Term
| What are the most common causes of NC? |
|
Definition
Viral Upper Resp. Tract Infections
Allergic Rhinitis |
|
|
Term
| What is the pathophysiology of NC? |
|
Definition
Infection causes a local inflammatory response that produes mobilization of extracellular fluid into the nasal mucosa
this results in swelling |
|
|
Term
| What are some signs and symptoms fo NC? |
|
Definition
Inc nasal discharge
nasal stuffiness
dec nasal ventilation
reduced olfactory sensation
inc sinus pressure
throat pain and irritation |
|
|
Term
Upper Respiratory Tact Infection or Allergic Rhinitis?
1) Sneezing, itchy eyes and nose
2) self-limiting, 7-10 days
3) triggers are pollens and allergens |
|
Definition
|
|
Term
| What non drug therapy can be used to treat nasal congestion? |
|
Definition
humidifiers
adequate hydration |
|
|
Term
T/F
Refer pt. to a physician when therapy is accomanied by a fever |
|
Definition
|
|
Term
Nasal decongestants stimulate______
1) sympathetic/parasympathetic nervous system
2) alpha/ beta adrenergic receptors
|
|
Definition
sympathetic
alpha adrenergic |
|
|
Term
| How do nasal decongestants affect blood vessels and nasal mucosa? |
|
Definition
| Constrict blood vessels and reduce nasal mucosal swelling and congestion |
|
|
Term
| How do nasal decongestants indirectly stimulate receptors? |
|
Definition
| By displacing Norepi from storage and they then bind to the alpha adrengeric receptors |
|
|
Term
Direct or Indirect decongestants
1) Phenylephrine
2) Ephedrine
3) Pseudophedrine
4) Oxymetazoline
5) Tetrahydrozoline
|
|
Definition
1) Phenylephrine- Direct
2) Ephedrine-Indirect
3) Pseudophedrine-Mixed
4) Oxymetazoline- Direct
5) Tetrahydrozoline-Direct |
|
|
Term
T/F
Non Rx decongestants are NOT approved by the FDA for nasal congestion assoc. with SINUSITIS |
|
Definition
|
|
Term
T/F
Oral decongestants are just as effective as Topical |
|
Definition
False
Topical products provide relief within 3-5 minutes |
|
|
Term
| What are the advantages of using topical decongestants? |
|
Definition
No documentation required to purchase
simple to use, inexpensive
cover large surface area
|
|
|
Term
| Why should topical decongestants be used for max 3 days? |
|
Definition
| because of rebound congestion |
|
|
Term
T/F
Oral decongestants have a longer duration of action than topical products |
|
Definition
|
|
Term
T/F
Topical decongestants can be used for a longer period of time and cause less irritation than oral. |
|
Definition
FALSE
Topical- max 3 days and prone to burning and stinging |
|
|
Term
| What are some ADE for oral decongestants? (Cardiovascular & CNS) |
|
Definition
Elevated BP, Tachycardia, palpitations or arrhythmias
restlessness, insomnia, anxiety |
|
|
Term
What are some precautions for decongestants? (other diseases)
|
|
Definition
may exacerbate diseases senstive to adrenergic stimulation
HTN, hyperthyroidism, BPH, DM, Heart disease |
|
|
Term
| What are the effects of nasal decongestants with MAOIs? |
|
Definition
|
|
Term
| What is the restricted time limit for administration of an MAOI and a nasal decongestant? |
|
Definition
| not concurrently or within 2 weeks of d/c the MAOI |
|
|
Term
Why cant Nasal Dec. be taken with urinary alkinizers?
What happens? |
|
Definition
Rasing the pH causes the nasal decongestant(amine) to be in its UNionized form and get reabsorbed.
Get increased drug concentration |
|
|
Term
| What effect do tricyclic antidepressants have on nasal dec.? |
|
Definition
| cause increased BP in direct acting agents and decreased activity of indirect acting agents |
|
|
Term
| Why shouldnt SSRIs not be taken with nasal dec.? |
|
Definition
|
|
Term
| If a male patient is taking Flomax, would you recommend an oral decongestant? Why/Why not? |
|
Definition
| No, because the flomax indicates BPH. If he were to take an oral decongestant it would exacerbate urinary retention. |
|
|
Term
| Dosages are best determined by a child's_____ |
|
Definition
|
|
Term
| What is the max. dosage for pseudophedrine? |
|
Definition
|
|
Term
| What are the provisions and the CMEA? |
|
Definition
Daily & monthly purchase limits
Placement of drug behind the counter
Sales log book
Employee training
Customer ID
Self-certification of regulated sellers |
|
|
Term
| What are the maximum sales per day and month of pseudophedrine? |
|
Definition
|
|
Term
T/F
Sudafed PE contains the active ingredient pseudophedrine and is therefore sold behind the counter |
|
Definition
FALSE
the active ingredient is phenylephrine HCl and it is sold OTC |
|
|
Term
T/F
Phenylephrine HCl is more effective nasally than orally |
|
Definition
|
|
Term
What is the longest acting topical nasal dec.?
|
|
Definition
| Oxymetazoline Spray (Afrin) |
|
|
Term
| What is the age limit on Afrin nasal spray? |
|
Definition
|
|
Term
| Which imidazoline derivative is also used in opthalmic formulations? |
|
Definition
|
|
Term
| Why isnt phenylephrine HCl nasal spray the 1st choice for nasal decongestion? |
|
Definition
| it has a short duration (Q4hrs) |
|
|
Term
| What should be a counseling point on nasal inhalers? |
|
Definition
| They lose their efficacy after 2-3 months even when tightly capped |
|
|
Term
| What recommendations should be made to eldery patients seeking nasal decongestants? |
|
Definition
Use with caution b/c more prone to ADE
Avoid sustained release products |
|
|
Term
| What effects does pseudophedrine have on fetal development? |
|
Definition
| Linked to abdominal wall defects in newborns |
|
|
Term
| What advise should be given to pregnant women seeking nasal dec.? |
|
Definition
| avoid products labled "max strength, long acting" etc. |
|
|
Term
What is the preferred topical nasal dec in pregnant and lactating women?
Why? |
|
Definition
| Oxymetazoline b/c of its poor systemic absorption |
|
|
Term
What is the preferred oral nasal dec in lactating women?
|
|
Definition
|
|
Term
What intranasal decongestants should be avoided in lactating mothers?
|
|
Definition
| Xylometazoline adn naphazoline |
|
|
Term
| What is the age limit on nonprescription cold medications? Why? |
|
Definition
younger than 2 years, b/c lack of efficacy and high risk of ADR and death
manufacturers voluntarily raised it to 4 years |
|
|
Term
What are other options for patients that cant tolerate nasal decongestants?
How does it work? |
|
Definition
Saline Nasal products
moistens the nasal passages and irrigates sinuses
Camphor, Eucalytpus Oil, Menthol (Vicks)
relieves nasal congestion and cough |
|
|
