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86 Cards in this Set
- Front
- Back
Which drugs are recommended for a patient with a headache ?
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1) Acetaminophen
2) NSAIDs: ASA, Ibuprofen, Naproxen |
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Why should ASA not be given to children under the age of 19 with viral infections?
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Circumstantial evidence of an increased incidence of Reye's Syndrome
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"Acetaminophen has been shown to decrease Nasal Obstruction and Rhinorhea" True or False?
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TRUE
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"Acetaminophen has been shown to decrease sneezing, coughing and sore throat" True or False?
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FALSE, no effect has been shown on any of these symptoms
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"NSAIDS have shown to decrease symptoms of Headache, Ear Pain and muscle and joint pain" True or False?
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TRUE
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Are 1st Gen Antihistamines effective for Runny Nose and Sneezing?
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Side effects generally outweigh the benefits (studies show benefit for Rhinorhea only)
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Are 2nd Gen Antihistamines effective for Runny Nose and Sneezing?
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No benefit
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Are 1st Gen Antihistamines + Decongestant effective for Runny Nose and Sneezing?
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Side effects generally outweigh benefits (small benefits for Rhinorrhea and Nasal Obstruction)
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Is Intranasal Ipratropium effective for Runny Nose and Sneezing?
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Studies have limitations and show small benefit compared to placebo
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Are Antitussives (DM/ Codeine) effective for Cough in Children?
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Showed no effect between placebo and study group
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Are 1st Gen Antihistamines effective for Cough in Children?
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No benefit and increased drowsiness in all groups
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Are 1st Gen Anthistamines effective for Rhinorrhea?
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Small possible benefit but increased side effects
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Are Antihistamines and Decongestants effective for Cough in Children?
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No benefit
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Are Antihistamines and Decongestants effective for Runny Nose and Congestion in Children?
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Possible benefit in older children but the increased side effects outweigh benefits
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Are decongestants effective in Children?
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Insufficient data to conclude
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Are Expectorants effective in Children?
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No benefit
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"Health Canada restricts use of Cold Medicine to children greater than _____ years old"
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6
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What are the unacceptable dosage forms for Children 6-12 yrs old? (2)
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1) Modified Dose Release (Oral SR, EC, Bilayer products)
2) Novel dosage forms (multiple ingredient thin strips, lollipops, freezer pops) |
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What are the general non drug measures for Common Cold? (7)
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1) Wash hands with soap and water
2) Chicken soup (with lots of vegies) 3) Warm Beverages: Honey Lemon Drink, Warm Juice (warm more effective than room temp) 4) Bed Rest 5) Vaporizers 6) Humidifier 7) Fluids |
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What are the non drug measures of Common Cold for Children?(5)
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1) Saline Nasal Drops (1-2 gtts each nostril QID) 2) Nasal Bulb Aspirator (for<4 yrs old)
3) Upright Positioning 4) Increase Humidity 5) Cool Mist |
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What are the non drug measures for sore throat? (6)
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1) Fluids
2) Hard, sugarless candies 3) Salt Water Gargle: (1/4-1/2 teaspoon of salt in 250ml warm water) 4) Honey Lemon Drink 5) Lozenges 6) Throat Spray & Gargles |
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What are the non drug measures for Fever?(2)
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1) Remove layers of clothing as appropriate
2) Tepid waters sponge bath |
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Why should a sponge bath for fever be tepid not cold?
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Because if it is cold, it can shut down body's ability to cool itself
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What are the non drug measures for Runny Nose? (2)
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1) Elevate Head of Bed
2) Use tissues (e.g. Anti-viral tissue) |
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When do we refer a dry cough to a physician?
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If the duration of dry cough is greater than 7 days
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What are the non-drug measures of dry cough ?(4)
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1) Salt Water Gargle
2) Fluids/Hot Drinks 3) Hard(sugarless) Candies 4) Honey |
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What are the typical doses of Honey?
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2-5yo: 2.5mL
6-11yo: 5mL 12-18yo: 10mL |
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"Frequent use of honey may result in _____"
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Caries
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Why should honey be avoided in <1 year old?
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Due to fears of chocking and Infant Botulism
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"Anaphylaxis to honey has been reported" True or False?
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TRUE
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Are lozenges effective for Dry cough?
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No evidence to suggest
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Are 2nd Gen Antihistamines effective for Dry Cough?
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No evidence for benefit
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Are 2nd Gen Antihistamines+Pseduoephedrine effective for Dry Cough?
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No evidence for benefit
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Are 1st Gen Antihistamines+Pseduoephedrine effective for Dry Cough?
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Statistically significant but unaware if clinically significant
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Is Naproxen effective for Dry Cough?
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Cochrane review suggests no benefit for cough
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Is Codeine effective for Dry Cough?
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No evidence for benefit
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Is Honey effective for Dry Cough?
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No data in adults but is still recommended
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Is DextraMethorphan effective for Dry Cough?
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Enough evidence to recommend (30mg)
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"There is high occurrence of cross-reactivity with Dextromethorphan and Codeine" True or False?
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False, similar structure but cross reactivity isnt common
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When do we refer a productive cough to a physician?
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When sputum is green, yellow or containing blood (since it indicates bacterial infection)
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What are the non-drug measures of Productive Cough?(2)
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1) Fluids to stay hydrated
2) Humidifier |
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Is Guaifenesin effective for Productive Cough?
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Aids in expectroation of sputum and decreases in cough frequency
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"DM-E in combination is not commonly recommended because antitussives aren't effective" True or False?
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TRUE
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What is the only one situation where DM-E in combo is recommended?
