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OTC FINAL
Stack #29758
| Question | Answer |
|---|---|
| How many colds per year do children have? | 6-10 |
| What affects the development of severity of a cold? | Stress Allergic Disorders Menstrual Cycle |
| Name 8 Symptoms of the common cold | 1 Sore throat 2 Nasal congestion 3 Rhinorrhea 4 Sneezing 5 Cough 6 Chills 7 HA 8 Malaise (Myalgia, Fever: children) |
| How long do symptoms last for the common cold? | Symptoms can last 2-14 days, but 2/3 of people recover in 7 days |
| Ascorbic Acid | HAs not been shown to prevent or shorten the duration of colds |
| Zinc | Controversial Evidence |
| What are active ingredients found in combination products to treat pain and cold symptoms, flu and allergy | Decongestant Antihistamine Analgesic Expectorant |
| Pseudophedrine | Sudafed (Systemic) Alpha-adreneric agonist Produces vasoconstriction in the blood vessels of the nasal mucosa |
| Decongestants SFX | Cardiovascular stimulation Increased BP, tachycardia, arrhtyhmias CNS Stimulation Restlessness, insomnia, anxiety, tremors, fear hallucinations |
| What group of patients are more likely to experience AE related to decongestants | HBP CV Disease Cold Children and geriatric |
| Phenylephrine (topical/nasal) | Neo-synephrine Short-acting (4-6 hours) |
| Xylometazoline (topical/nasal) | Otrivin Intermediate acting (8-10 hours) |
| Oxymetazoline (topical/nasal) | Afrin Long-acting (12 hours) |
| What are the drug interactions of decongestants? | Antagonizes antihypertensives effects, hypertensive crisis/cardia arrythmias with MAOIs |
| MOA of antihistamines | Block H1 receptors preventing histamine from stimulating them and exert anticholinergic andsedative effects |
| What is the role of antihistamines in the common cold? | We use antihistamines for their anticholinergic SFX. Histamine has nothing to do with colds. |
| Diphenhydramine | (antihistamine)Benadryl |
| Brompheniramine | (antihistamine)Dimetapp |
| Chlorpheniramine | (antihistamine)Chlor-Trimeton |
| Clemastine | (antihistamine)Tavist |
| Tripolidine | (antihistamine)Actifed |
| Loratadine | (antihistamine)Claritin useless in colds has no anticholinergic effects |
| What are the common SFX associated with antihistamines? | Sedation, dizziness, anticholinergic |
| Antihistamines are contrainidcated in what type of patients? | Patients with narrow-angle glaucoma, BPH, BLadder obstruction. Geriatric patients are more likely to suffer dizziness, excessive sedation, syncope, hypotension |
| Antihistamine: SFX in children | Paradoxical CNS stimulation, irritability, insomnia, tremors, convulsions |
| Combination: Antihistamine/Decongestant | Drixoral, PediaCare, COmtrex, Benadryl (allergy and sinus HA) |
| Acute Cough | Acute </=3 weeks, URT, PE, Pneumonia |
| What drugs cause cough? | ACE inhibitors, Beta-Blockers (Systemic and opthalmic in patients with COPD) |
| Productive Cough | "wet" "cheesy" Clear (bronchitis) Purulent (bacterial infection) Discolored (inflammatory disorders) Malodorous (anaerobic bacterial infection) |
| Nonproductive cough | "Dry" "Hacking" Viral, Atypical bacterial, GERD, Cardiac diseases, Drugs |
| Antitussive | Cough suppressant, Control or eliminate cough, For the non-productive cough |
| Expectorant | Stimulates bronchial mucus production; for non productive coughs when cannot cough up mucus |
| Coughs to refer | Thick yellow or green phlegm, Fever >101.5, Cough >7-10 days, Weight loss, Night sweats, Hemoptylisis, Foreign object aspiration, Underlying disease states |
| Vaporizers or humidifiers | Increased humidity may soother airways and decrease cough. May accelerate mold growth and worsen allergies |
| Cool mist or Warm-mist? What should you recommend? | Both do the same job, so better to use cool since the warm might burn. Cannot put Vicks in cool mist. |
| Dextromethorphan | Acts centrally on cough center of the medulla. Non-opiod, no analgesic,s edative, respiratory depressant, addictive properties at usual doses |
| Destromethorphan SFX | dizziness, GI dustrubances. Additive with CNS depressants |
