx for severe (inpt) bacterial sinusitis
ampicillin/sulbactram 3 g IV qid
alt: levofloxacin OR ceftriaxone
what abx are NOT recommended for bacterial sinusitis dt high rates of resistance to strep pneumo
macrolides
bactrim
2nd and 3rd gen cephalosporins
