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Flashcards in ENT Pharm Deck (100)
1

What nasal spray is an antihistamine?

Azelastine HCl (Asteliln)

2

What nasal spray is a corticosteroid?

Fluticasone Propionate (Flonase)

3

What nasal spray is a anticholinergic?

Ipratropium Br (Atrovent)

4

What nasal spray is a mast cell stabilizer?

Cromolyn Na (Nasalcrom)

5

How long should patients use Oxymetazoline

3-5 days. Professor White said more like 5.

6

What is the MoA for oxymetazoline?

Vasosconstriction (direct-acting alpha agonist)

7

What are some SE/ADRs of oxymetazoline?

Rebound mucosal congestion & vascular irritation, stinging, burning, dryness, sneezing; hypertension in large dose; epistaxis, tachyphylaxis

8

Contraindications for oxymetazoline?

Continuous use, glaucoma

9

What should we monitor with oxymetazoline?

Length of use

10

What class is oxymetazoline?

Topical Nasal Decongestant NS

11

What class is Azelastine?

Nasal Spray-antihistamine

12

When do you use azelastine?

allergic rhinits

13

What is the MoA for azelastine?

H1 receptor blocker

14

Side effects of azelastine?

Headache, bitter taste, rhinitis, cough, somnolence; Hypertension, tachycardia, anxiety, glaucoma

15

Contraindicated for azelastine?

Hypersensitivity, glaucoma

16

What kind of nasal spray is Oxymetazoline?

Decongestant

17

Dx-Dx interactions for azelastine?

Other anti-cholinergic or sedating drugs

18

What class is Fluticasone a part of?

Corticosteroid nasal spray

19

When do you use Fluticasone?

Rhinitis (allergic, occupational, atrophic, vasomotor)

20

What is the MoA of Fluticasone?

Anti-inflammatory with vasconstrictor activity

21

SE/ADR of fluticasone?

Burning, irritation, dryness, headache, epistaxis; nasal septal perforation, epistaxis

22

What should we monitor in patients who take fluticasone?

Epistaxis

23

What class is Ipratropium Br a part of?

Anticholinergic (antimuscarinic) nasal spray

24

When do we use Ipratropium?

Vasomotor rhinits

25

MoA for Ipratropium?

Blocks acetylcholine at muscarinic receptors in parasympathetic nervous system

26

SE/ADR for ipratropium?

Epistaxis, dryness, nausea; avoid with glaucoma

27

What is contraindicated for Ipratropium?

Hypersensitivity; caution in asthma, prostatic hypertrophy, angle-closure glaucoma

28

Dx-Dx, ipratropium?

other anticholinergics

29

What class is Cromolyn a part of?

Mast cell stabilizer nasal spray

30

When do you prescribe cromolyn?

Allergic rhinits

31

MoA for cromolyn?

Stabilizes mast cell membrane so mediators (histamine, leukotrienes, etc) not released

32

SE/ADR for cromolyn?

Local stinging, burning, unpleasant taste, sneezing, occasional epistaxis

33

H1 antihistamine receptors are?

smooth muscle, endothelium, brain

34

H2 antihistamine receptors are?

GI mucosa, cardiac muscle, mast cells, brian

35

H1 generation is sedating or no?

Sedating

36

H2 generation is sedating or no?

Not sedating

37

What kind of drug is diphenhydramine?

1st generation antihistamine

38

When do you use diphenhydramine?

Allergic rhinitis

39

MoA for diphenhydramine?

H1 blocker

40

SE/ADR for diphenhydramine?

drowsiness (frequently significant); anti-cholinergic side effects.

41

Contraindications for diphenhydramine?

Prostatic hypertrophy, dementia; caution in asthma, angle-closure glaucoma

42

What often happens when children take diphenhydramine?

They get cray cray. That means crazy.

ok, ok..hyperactivity/excitatory impact

43

Dx-Dx for diphenhydramine?

other sedating drugs, especially other anti-cholinergic

44

Is diphenhydramine is effective as nasal corticosteroids?

Nope

45

What class does Fexophenadine belong to?

2nd generation oral antihistamine

46

When do use fexophenadine?

allergic rhinits

47

How many things do we use to treat allergic rhinitis?

too many. moving on.

48

MoA for fexophenadine?

H1 receptor blocker

49

SE/ADR for fexophenadine?

Headache, somnolence, dizziness; increases any anticholinergic effect of other co-administered drugs

50

Does fexophenadine cross the blood brain barrier?

Nope

51

What class does Benzocaine Otic belong to?

Topical otic analgesic

52

When do we use Benzocaine Otic?

Otalgia with intact tympanic membrane

53

MoA for benzocaine otic?

Topical analgesic

54

SE/ADR for benzocaine otic?

Vertigo

55

How effective is this in children?

About 50 percent of the time. Lasts about 30-60 minutes

56

What is the pH or eye drops?

7

57

What is the pH of ear drops?

58

What class does Neomycin, Colistin, Hydrocortisone, Thonzonium (Corticosporin-TC Otic Solution/Suspension) belong to?

