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Nurp 423 Exam 1 > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What is 1st line treatment in allergic rhinitis?

A

Antihistamine

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2
Q

MOA of an ICS:

A

They help relieve congestion and rhinorrhea by limiting late-phase response and reducing inflammation.

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3
Q

Examples of ICS:

A

Budensonide, Flonase, Nasacort, Nasonex

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4
Q

When would a patient see effect of an ICS?

A

Begin working in 3-12 hours but patients may not experience max effect for 1-2 weeks.

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5
Q

When should an ICS be started for allergic rhinitis?

A

2-4 weeks prior to start of allergy season.

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6
Q

Adverse events of ICS:

A

Irritation, bleeding, septal perforation, can decrease height of children at high doses.

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7
Q

Is a mast cell stabilizer that prevents antigen-induced degranulation, decreasing the inflammatory response.

A

Intranasal cromolyn

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8
Q

Most common virus in an URI?

A

Rhinovirus

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9
Q

MOA of topical decongestants:

A

Stimulate the alpha and beta adrenergic receptors and this causes shrinkage of the tissue and vasoconstriction which relieves congestion and promotes drainage.

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10
Q

Example of a topical decongestant and how long to use for?

A

Afrin

No longer than 3 days d/t rebound congestion

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11
Q

Side effects of topical decongestants?

A

Bradycardia, tachycardia, HTN, and hypotension

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12
Q

MOA of oral decongestants:

A

Vasoconstriction of capillary vessels, theoretically decreasing congestion. They are sympathomimetic (stimulate the sympathetic nervous system).

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13
Q

Example of oral decongestants:

A

Pseudoephedrine (Sudafed)

Phenylephrine

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14
Q

What age can not relieve oral decongestants?

A

Do not give to children under 4.

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15
Q

Side effects of oral decongestants?

A

Tachycardia, HTN, anxiety, restlessness, irritability

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16
Q

Contraindications of oral decongestants:

A

CAD, uncontrolled HTN, narrow angle glaucoma, MAOI within 14 days

Use caution in elderly
Do not use in children under 4

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17
Q

Oral decongestants and 1st generation antihistamines Together May cause:

A

Urinary retention in BPH

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18
Q

MOA of expectorants:

A

Increase the output of respiratory tract fluid by decreasing the adhesiveness and surface tension of the respiratory tract and by facilitating the removal of viscous mucous.

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19
Q

Goal is to loosen bronchial secretion so they can be eliminated:

A

Expectorants

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20
Q

What is the best expectorant?

A

Hydration

21
Q

How long can you use expectorants for?

A

No longer than 1 week

22
Q

Example of expectorant:

A

Quaifenensin (robitussin)

23
Q

Side effects of expectorants:

A

Most common GI upset

Drowsiness, HA, dizziness

24
Q

MOA of antitussives:

A

Diminish cough reflex by direct inhibition of the cough center in the medulla.

25
Q

When to use antitussives:

A

Nonproductive, irritating cough

26
Q

Examples of antitussives:

A

Dextromethorphan
Tessalon perles
Codeine

27
Q

Dextromethorphan plus what may induce a serotonergic syndrome?

A

Antidepressants

28
Q

MOA of tessalon perles:

A

Numbs respiratory tract

29
Q

Tessalon perles are pregnancy category:

A

C

30
Q

Tessalon perles contraindications:

A

Do not use in kids under 10 or with an MAOI.

Do not use more than 2-3 times daily

31
Q

Do not use ASA in children with viral illness d/t:

A

Risk of Reye’s syndrome: sudden inflammation and swelling of the liver and brain that is often accompanied by a scaly rash

32
Q

MOA of anticholinergic agents:

A

Local application to the nasal mucosa that inhibits vagally mediated reflexes by antagonizing the action of acetylcholine at the cholinergic receptor, which inhibits secretions from the serous and seromucous glands lining the nasal mucosa.

33
Q

Example of an anticholinergic agent:

A

Ipratropium bromide

34
Q

Anticholinergic agents contraindicated in:

A

Children under 5

35
Q

Most common cause of viral sinusitis:

A

Rhinovirus

36
Q

Common bacterial pathogens of sinusitis:

A

S pneumoniae
H influenza
M catarrhalis
S aureus

37
Q

First-line antibiotics in sinusitis:

A

Amoxicillin
Augmentin *
Beta-lactamase cephalosporin

38
Q

Second line antibiotics for sinusitis:

A

High-dose amoxicillin

Respiratory fluoroquinolone- moxifloxacin or levofloxacin

39
Q

Antibiotics for sinusitis with PCN allergy:

A

Kids- macrolides or cefurozime

Adults: doxy or respiratory fluoroquinolone- Moxi/levo

40
Q

How long before you switch antibiotics with sinusitis:

A

Worsening after 72 hours on antibiotic

Can take 3-4 days for relief

41
Q

What is azelastine (astelin, patanase)?

A

Topical antihistamine used in allergic rhinitis

42
Q

Side effects of azelastine?

A

Bitter taste, somnolence, ha, nasal burning

43
Q

What is Atrovent?

A

Anticholinergic that is good for a runny nose.

44
Q

Atrovent is pregnancy category?

A

C

45
Q

Indications for Atrovent?

A

Allergic and non allergic rhinitis

46
Q

Is intranasal cromolyn safe in pregnancy?

A

Yes

47
Q

How long for intranasal cromolyn to work?

A

Up to 2 weeks

48
Q

What is an ocular antihistamine?

A

Patanol, pataday

49
Q

Are ocular antihistamines safe in pregnancy?

A

No category c

Nurp 423 Exam 1 (3 decks)

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