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54 Cards in this Set

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Coticosteroids Nasal Spray MOA;
Supresses the immune response to allergies.
Coticosteroids Nasal Spray CI;
Hypersensitivity, systemic fungal inf, status asthmatius, infections of nasal mucosa, viral, TB, fungal or infection of resp. sx.
Aerobid dosage;
6-15yrs;2 sprays in one nostril bid
Adults;2 sprays in each nostril bid
Beconase dosage;
=>yrs; 1-2 sprays in each nostril bid.
Flonase dosage;
=>4yrs;1 spray in each nostril qd.
Adults;2 spray in each nostril bid.
Nasacort dosage;
6-11yrs;1 spray in each nostril qd
Adults;2 sprays in each nostril qd.
Rhinocort dosage;
1 spray in each nostril qd
Coticosteroids Nasal Spray ADR;
Minimal systemic absorption, H/A, nausea/vomiting, pharyngitis, nasal irritation, nosebleed, rarely cough or bronchospasm.
Coticosteroids Nasal Spray Precautions;
Preg cat C (no steroids should be used in pregnancy) use w/caution, can cause growth reduction, use lowest dose in children & monitor growth.
Nasalcrom Nasal Spray indications;
Prevention & tx for Seasonal & Perennial Allergic Rhinitis.
Also a profalactic drug.
Nasalcrom Nasal Spray MOA;
Prevents mast cell release of histamine & leukotrienes.
Nasalcrom Nasal Spray dosage;
=>2yrs;1spray in each nostril 3-4 times a day
or before exercise/allergen exposure.
Nasalcrom Nasal Spray CI;
Acute asthma attack
Nasalcrom Nasal Spray ADR;
Sneezing, burning, irritation of nose, H/A, unpleasant taste, rarely anaphylaxis
Nasalcrom Nasal Spray Precautions;
Pregnancy Cat B
Name some examples of PCN antimicrobials;
PCN, Dicloxacillin, Amoxicillin & Ampicillin
PCN Antimicrobials indications;
Throat infections
Sinus infections
Ear infections
PCN Antimicrobials MOA;
Inhibit cell wall synthesis in bacteria.
PCN's spectrum;
Gram+ & gram-; staph, strep & e coli.
Not pseudomonas (strep pneumoniae causes 35-50% of otitis media)
Docloxacillin spectrum;
Gram+ & gram- plus penicillinase producing staph, used for otitis externa.
Amoxicillin/Ampicillin spectrum;
Extended spectrum like PCN but more gram-, used in OM & sinusitis.
What is Augmentin?
Amoxicillin & Claulanic acid.
PCN Precautions;
Fatal anaphlaxis, caution w/asthmatic pts. Prolonged use may result in fungal or bacterial super infection (C. difficile diarrhea/pseudomembranous colitis.
Preg Cat B
Adjust dose w/renal function impairment.
What is Cephalosporin?
A antimiccrobial simular to PCN.
Cephalosporin indication?
Used in otitis media, pharyngitis & tonsillitis.
Cephalosporin MOA;
Inhibits bacterial cell wall formation.
Spectrum of 1st generation Cephalosporins;
Keflex (cephalexin)- same as PCN; staph, e coli & k pneumoniae.
Spectrum of 2nd generation Cephalosporins;
Cefzil (cefprozil) same +3gram- H. influenzae (25% of ear infections), E aerogenes & Moraxella sp.
Spectrum of 3rd generation Cephalosporins;
Omnicef (cefdinir) increased gram - to include serratia sp.
Cephalosporin Precautions;
PCN allergy (5-15% cross reactivity).
Super infection; C. difficile.
Caution w/renal impairment.
Erythromycin Indications;
Used as alternative to PCN/Cephalosporin allergy.
Cephalosporin MOA;
(Macrolide) binds to ribsome & inhibits protein synthesis.
Cephalosporin spectrum;
Same as PCN
Clarithromycin (Biaxin) & Azithromycin (Zithromax) are more specific to H. influenzae.
Cephalosporin Precautions;
Hypersensitivity, Rarely macrolides assoc w/QT prolongation, Super infection, Hepatic impairment, aggravated weakness observed in myasthenia gravis.
Which antimicrobials can cause ototoxicity?
Neomycin (gram-organisms)
Damage to cochlear membrane (tennitis & permanent hearing loss)
Which aminoglycosides have a black box warning?

& for what?
Gentamycin & Tobramycin-neurotoxicity, nephrotoxicity, neuromuscular blockade/respiratory paralysis.
What antivirals are used for ENT?
Zovirax (acyclovir)
Valtrex (valacyclovir)
Antivirals indications;
Herpes virus
Antivirals MOA;
Compete w/proteins in DNA synthesis.
Zovirax(acyclovir) Dosage;
200mg q4hr or 5x per day for 10 days.
Valtrex (valacyclovir dosage.
2 gm bid for 1 day.
Antivirals CI;
Antivirals ADR;
Antivirals Precautions;
Immunocompromised (hemolytic anemia).
Renal dz (fatal renal failure)
Preg cat B
Not indicated <2yrs
List some examples of ENT antivungals;
Diflucan (fluconazole)
Nizoral (ketoconazole)
ENT antivungals indications;
Oropharyngeal candidiasis especially in immunocompromises pts.
Oral thrush
Diflucan (fluconazole)
Nizoral (ketoconazole) MOA;
Inhibits fungus cell wall formation.
Nystatin MOA;
Increases permeability & leakage.
Diflucan (fluconazole) Dosage;
200mg qd.
Nizoral (ketoconazole) Dosage;
200-400mg qd.
Nystatin Dosage;
400,000 to 600,000 units swish and swallow 4 x qd.
ENT antivungals CI;
ENT antivungals ADR;
Nausea, vomiting, diarrhea, hematological & hepatic effects (azole).
Endocrine Effects Nizoral (ketoconazole).
Inhibits androgen synthesis.
ENT antivungals Precautions;
Renal or hepatic dysfunction.
Azoles are teratogenic, do not use in pregnancy (X).
Nystatin is preg cat B.