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What is the primary action of decongestants on the nasal mucosa?
What is a potential side effect of using nasal decongestants?
What condition should prompt caution when using pseudoephedrine?
How long should nasal decongestants typically be used to avoid adverse effects?
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What beneficial effect does nasal decongestants have compared to systemic decongestants?
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What is a common use of pseudoephedrine?
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Which of the following symptoms is NOT commonly associated with nasal decongestant use?
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What mechanism allows decongestants to reduce nasal congestion?
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What effect do intranasal glucocorticoids have on nasal mucosa?
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What is a potential interaction of intranasal glucocorticoids with beta blockers?
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What adverse effect might occur with the use of intranasal glucocorticoids?
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Why should large amounts of caffeine be avoided when using intranasal glucocorticoids?
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What is the recommended duration for using intranasal glucocorticoids?
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What should be monitored when using intranasal glucocorticoids alongside OTC cold medicines?
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What condition may be worsened due to the use of intranasal glucocorticoids when interacting with MAOIs?
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What is a common side effect of prolonged use of intranasal glucocorticoids?
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What is one of the primary actions of diphenhydramine?
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Which of the following adverse effects is associated with diphenhydramine?
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What distinguishes loratadine from diphenhydramine?
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Under what conditions should diphenhydramine be administered with caution?
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Which indication is listed for loratadine?
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What is a characteristic of second-generation antihistamines like loratadine compared to first-generation like diphenhydramine?
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What adverse effect is most commonly associated with decongestants?
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What is a potential consequence of using decongestants improperly?
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What is the primary action of antitussives?
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What condition is fluticasone primarily indicated for?
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Which adverse effect is associated with dextromethorphan?
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What is the expected effect of guaifenesin in the body?
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How quickly does dextromethorphan typically begin to work after administration?
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What is a common side effect of expectorants like guaifenesin?
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For which of the following conditions is fluticasone NOT typically indicated?
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What is the duration of action for dextromethorphan?
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What is the primary purpose of mucolytics like Acetylcysteine?
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In which condition should mucolytics be avoided due to the risk of exacerbating symptoms?
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What is an important consideration when administering Acetylcysteine orally?
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Which of the following practices is advised before administering Acetylcysteine via nebulizer?
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What side effect is potentially associated with Acetylcysteine?
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Which of the following is a contraindication for using acetylcysteine?
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How does Acetylcysteine help with airway clearance?
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What is a suggested intake of water for optimal mucous clearance?
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Study Notes
Antihistamines
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Diphenhydramine is a first-generation antihistamine
- It completes with histamine for binding at H1-receptor sites and antagonizes histamine effects
- Indications include allergic rhinitis, common cold, pruritus, and urticaria
- Adverse effects include drowsiness, dizziness, fatigue, and disturbed coordination
- Caution: Avoid driving or operating dangerous machinery and alcohol use
- Avoid: in patients with glaucoma and COPD
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Loratadine is a second-generation antihistamine
- Indications include allergic rhinitis, pruritus, and urticaria
- Adverse effects are similar to first-generation antihistamines, but is less sedating and has fewer anticholinergic symptoms
- Given PO, IM, or IV
- Found in many OTC cold medicines
Decongestants
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Oxymetazoline is a nasal decongestant
- Stimulates alpha-adrenergic receptors resulting in vasoconstriction of capillaries in the nasal mucosa which shrinks nasal mucous membranes and decreases fluid (runny nose)
- Indications include nasal congestion
- Adverse effects include rebound congestion, nasal irritation, blurred vision, dry eyes, and headache
- Extreme Caution: in patients with HTN, cardiac disease, hyperthyroidism, and diabetes
- Limit use to 3 days
- Acts quickly and has fewer adverse effects than systemic decongestants
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Pseudoephedrine is a systemic decongestant
- Stimulates alpha-adrenergic receptors resulting in vasoconstriction of capillaries in the nasal mucosa which shrinks nasal mucous membranes and decreases fluid (runny nose)
- Indications include rhinitis and the common cold
- Adverse effects include:
- CNS: dizziness, headache, restlessness, insomnia
- CV: palpitations, dysrhythmias, HTN and tachycardia
- Extreme Caution: in patients with HTN, cardiac disease, hyperthyroidism, and diabetes
- Interactions: increase HTN with MAOIs and beta blockers
- Avoid large amounts of caffeine
- Given PO in regular and extended-release
- Combined with other drugs in OTC cold medicines
- Works longer than nasal forms of decongestants
Intranasal Glucocorticoids
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Fluticasone is an intranasal glucocorticoid
- Produces anti-inflammation resulting in a decrease in allergic rhinitis symptoms
- Indications include allergic rhinitis and asthma
- Adverse effects include headache, blurred vision, fatigue, insomnia, pharyngitis, nasal candidiasis/irritation
- Short-term use only
- 2 sprays per nostril per week 1
- 1-2 sprays qd PRN
Antitussives
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Dextromethorphan is an antitussive
- Acts on the cough control center in the medulla to suppress the cough reflex
- Indication is temporary cough relief of a non-productive cough due to sore throat, irritation, or cold
- Rapid absorption, works in 15-30 minutes and lasts 3-6 hours
- Used in many OTC cold medicines
Expectorants
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Guaifenesin is an expectorant
- Loosens bronchial sections to be eliminated by coughing
- Indications include cough with URI and cold
- Adverse effects include headache, dizziness, drowsiness, nausea, vomiting
- Hydration is important, take with a full glass of water
- Drink 8 glasses/day
- In many OTC cold medicines
Mucolytics
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Acetylcysteine is a mucolytic
- Thins mucous secretions
- Indications include cystic fibrosis, atelectasis
- Adverse effects include GI irritation, rash, oropharyngeal irritation
- Avoid with: asthma, agents with dextromethorphan(cough suppressant), and agents with acetaminophen (liver toxicity)
- Given via nebulizer
- Given 5 minutes before a bronchodilator
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Description
This quiz covers important information on antihistamines and decongestants, including their classifications, indications, and adverse effects. It focuses on first-generation antihistamines like Diphenhydramine and second-generation ones like Loratadine, along with the decongestant Oxymetazoline. Test your understanding of their uses and precautions in pharmacology.