| Antitussives SFX | nausea, abdominal pain, dizziness |
| Antihistamine for cough | Added to many cough and cold remedies as antitussives and to treat rhinorrhea and nasal congestion, may act indirectly by reducing postnasal drips (efficacy no well documented) |
| Ahtihsitamine for cough SFX | drowsiness, disturbed coordination, anticholinergic SFX (efficacy not well documented) |
| Topical Antitussives | Inhaled vapors stimulate sensory nerve endings within the nose and mucosa creating a local anesthetic sensation and improved air flow (efficacy data lacking) |
| Topical Antitussives SFX | burning sensations in the mouth, N/V/D |
| Camphor | Antitussive |
| Menthol | Antitussive |
| Chlorasepctic | Antitussive |
| Cepacol | Antitussive |
| Guaifenesin | Efficacy questionable at previously available OTC doses. |
| Guaifenesin SFX | (Expectorant) Symptom: Cough (wet, junky)well tolerated, N/V/D, dizziness, HA abdominal pain, NO DI's |
| 3 Antitussive/Expectorant Combination products | Robitussin DM, Benylin, Diabetic Tussin |
| Pain relievers | 1 Salicylates (ASA most common) 2 NSAIDS (Ibuprofen, naproxen, ketoprofen) 3 Acetaminophen (APAP: has no antiinflammatory effect) |
| Symptoms treated w/ antipyretic, analgesics | Fever, HA, aches and pains |
| SAR | Seasonal, repetitive and predictable |
| PAR | Perennial; persist through the year, no seasonal pattern |
| Etiology of Allergic Rhinitis | Triggeered by aeroallergens, outdoor, indoor, occupational |
| Signs and symptoms of Allergic Rhinitis | Engorged nasal mucosa, posterior oharynx my have cobblestone appearance, dark circles under eyes due to venous congestion, open mouth breathing, |
| 3 Steps to treating Allergic Rhinitis | Avoid allergens, Pharmacotherapy, Immunotherapy |
| Pharmacologic Therapy for SAR | regular use of medication. Starting meds at least 1 week before symptoms usually appear (antihistamines and decongestant) |
| Pharmacologic therapy for PAR | Regular use of meds starting before known exposures (antihistamines and decongestant) |
| Intranasal Cromolyn | May help if intranasal and systemic antihistamjines fail. Stabilizes mast cells, preventing mediator release. |
| Intranasal Cromolyn dosing | One spray in each nostril 3-6 times QD. 3-7 days for initial effect, 2-4 weeks max effect. |
| Intranasal Cromolyn SFX | sneezing, nasal stinging and burning |
| Antihistamine SFX | (Anticholinergic) Dryness; eyes, motuh nose, blurred vision, urinary retention, constipation, tachycardia |
| Anthistamine SFX high doses | NErvousness, Tremor, Insomnia, Agitation, Irritability |
| Antishistamine SFX CNS Stimulation | Anxiety, Hallucinations, Appetitie stimulation, Muscle Dyskinesias (spams), activation of epileptogenic foci |
| Antihistamines SFC CNS Depression | Sedation, Impaired performance (Bendadryl is bad for old people) |
| Antihistamine Drug interactions | benzodiazapines, barbiturates, opioids, phenothiazines (potentiates CNS depressant effects) |
| Nasal wetting agents | Saline, propykene, polyethylene glycol sprays (NO SFX) |
| What is immunotherapy most effective for | Pollen-related allergens |
| Immunotherapy dosing | Maintnance dose 4-8 months. Maintenace dose injections every 3=4 weeks for 3-5 years. |
| What is the initial drug of choice for pregnant women? | Intranasal cromolyn |
| Which drugs are not tolerated after the first trimester in pregnant women to treat allergic rhinitis? | Loratadine and Cetirazine (Which drugs are not tolerated after the first trimester inWhich drugs are not tolerated after the first trimester in pWhich drugs are not tolerated after the first trimester in preWhich drugs are not tolerated aftgnregn pregnRX) |
| Which drug do you avoid for the first trimester of pregnancy to treat allergic rhinitis? | Pseudophedrine |
| What drugs do you use in children to treat allergic rhinitis? | Non-sedating antihistiamine |
| Which drugs do you avoid in children to treat allergic rhinitis? | Systemic corticosteroids and topical decongestants |
Created by:
maddskillzz
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