Question 1
Question
Which of the following is/are true regarding antitussive medications?
(select all that apply)
Answer
-
Used to suppress coughing
-
May be used long-term
-
Better for dry (non-productive) cough
-
Not very effective at current OTC doses
-
Contraindicated in children < 6 years old
Question 2
Question
Why would antitussives be contraindicated?
Answer
-
They cause gastrointestinal symptoms if used over 7 days.
-
Coughing is a defense mechanism which we don't want to suppress.
-
Patient has a productive cough.
-
Patient is < 2 years old
-
All of the above
-
All but A
Question 3
Question
What is the mechanism of action of Codeine and what is it's brand name?
Answer
-
Inhibits cough through direct effect on brainstem cough center. Also might inhibit peripheral afferent neurons that initiate coughing.
-
Competes for H1 receptor sites on respiratory tract to reduce secretion and stop coughing
-
Robitussin AC
-
Robitussin DM
-
Delsym
Question 4
Question
What is the mechanism of Dextromethorphan and what is/are it's brand names?
Answer
-
Soothing to the airway through vaporization.
-
Inhibits cough reflex by a similar mechanism to Codeine (inhibits cough through direct effect on brainstem cough center) but is a non-narcotic.
-
Inhibits cough reflex by a similar mechanism to Codeine (inhibits cough through direct effect on brainstem cough center) but is a narcotic and provides stronger action.
-
Robitussin AC
-
Robitussin DM
-
Vicks Vaposteam
-
Delsym
Question 5
Question
Which two medications are sold as Vicks?
Answer
-
Delsym
-
Menthol
-
Carnauba
-
Camphor
-
Lanolin
Question 6
Question
What are some common adverse effects of Codeine?
Answer
-
Fatigue
-
Abdominal pain
-
Drowsiness
-
Dizziness
-
Ataxia
Question 7
Question
What are some common side effects of Dextromethorphan?
Answer
-
Confusion
-
Ataxia
-
Irritability
-
Nervousness
-
Excitement
Question 8
Question
What is the primary side effect of Benadryl?
Answer
-
Shortness of Breath
-
Ataxia
-
Vomiting
-
Insomnia
-
Drowsiness
Question 9
Question
Which drug do the young whippersnappers Robo Trip with?
Answer
-
Robitussin AC
-
Robaxin
-
Diphenhydramine
-
Dextromethorphan
-
Tylenol
Question 10
Question
What are some therapeutic benefits of Expectorants?
Answer
-
Compete for H1 receptor sites on respiratory tract to reduce secretion and stop coughing.
-
Facilitate production and ejection of mucus.
-
May increase pulmonary function
-
Prevents respiratory passages from being clogged by thick, viscous secretions.
-
Reduce secretions from upper airway so as to prevent drainage into the lower respiratory tract.
Question 11
Question
Which of the following are Adverse Effects of Decongestants?
Answer
-
Headache
-
Dizziness
-
Hypertension
-
Palpitations
-
Seizures
-
Nausea
-
Nervousness
Question 12
Question
Which of the following are characteristics of decongestants.
Answer
-
Binds to receptors located on blood vessels of nasal mucosa and stimulate vasoconstriction and resulting in drying up of mucosal vasculature and decreased local congestion
-
Usually beta-2 adrenergic agonists.
-
Usually beta-1 adrenergic agonists.
-
Usually alpha-1 adrenergic agonists.
-
Almost exclusively systemic medications.
-
May be systemic or local medications.
-
Almost exclusively local medications
-
Can cause CNS depression, avoid excessive use
-
Can cause CNS excitation, avoid excessive use
Question 13
Question
Which oral decongestant rocks and which one sucks?
Answer
-
Phenylephrine
-
Pseudoephedrine
Question 14
Question
When is the best time to take an oral decongestant?
Answer
-
In the morning to reduce the negative consequences of CNS excitation.
-
In the evening to reduce the negative consequences of CNS depression.
-
Any time of day as CNS effects are not often seen in decongestants.
-
In the evening to help congested patients sleep.
Question 15
Question
What is the chief concern with Afrin administration and what is its generic name?
