PC707-Module 6-Respiratory & ENT Exam with 100% Verified and Updated Solutions

PC707-Module 6-Respiratory & ENT Exam with 100% Verified and Updated Solutions What is the treatment goal for upper respiratory infections? - answer-symptom relief -if a medication is needed--prescribe a SINGLE medication to target the most bothersome symptom* -consider cost, risk versus benefits, efficacy What medications can be used in the symptom management of upper respiratory infections? - answer-anti-histamines -nasal decongestants -anti-tussives -expectorants -saline spray/drops How are anti-histamines helpful in symptom management for upper respiratory infections? - answer-the anti-cholinergic SIDE EFFECTS can be helpful --->dry mucous membranes, decrease secretions etc. What is the mechanism of action for anti-histamines? - answer-competitively binds to H1 receptors to prevent binding of histamine and therefore no histamine effects* -does NOT prevent actual histamine release--just histamine binding* -onset within 15-30 minutes What are the major side effects of anti-histamines? - answer-anti-cholinergic effects---> -dizziness, hypotension, dry mouth, drowsiness, constipation, blurry vision, decreased appetite, urinary retention etc. -this is because antihistamines cross bind to block cholinergic receptors* Which generation of anti-histamines are the most sedating? Why? - answer-1st generation- -such as diphenhydramine (Benadryl) -they are more lipophilic--so they easily cross the BBB to cause slower neuronal firing & decreased production of neurotransmitters* Which 2nd generation anti-histamine is the most sedating? - answer-cetirizine (Zyrtec) -most other ones cause little sedation because they work more peripherally* Which 2nd generation anti-histamine has several drug to drug interactions: - answer- fexofenadine (Allegra) --->interactions with anti-fungals (azoles), erythromycin, etc. Concern with long-term use of 1st generation anti-histamines? - answer-long term anti- cholinergic effects -increases risk of developing dementia* What is the mechanism of action for nasal decongestants? - answer-acts on adrenergic alpha-1 receptors to cause vasoconstriction, decreased inflammation, decreased blood flow & fluid exudate -causes vasoconstriction of the nasal mucosa vessels (which are usually dilated from histamine effects)* Nasal decongestants have great efficacy. True or false? - answer-false -little proven efficacy -limited evidence What is important to remember about OTC decongestants? - answer-they often contain other agents such as anti-histamines, caffeine, pain relievers -need to educate patients about potential drug interactions or contraindications for use* What is the primary difference between OTC & prescription decongestants? - answer- dosing frequency Why should nasal decongestants only be used for 3 days or less? - answer-can develop rhinitis medicamentosa (rebound congestion) Side effects of nasal decongestants? - answer-sneezing & nasal dryness -increases intraocular pressure -CNS/sympathetic stimulation--tremors, tachycardia, arrhythmias, hypertension* -insomnia Decongestants are contraindicated for: - answer-uncontrolled HTN -use of MAOIs -severe CAD -BPH -glaucoma -concurrent use of CNS stimulants (Ritalin, Caffiene, etc.) -use with CAUTION with controlled HTN Use of saline drops/spray? - answer-helpful in clearing nares of mucous -can decrease time allergens come in contact with nasal mucosa to prevent cascade -ocean spray or saline drops Why should decongestants be used very cautiously in the elderly? - answer-increased risk of adverse effects* -only use in this population as last resort Example of decongestants? - answer-oxymetazoline (Afrin)---nasal -pseudoephedrine (Sudafed)--oral Anti-tussives for URIs: - answer-potential to prevent or relieve a non-productive cough -lack of evidence to support effica