Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
82 Cards in this Set
- Front
- Back
|
Characterized by inflammation of the lining of the nose;
symptoms include rhinorrhea, sneezing, and itching of the nose and eyes. Nasal congestion can occur. Sore throat may be associated with postnasal drip. |
Allergic Rhinitis
|
|
|
Caused by reactions to inhaled antigenic substances
|
Allergic Rhinitis
|
|
|
What are some SS of allergic rhinitis?
|
Nasal obstruction, congestion, rhinorrhea, sneezing, pruritus, anosmia or dysosmia, postnasal drip, chronic pharyngitis, hoarseness, irritated and watering eyes,
Nasal congestion is the most common chronic symptom. |
|
|
What products provide symptomatic relief for allergic rhinnitis?
|
Antihistamines, mast cell stabilizers, and decongestants
|
|
|
What does an MAOi do to antihistamines?
|
Concurrent use of a MAOi may prolong and intensify sedative and anticholinergic effects.
|
|
|
What is the adult dosage for diphenhydramine?
|
25-50 mg q 4-6hours, not to exceed 300mg in 24 hours.
Exactly half the doseage for children age 6-11 y/o. |
|
|
What is the dosage of Clemastine fumarate, an ethanolamine antihistamine?
|
Adult: 1mg every 12 hour, not to exceed 2mg in 24 hours.
|
|
|
What was one of the first antihistamines for companies to make in extended release form?
|
Chlorpheniramine maleate
|
|
|
What is the dose of chlorpheniramine maleate?
|
Chlor-Trimeton 4 hour allergy tabs (IR 4mg):Adult 4mg q4-6 hours, not to exceed 24 mg in 24 hours; Children age 6-12y/o, 2mg every 4-6hours, not to exceed 12mg in 24hours.
Chlor trimeton 8 hour Allergy tabs (Controlled release)Adult, 12y/o and older: 8mg every 8-12 hours, not to exceed 24mg in 24hours. 12mg CR tabs every 12hour |
|
|
An alkylamine antihistamine,
Available in OTC combination products (Dimetapp) |
Brompheniramine maleate
|
|
|
available in combination products i.e. Drixoral
|
Dexbrompheniramine maleate
|
|
|
Nolahist
|
Phenindamine tartrate
Adult dose - 25mg every 4-6hours |
|
|
Actifed
|
Triprolidine hydrochloride
|
|
|
Available in combo products such as vick's nyquil. Not as single agent
|
Doxylamine succinate
|
|
|
available in OTC combo products
|
phenyltoloxamine citrate
|
|
|
What are the mast cell stabilizers?
|
Stabilize mast cells that release histamine to prevent and treat symptoms of seasonal and perennial allergic rhinitis.
Nasalcrom Nasal Spray - 40 mg/ml |
|
|
The subjective feeling of nasal stuffiness due to swelling of nasal mucosa.
|
Nasal congestion
|
|
|
What are the most common causes of nasal congestion?
|
respiratory tract infections and allergic rhinitis.
|
|
|
Describe the pathophysiology of nasal congestion
|
Upper respiratory tract infections may cause a local inflammation response that produces mobilization of extracellular fluid into the nasal mucosa. Increased production and secretion of nasal mucus results in swelling of nasal mucosa, culminating in symptoms of nasal fullness, nasal stuffiness, and rhinorrhea.
|
|
|
How long does it take for viral URIs to clear?
|
Viral URIs are usually self limiting and resolve in 7-10 days.
|
|
|
How do nasal decongestants work?
|
They are sympathomimetic amines that are administered directly to swollen membranes or systemically via po.
They cause constriction of blood vessels, reduce mucosal swelling and congestion, and decrease nasal airflow resistance. |
|
|
compare systemic decongestants with topical versions.
|
Oral decon are indirect-acting agents, causing release of NE in the nasal vasculature. Oral forms produce a slower and less pronounced relief of nasal congestion than the topical forms. Oral is not as effective but has a longer duration of action.
|
|
|
What indication was removed for use of nasal deconestants?
|
Sinusitis - pts should see dr.
|
|
|
What diseases are CI for OTC use of nasal decong?
|
"Do not use this product if you have heart disease, HTN, thyroid disease, DM, or BPH unless directed by doctor.
|
|
|
Some imp. things about administration of decongestants?
|
Oral decongestants - if symptoms do not improve within 7 days or are accompanied by fever, a physician should be consulted.
Topical decongestants - usually provide relief of symptoms in 3-5minutes; should not be used for longer than 3 consec days. |
|
|
What is the dosage for PSE?
|
Adult: 60mg every 4-6hours, 120mg every 12 hours, or 240mg every 24hours
6-11y/o: 30mg q 4-6hours, not to exceed 120mg/24hour 2-5y/o: 15mg every 4-6 hours, not to exceed 60mg in 24hours. |
|
|
What is the dose for phenylephrine?
|
Orally: 10mg every 4hours, not to exceed 60mg in 24 hours.
