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Endo/Pulm Quiz 2 Part 2 - Coggle Diagram
Endo/Pulm Quiz 2 Part 2
mometasone (Nasonex)
common ADRs: nasal irritation/burning, HA, pharyngitis, viral infection
rare ADRs: severe hypersensitivity, glaucoma, pneumonia, secondary hypocortisolism, osteoporosis
interactions: desmopression (nasal corticosteroids may enhance hyponatremic effect of desmopressin)
efficacy: control of rhinitis signs and symptoms
indications: seasonal and perennial allergic rhinitis, nasal polyp
toxicity: BMD and growth and development in children should be monitored; routine ophthalmologic examinations should be performed; monitor for S/S of adrenal suppression or infection
class: intranasal corticosteroid
counseling: advise patient on proper administration technique; nasal spray needs to be primed before using and if not used for 1 wk; instruct patients to monitor for signs of toxicity, especially adrenal insufficiency
triamcinolone nasal (Nasacort AQ)
indications: perennial or seasonal allergic rhinitis
interactions: desmopression (nasal corticosteroids may enhance hyponatremic effect of desmopressin)
class: intranasal adrenal glucocorticosteroid
common ADRs: nasal irritation and burning, HA, pharyngitis
rare ADRs: severe hypersensitivity, glaucoma, pneumonia, secondary hypocortisolism, osteoporosis
efficacy: control of rhinitis signs and symptoms
toxicity: BMD and growth and development in children should be monitored; routine ophthalmologic examinations should be performed; monitor for S/S of adrenal suppression or infection
counseling: use proper administration technique; monitor for signs of toxicity, especially adrenal insufficiency, especially growth delay in children
olopatadine (Patanol, Pataday)
common ADRs: none
rare ADRs: hypersensitivity reaction
interactions: none known
efficacy: reduction in ocular redness, itching, and irritation
indications: allergic conjunctivitis
toxicity: signs of hypersensitivity
class: ophthalmic antihistamine
counseling: wash hands; for administration lie down or tilt head back; with index finger, pull down lower eyelid to form pocket and hold dropper close to eye with other hand; drop correct number of drops into pocket; gently close eyes; place index finger over inner corner of eye for 1 min; do not rinse or wipe dropper or allow to touch anything, including eye; put cap on bottle right away; BID dosing should be at least 6-8 h apart; remove contact lens prior to administration and wait at least 10 min before reinserting; do not sue contact lenses if eyes are irritate
bupropion (Aplenzin, Forfivo,
Wellbutrin, Zyban)
common ADRs: agitation, constipation, dizziness, HA, insomnia, nausea, tachyarrhythmia, tremor, xerostomia
rare ADRs: cardiac dysrhythmia, mania, seizure, suicidal thoughts, wide QRS complex
interactions: alcohol (increased risk of seizures), CYP3A4/5/ 2B6 inducers/inhibitors, CYP2D6 substrates
efficacy: improvement in depressive symptoms, may require 4-6 wk; abstinence from tobacco products
indications: depression, seasonal affective disorder, smoking cessation assistance
toxicity: worsening of depression, suicidality, or unusual changes in behavior, especially at the invitation of therapy or with dosage increases or decreases; BP and HR in patients using concomitant nicotine replacement therapy; incidence of seizure
class: monocyclic antidepressant
counseling: avoid alcohol, CNS depressants, and activities requiring mental alertness; take at same time each day and at bedtime if possible; if taking ER, tablet shell may remain intact and visible in the stool
tiotropium (Spiriva)
rare ADRs: bowel obstruction, cerebrovascular accident, bronchospasm
efficacy: monitor pulmonary function tests, SOB
common ADRs: xerostomia, URTI
interactions: other anticholinergic agents (additive effect with tiotropium), donepezil/bupropion (lowered seizure threshold)
toxicity: seek medical attention if severe anticholinergic SE occur, including bladder obstruction, narrow-angle glaucoma, BPH, and urinary retention
indications: COPD, asthma
counseling: advise patients that drug is not indicated for acute bronchospasm; drug may cause increase in HR, dry mouth, constipation, urinary difficulty and retention, respiratory tract infection, and sinusitis; warn patients drug capsules are for inhalation only and not be be swallowed; when using HandiHaler, patients should inhale contents of each capsule twice to ensure drug delivery; max benefit in asthma may not be seen for 1-2 months
class: anticholinergic bronchodilator
varenicline (Chantix)
common ADRs: dream disorder, nausea, HA, insomnia, irritability
rare ADRs: abnormal behavior, suicidal thoughts, angioedema, hypersensitivity rxns, increased risk of accidents, increased risk of CV related events, sleepwalking, seizures
interactions: bupropion/H2 antagonists/quniolone abx/TMP (may increase varenicline serum concentration via unknown mechanisms)
indication: smoking cessation
efficacy: abstinence from tobacco
class: smoking cessation agent
toxicity: mental status changes
counseling: take drug after each with full glass of water; if experience sleepwalking, seizures, signs of hypersensitivity (SOB), mental status changes or suicidal ideation, stop taking and contact HCP; may be used with other nicotine replacement products to help alleviate withdrawal from nicotine; limit alcohol use