Antibiotic-hydrocortisone Otic solution/suspension

FYI just calling this drug Corticosporin from now on.

59

When do we use Corticosporin-TC?

Otitis externa with intact tympanic membrane

60

SE/ADR of corticosporin?

Mucosal irritation and edema with over use; Neomycin sensitivity can develop during course of use

61

What do we need to look out for with corticosporin?

Hypersensitivity--especially to neomycin

62

What class does Nystatin belong to?

Polyene Antifungal Antibiotic, topical use only, candida species only

63

When do we use Nystatin?

Thrush, oral candidiasis in immune intact host

64

MoA of nystatin?

Binds to fungal membrane, creates pores in membrane disrupting membrane integrity

65

SE/ADR of nystatin?

Unpleasant taste, NVD; Too toxic for systemic use (IV or IM)

66

Is the oral form absorbed systemically?

No. Swish/swirl/swallow 4 times a day

67

What class does Meclizine belong to?

Antiemetic, antihistamine

68

When do use Meclizine?

Prevent/treat vertigo, motion sickness

69

MoA of Meclizine?

Anticholinergic impact on chemoreceptor trigger zone; blocks conduction in middle ear vestibular-cerebellar pathway

70

Contraindications for meclizine?

Hypersensitivity; caution in asthma, prostatic hypertrophy, angle-closure glaucoma, dementia

71

SE/ADR of meclizine?

Sedation, thickening bronchial secretions

72

Dx-dx of meclizine?

Avoid ethanol, other anticholinergic medications

73

What class does acyclovir belong to?

Nucleoside Anti-herpes virus

74

When do you use acyclovir?

HSV-1, HSV-2, VZV, EBV, CMV (not as much(, HHV-6

75

MoA for acyclovir?

Block herpes virus nucleic acid synthesis

76

SE/ADR for acyclovir?

Nausea, diarrhea, headache; nephritis, tremors, delirium, seizures with overdose

77

What else should we know about acyclovir?

White wrote A LOT so....

PO, IV, topical formulations; requires viral kinase for activation so accumulates only in virus infected cells. Eliminated via glomerular filtration and tubular secretion; variability in viral sensitivity so varying dosing levels by virus; resistance may develop.

If any of you are still reading this, i love you.

78

What class does Betaxolol belong to?

Ophthalmic beta1 blocker anti-glaucoma drug

79

When do you use Betaxolol?

Chronic open-angle glaucoma; ocular hypertension

80

MoA of Betaxolol?

Reduces IOP by decreasing production of aqueous humor

81

SE/ADRs of Betaxolol?

Ocular discomfort, bradycardia, bronchospasm, depression, heart block, exacerbation heart failure

82

Contraindications for betaxolol?

Sinus bradycardia, heart block >1st degree

83

What should you monitor when patients are on betaxolol?

IOP

FYI, that's for every glaucoma drug so i'm only asking it once. Monitor IOP. Got it!?!?

84

What class of drug is Bimatoprost?

Ophthalmic prostaglandin anti-glaucoma drug

85

How does Bimatoprost work?

Synthetic analog of prostaglandin which deceases IOP by increasing outflow of aqueous humor

86

I want to make this clear... what does a prostaglandin do?

increases outflow of aqueous humor.

87

When do we use Bimatoprost?

Chronic open-angle glaucoma or ocular hypertension; hypotrichosis of eyelashes

88

SE/ADRs of Bimatoprost?

Ocular hyperemia, growth of eyelashes, ocular pruritus, headache, dry eyes, photophobia, brown pigmentation of iris and eyelid skin

89

Who shouldn't you prescribe this drug to?

People

90

What class does Brimonidine belong to?

Ophthalmic Alpha2 Agonist anti-glaucoma drug

91

When do you prescribe Brimonidine?

Chronic open-angle glaucoma, ocular hypertension

92

MoA for Brimonidine?

Selective agonism for alpha2-receptors causes reduced production of aqueous humor and increased outflow

AKA, this guy does both

93

SE/ADRs of Brimonidine?

Somnolence, allergic conjunctivitis, hyperemia, eye pruritus, HTN, xerostomia, CNS depression

94

Who don't we prescribe Brimonidine too?

Children

95

What class of drug does Dorzolomide belong to?

Ophthalmic Carbonic Anhydrous Inhibitor anti-glaucoma drug

96

When do you use Dorzolomide?

Chronic open-angle glaucoma or ocular hypertension

97

MoA for Dorzolomide?

Reversible inhibition of renal carbonic anhydrase causing increased renal excretion sodium, potassium, bicarbonate and water with decrease production of aqueous humor

98

SE/ADRs of Dorzolomide?

Eye discomfort, superficial punctate keratitis, ocular allergic reaction, blurred vision, photophobia, possible SJS

99

What happens when you co-administer verapamil and fexophenadine?

Increases the serum levels of fexophenadine

100

Who is going to rock this exam?

YOU ARE!

plus i was at 99 cards... needed one more.

but seriously. KILL IT!