Actually better used topically. |
|
|
What is the longest acting topical nasal decong?
|
an imidazoline derivative, Oxymetazoline HCL (Afrin)
Dose in 6y/o and older: 2 or 3 sprays in each nostril not more often than q10-12hours and not more than 2 doses in 24hours. |
|
|
an Intermediate acting topical decon.
|
Xylometazoline HCL (Otrivin)
12y/o and greater: one spray in each nostril not more often than q8-10hours.f |
|
|
a shorter acting topical decon.
|
Naphazoline HCL (privine)
also used in ophthalmic formulations. Doseage in 12y/o and greater: 1 or 2 sprays in each nostril not more than every 6 hours. |
|
|
another shorter acting topical decon..
|
Phenylephrine HCL (neo-synephrine)
Dosage in pts. 12y/o and greater: 2 or 3 drops or sprays not more often than every 4 hours. |
|
|
Short acting topical decon.
|
l-desoxyephedrine and propylhexadrine
Dosage in pts 12y/o and older: 2 inhalations in each nostril, not more than every 2 hours. Vick - 50mg Benzedrex - 250 mg |
|
|
What ingredients are in topical rub - Vicks vaporub
|
5.2% camphor, 1.2% eucalyptus oil, 2.8% menthol
|
|
|
What are the most common causes of cough?
|
Viral upper respiratory tract infections, allergic rhinitis, sinusitus, and postnasal drip. A productive cough is usally induced by the presence of mucus congestion in the lower airway.
|
|
|
Diagnostic/assessment considerations for cough.
|
Duration of cough
time course (chronic, acute, seasonal) Productive? (sputum color, viscosity) exposure to environmental or occupational irritants smoking history allergies pertinent medical problems medications (ACEi, nitrofurantoin) |
|
|
After how long of having a cough should a patient be referred to a physician?
|
Patients with persistent cough (longer than 2 weeks in duration) or cough accompanied by blood, sputum, wheezing, fainting, severe fatigue, fever, night sweats, or vomitting should be referred to physician.
|
|
|
What is some non drug therapy for coughs?
|
reduction of exposure to inhaled irriants
drinking large amounts of water (more than 8 glasses a day) - hydration aids expectoration by thinning respiratory tract mucus moisturizing the throat with saliva-producing hard candy-may help reduce the frequency and intensity of cough |
|
|
What is the most effective treatment of dry, hacking coughs?
|
Antitussives
|
|
|
What is the antitussive of choice for non-productive cough?
|
Dextromethorphan hydrobromide
|
|
|
What is an important clinical consideration of dextromethorophan?
|
It should not be used concurrently with an MAOi or for 2 weeks following discontinuation of the MAOi.
|
|
|
What is the dosage of dextromethorophan?
|
12y/oand greater: 30mg every 6-8 hours, not to exceed 120mg in 24hrs
6-11y/o: 15mg every 6-8hrs, not to exceed 60mg in 24hrs. 2-5y/o: 7.5mg every 6-8hrs, not to exceed 30mg in 24hrs. |
|
|
What is a clinical consideration of codiene?
|
It does not have any benefit over dextromethorphan.
Each dose should be administered with a glass of water or other fluid. |
|
|
Can diphenhydramine be used for cough?
|
Yes, but not for productive cough.
|
|
|
How does guaifenesin help suppress cough?
|
It helps to loosen phlegm and thin bronchial secretions to make coughs more productive.
|
|
|
What is the dose for guaifensin?
|
12y/o and greater: 200to 400mg every 4hours, not to exceed 2400mg in 24hours.
6-11y/o: 100to 200mg every 4 hours, not to exceed 1200mg in 24hrs 2-5y/o: 50-100mg every 4hours, not to exceed 600mg in 24hours. |
|
|
What is an important clinical consideration of guaifenesin?
|
Try to avoid expectorant and antitussive.
|
|
|
What OTC drug can be used for infertility in women?
|
Guaifenesin can decrease viscosity of vag. fluid.
|
|
|
What is the most common bacterial pathogen associated with pharyngitis?
|
Group A streptococcus
|
|
|
Explain the pathophysiology of pharyngitis..
|
Viral infection of the pharynx appears to stimulate production of bradykinin in the nose, which travels in a retrograde fashion and potentiates local pain sensation.