Answer
-
Nasal polyps
-
Rebound congestion
-
Epistaxis
-
Oxymetazoline
-
Xylometazoline
-
Phenylephrine
Question 16
Question
Choose the correct statements regarding Phenylephrine and Pseudoephedrine. (if you get something incorrect, try flipping the statements)
Answer
-
Phenylephrine is more bioavailable (90%) than Pseudoephedrine (38%)
-
Phenylephrine: a1 adrenergic, weak B adrenergic
Pseudoephedrine: a1 and B adrenergic
-
Phenylephrine has CNS effects, Pseudoephedrine does not.
-
Pseudoephedrine has more efficacy data than Phenylephrine.
-
Patients with heart conditions, asthma, and COPD need to be more cautious with Pseudoephedrine and less so with Phenylephrine
Question 17
Question
Which of these is NOT a condition in which we should be cautious when prescribing oral decongestants?
Question 18
Question
Which Histamine mediates allergic response and is therefore what our antihistamine drugs target?
Question 19
Question
Arrange these antihistamine medications in terms of their ability to cross the blood brain barrier, from most crossing to least.
Answer
-
Diphenhydramine, Loratidine, Fexofenadine, Cetirizine
-
Diphenhydramine, Fexofenadine, Loratidine, Cetirizine
-
Diphenhydramine, Cetirizine, Loratidine, Fexofenadine
-
Fexofenadine, Diphenhydramine, Cetirizine, Loratidine
-
Loratidine, Cetirizine, Fexofenadine, Diphenhydramine
Question 20
Question
Which of the following medications are First Generation Antihistamines?
Answer
-
Brompheniramine (Dimetapp)
-
Chlorpheniramine (Chlor-Trimeton)
-
Clemastine (Tavist)
-
Hydroxyzine (Atarax)
-
Levocetirizine (Xyzal)
-
Dimenhydrinate (Dramamine)
-
Diphenhydramine (Benadryl)
-
Desloratidine (Clarinex)
Question 21
Question
Which of the following are Second Generation Antihistamines?
Question 22
Question
While antihistamines are generally used more for allergic rhinitis and congestion, one medication has some efficacy in treating cold related rhinorrhea. Which is it?
Question 23
Question
What are some precautions and warnings to consider when prescribing antihistamines to patients?
Question 24
Question
What are some special considerations to make in elderly and children before prescribing Antihistamines?
Answer
-
Elderly patients having a paradoxical hyperactivity.
-
Children having a paradoxical hyperactivity.
-
Long half life in elderly, causing extended effect and increased fall risk.
-
Long half life in children, causing poor performance in school and social dysfunction.
Question 25
Question
When a combination product advertises itself as a Nighttime/PM medication, what is likely in the combination?
Answer
-
Pseudoephedrine, Phenylephrine (decongestant) but no antihistamine
-
Pseudoephedrine, Phenylephrine (decongestant) and/or an analgesic
-
Diphenhydramine, Chlorpheniramine, or Doxylamine
-
Dextromethorphan
-
Antihistamine
Question 26
Question
When a combination product advertises itself as a Nondrowsy/AM/Daytime medication, what is likely in the combination?
Answer
-
Diphenhydramine, Chlorpheniramine, or Doxylamine
-
Pseudoephedrine, Phenylephrine (decongestant) but no antihistamine
-
Pseudoephedrine, Phenylephrine (decongestant) and/or an analgesic
-
Dextromethorphan
-
Antihistamine
Question 27
Question
When a combination product advertises itself as a Sinus medication, what is likely in the combination?
Answer
-
Diphenhydramine, Chlorpheniramine, or Doxylamine
-
Pseudoephedrine, Phenylephrine (decongestant) but no antihistamine
-
Pseudoephedrine, Phenylephrine (decongestant) and/or an analgesic
-
Dextromethorphan
-
Antihistamine
Question 28
Question
When a combination product advertises itself as a Cough medication, what is likely in the combination?
Answer
-
Diphenhydramine, Chlorpheniramine, or Doxylamine
-
Pseudoephedrine, Phenylephrine (decongestant) but no antihistamine
-
Pseudoephedrine, Phenylephrine (decongestant) and/or an analgesic
-
Dextromethorphan
-
Antihistamine
Question 29
Question
When a combination product advertises itself as an Allergy medication, what is likely in the combination?
Answer
-
Diphenhydramine, Chlorpheniramine, or Doxylamine
-
Pseudoephedrine, Phenylephrine (decongestant) but no antihistamine
-
Pseudoephedrine, Phenylephrine (decongestant) and/or an analgesic
-
Dextromethorphan
-
Antihistamine