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When a wet cough is keeping the patient up at night
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What are the non drug measures for Nasal Congestion? (3)
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1) Humidifier/ Vaporizers
2) Saline Nasal Spray/Drops 3) Nasal saline irrigation/neti-pots |
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Is vick's VapoRub effective for Nasal Congestion?
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Helps in cough frequency severity, congestion severity and helps the ability to sleep
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Is Vick's VapoInhaler effective for Nasal Congestion?
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Lack of efficacy data, limited duration of action
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Is Vick's Breathe Right effective for Nasal Congestion?
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No solid evidence but frequently used by athletes
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"Vick's VapoRub should not be used under ___ years"
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2
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"Vick's VapoInhaler should not be used under ___ years"
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6
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Is oral Pseudoephedirne effective for Nasal Congestion?
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Has beneficial effect
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Is oral Phenylephrine effective for Nasal Congestion?
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Has doubtful effect
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Is topical Oxymetazoline effective for Nasal Congestion?
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Has positive efficacy
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Is topical Xylometzoline effective for Nasal Congestion?
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Has positive efficacy
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Is topical Phenylephrine effective for Nasal Congestion?
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Has positive efficacy
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Which topical decongestant has the shortest duration of action?
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Phenylephrine
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Why should topical decongestants be limited to 3-5 days?
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Rhinitis Medicamentosa occurs with prolonged topical use which leads to rebound congestion, which could be worse than the initial congestion
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Is vitamin C effective for prophylaxis for Cough and Cold?
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No clinical relevant effect in incidence of common cold. But helps reduce duration and severity of the cold
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Is vitamin C effective for the treatment of Cough and Cold?
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No difference when Vit C is started after symptoms onset
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Which groups of patients benefit from Vitamin C prophylaxis? (3)
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1) Marathon Runners
2) Skiers 3) Soldiers on Subarctic exercises |
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Is Echinacea effective for prevention of Cough and Cold?
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No evidence of benefit for prevention after taking product for 8-12 weeks
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Is Echinacea effective for treatment of Cough and Cold?
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Some evidence that aerial parts of E.purpurea might be effective for early treatment of colds in adults
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"A patient would need to take Cold-FX (American Ginseng) 200mg BID x 4months to prevent 0.25 colds" True or False?
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TRUE
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Is Zinc effective for prevention of Cough and Cold?
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When used for 5 months (in children 5-8) reduces colds, and school absenteeism
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Is Zinc effective for treatment of Cough and Cold?
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If administered within 24hrs of onset of symptoms, reduces duration of symptoms and severity of symptoms in adults. Unclear in children
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"Zinc Lozenges are tolerated better than Syrup" True or False?
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False, Syrup is better tolerated then lozenges
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Why would you avoid Intranasal Zinc?
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Anosmia (Absence of Smell)
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Does Vitamin D benefit Cough and Cold?
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Likely no benefit according to 2 RCTs
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"Acetaminophen is considered safe in all trimesters of pregnancy" True or False?
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TRUE
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"Low Dose ASA (<150mg/day) is unsafe in pregnancy" True or False?
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FALSE
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Are NSAIDS safe in pregnancy?
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No, risk of spontaneous abortions. Should also be avoided if trying to conceive
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"Dextramethorphan can be used in any trimester of pregnancy" True or False?
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TRUE
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"Oral Pseudoephidrine are considered safe in pregnancy" True or False?
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False, Risk Factor C, small increase in birth defects of vascular disruption
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"Diphenhydramine/Chlorpheniramine are considered safe in pregnancy" True or False?
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TRUE
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"Guaifenesin is not safe for pregnancy" True or False?
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FALSE
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"Pseudoepedrine may decrease breast milk production" True or False?
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TRUE
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Which common medical conditions are contraindicated for Oral Decongestants? (7)
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1) Heart Disease
2) Hyperthyroidism 3) Diabetes 4) Angle Closure Glaucoma 5) Prostatic Hyperplasia 6) Urinary Retention 7) Uncontrolled Hypertension |
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Which common medical conditions are contraindicated for Topical Decongestants? (2)
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1) Heart Disease
2) Angle Closure Glaucoma |
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Which common medical conditions should be monitored closely with Topical Decongestants? (4)
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1) Hypertension
2) Diabetes 3) Prostatic Hyperplasia 4) Urinary Retention |
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Which common medical conditions are contraindicated for First Gen Antihistamines? (3)
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1) Heart Disease
2) Hyperthyroidism 3) Angle Closure Glaucoma |
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Which common medical conditions should be monitored closely with First Gen Antihistamines? (3)
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1) Asthma/COPD
2) Prostatic Hyperplasia 3) Urinary Retention |
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Which common medical conditions are contraindicated for Dextramethorphan? (1)
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1) Asthma/COPD
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Which classes of medications interact with Oral Decongestants?(2)
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1) MAOIs + Linezolid (Hypertensive Crisis)
2) SNRIs (Increased BP, HR) |
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Which classes of medications interact with Topical Decongestants?(2)
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1) MAOIs + Linezolid
2) SNRIs (Increased BP, HR) |
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Which classes of medications interact with First Gen Antihistamines? (6)
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1) CNS Depressants (additive depression)
2) MAOIs + Linezolid 3) TCAs 4) SNRIs 5) SSRIs 6) Potassium Salts |
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Which classes of medications interact with Dextramethorphan? (4)
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1) MAOIs + Linezolid (SS syndrome) 2) SNRIs (SS syndrome) 3) SSRIs (SS syndrome) 4) Strong CYP450 2D6 inhibitors (increased DM conc)
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