These infections usually last about 4-7 days. |
|
|
What are some sigsn of GAS?
|
The presence of a creamy white exudate on the tonsils with lymph node tenderness and enlargement are often indicators of infectious mononucleosis.
|
|
|
What are some diagnostic/assessment considerations for pharyngitis?
|
type of sore throat
time course presence of redness, ulcers, white patches, exudate presence of swollen lymph nodes, fever, oral ulcers, common cold symptoms similiar symptoms known to be present in family members |
|
|
What is some non-drug therapy for pharyngitis?
|
Ingestion of cold liquids or solids
salt water gargle hard candies |
|
|
What are some local anesthetics used with pharyngitis?
|
Benzocaine (Spec-T sore throat lozenges 10mg; Hurricaine topical gel - 20%)
Dyclonine HCL (cepacol, sucrets) Phenol, kind of weak (cheracol, vicks chloraseptic) |
|
|
What antiseptics are used for pharyngitis?
|
Cetylpyridiunium chloride (cepacol antiseptic gargle 0.05%)
|
|
|
What counterirritants are used for pharyngitis?
|
Menthol, eucalyptus oil, thymol, and hexylresorcinol
|
|
|
What analgesics are used for pharyngitis?
|
APAP, ASA, NSAIDS
|
|
|
An acute, usually afebrile, viral infection of the upper respiratory tract with inflammation of all or part of the airways
|
Common cold
|
|
|
What is the most common cause of the common cold?
|
Rhinoviruses
Coronaviruses and parainfluenza viruses cause the common cold but are associated with winter peaks |
|
|
What is the most common route of transmission of the common cold?
|
direct hand to hand contact
|
|
|
Describe the length of symptoms associated with the common cold.
|
Symptoms usually peak on day 2 or 3 and usally resolve in 7 days, except for cough which may last longer.
|
|
|
Know how to differentiate the common cold from other similiar conditions!!!
|
Ok
|
|
|
Acute sinusitis
|
A symptomatic sinus infection lasting less than 8 weeks
chronic persists for 2months despite treatment |
|
|
What is the most common symptom of sinusitis?
|
FAcial pain
Other symp include: dysosmia, anosmia, nasal obstruction, purulent rhinnorhea |
|
|
What are some non-drug therapies for sinusitis?
|
steam inhalation with or without soothing agents like menthol, topical saline solutions
|
|
|
What are the nonprescription drug therapies for sinusitis?
|
Prescription antibiotics are the mainstay
symptomatic relief can be adjuncts. Early decon in pts with URTI and a history of acute sinusitis may be beneficial |
|
|
What are some diagnostic considerations of cold sores?
|
Classic cold sores can be readily identified based on appearance and location.
Frequency of cold sore occurrence occurrence of prodrone sunlight or wind exposure recent cold, fever, or other illness recent stressful periods recent local trauma to the lip. |
|
|
What is some non-drug therapy for cold sores?
|
avoidance of precipitating factors
ice during early stages lipbalm with spf may reduce photoactivation |
|
|
How does docosanol work?
|
It is an alcohol that enters healthy cells and modifies the membrane in a manner that prevents viral organisms in infected adjacent cells from entering the healthy cells. It has been shown to shorten the healing time.
|
|
|
How often is abreva applied?
|
5 times a day until lesion is healed
|
|
|
What are some local anesthetics used for cold sores?
|
Tetracaine HCL, Lidocaine, Benzocaine, Dyclonine, Dibucaine.
|
|
|
What are some antiseptics used to treat cold sores?
|
Cetylpyridinium chloride
Benzalkonium chloride |
|
|
What are some astringents used for their drying powers to treat cold sores?
|
Tannic acid
benzyl alcohol Zinc acetate Benzoin compound tincture alcohol |
|
|
What are some oral products used for cold sores?
|
oral analgesics provide longer lasting analgesia
Pro-biotics such as lactobacillus acidophilus and bulgaricus, L-lysine, and citrus biovlavonoids are used by some people |
|
|
What are some imporatn diagnostic considerations for canker sores?
|
Need to distinguish from cold sores, oral candidiasis, and leukoplakia
|
|
|
How long do canker sores last?
|
There is no cure.
The lesions are self limiting between 7-14 days. |
|
|
What is some non-drug therapy for canker sores?
|
A warm saline rinse for 30 to 60 seconds
Iron, folic acid, or vitamin B12 if resulting from nutrional deficiencies avoidance of acidic or citrus foods |
|
|
What are some nonprescription drug therapy for canker sores?
|
Bioadhesive topical formulations to reduce friction
astringents to promote drying oral analgesics |
|
|
What are some antiseptics used for canker sores?
|
Carbamide peroxide
hydrogen peroxide sodium peroxyborate benzyl alcohol |
|
|
What is an obtundent/analgesic used for tootheache?
|
Eugenol
|
|
|
What are some agents used to treat teething?
|
Benzocaine (baby anbesol)
Baby numzit Highland's teething (that thing DH showed us in class) |
|
|
What are the 3 overlapping stages of wound healing?
|
1. Inflammatory phase (3-4days)
2. Proliferative phase (3days-3weeks) 3. Remodeling (begins at 3 weeks - years) |
|
|
For optimal healing of more severe wounds, a dressing should be selected with the following features....
|
1. control of excess exudate by absorption
2. maintenance of a moist wound environment 3. oxygen permeability 4. ease in removal without disrupting delicate new tissue 5. appropriate size and contour for the affected body part 6. comfort and convenience |
