Allergic Rhinitis Flashcards
State the type of rhinitis:
Disease caused by an IgE mediated inflammatory response of the nasal mucous membranes after exposure to inhaled allergens. Symptoms include: Rhinorrhea, nasal congestion, nasal itching, and sneezing
Allergic rhinitis
State the type of rhinitis:
Disease caused by an IgE mediated inflammatory response to seasonal aeroallergens. Length of exposure is dependent on geographic location and climatic conditions
Seasonal Allergic rhinitis
State the type of rhinitis:
Disease caused by an IgE mediated inflammatory response to year-round environmental aeroallergens. Including dust mites, mould, animal allergens or occupational allergens
perennial allergic rhinitis
State the type of rhinitis:
Disease caused by an IgE mediated inflammatory response and characterized by persistent symptoms >4days per week and >4 weeks per year
persistent allergic rhinitis
State the type of rhinitis:
Disease caused by an IgE mediated inflammatory response that can occur if an individual is in contact with an exposure that is not normally a part of the individual’s environment (ex. cat at friend’s house)
episodic allergic rhinitis
Symptoms of allergic rhinitis
sneezing, nasal congestion, nasal itching, rhinorrhea, eye redness can also be present
What is allergic rhinitis caused by?
IgE - mediated reactions to inhaled allergens
what two conditions is allergic rhinitis linked to?
asthma and conjunctivitis
What three conditions coexist in individuals due to shared genetic conditions?
allergic rhinitis, asthma, atopic dermatitis
How long are symptoms for intermittent allergic rhinitis?
< 4 days/week or <4 consecutive weeks
How long are symptoms for persistent allergic rhinitis?
> 4 days/week or >4 consecutive weeks
A patient is having some symptoms of allergic rhinitis but has normal sleep, no impairment of daily activities, sports, and leisure. Normal work days. Is this considered mild or moderate-severe rhinitis?
mild allergic rhinitis
what classification of allergic rhinitis consists of abnormal sleep, impairment of daily activities, sport, leisure, and problems at work and school.
moderate-severe allergic rhinitis
What is the term called when the body produced IgE antibodies due to genetic and/or environmental factors?
Atopy
T or F: allergic rhinitis is considered a localized disorder
False: part of the respiratory tract now
What cells take up the allergens in the nasal mucosa during allergic rhinitis?
a) mast cells
b) basal cells
c) dendritic cells
d) epithelial cells
c) dendritic cells
List some risk factors associated with allergic rhinitis?
concomitant asthma family history of atopy ethnic origin other than white european antibiotic use maternal and paternal smoking early introduction of food or formula no older siblings allergen exposure pollutants higher socio economic class heavy alcohol consumption
What types of medication cause symptoms of allergic rhinitis?
beta-blockers, ASA, NSAIDS, ACE inhibitors hormone therapy cocaine
What are some visible signs of allergic rhinitis in kids?
mouth breathing
rubbing at nose
sniffling or throat clearing
dark circles under eyes bc of nasal congestion
T or F: allergic rhinitis is easily diagnosed in primary care
False: often undetected in primary care
What test is used to identify specific allergic triggers of rhinitis
Skin prick testing
Which specific drug does not appear to reduce skin test reactivity?
Montelukast
List 3 general factors that can affect the quality of the allergen extract
Age, seasonal variations, drugs
List 4 classes of therapeutic options
- education
- allergen avoidance
- pharmacotherapy
- allergen immunotherapy
List the general steps a patient usually takes when having rhinitis or asthma symptoms 1. 2. 3. 4. 5.
- self-care
- pharmacist
- general practitioner
- specialist
- Emergency Care
Group the order of medications in order when a patient has allergies
(leukotriene receptor antagonists,
combination intranasal corticosteroid/ antihistamine spray,
allergen avoidance
oral antihistamines
intranasal corticosteroids
allergen immunotherapy
- allergen avoidance
- oral antihistamines
- intranasal corticosteroids
- combo intranasal corticosteroid and antihistamine spray
- leukotriene reeptor antagonists
- allergen immunotherapy
Tips for allergen avoidance
keep window closed
using screen filters
using an air conditioner
limit time outdoors
oral antihistamines _________ action of histamine by acting as neutral receptor _________ of histamine H1 receptor
oral antihistamines BLOCK action of histamine by acting as neutral receptor ANTAGONIST of the histamine H1 receptor.
They do not prevent release of histamine
List 2 non-sedating 2nd antihistamines
- fexofenadine
2. bilastine
Pros of oral antihistamines?
Cons of oral antihistamines?r
Pros: once-daily administration, rapid/effective action, low cost
Cons: less effective than intranasal corticosteroids, some sedation experienced, limited penetration of the BBB
Which receptor do oral and intranasal antihistamines target?
H1 receptor
Pros and cons of intranasal antihistamines?
Pros: rapid onset of action, first or second line of action
Cons: bitter taste, epistaxis, headache, somnolence, nasal burning
Intranasal > oral antihistamine for nasal congestion
How long does it take to reach the peak effect when taking intranasal corticosteroids?
several hours to days
What symptoms do intranasal corticosteroids improve?
sneezing, itching, rhinorrhea, congestion
Which intranasal corticosteroid can improve allergic eye symptoms?
fluticasone furoate
What are some adverse effects of intranasal corticosteroids
nasal dryness, burning, stinging, blood-tinged secretions, and epistaxis
What should a patient be monitoring for when taking intranasal corticosteroid?
intraocular pressure, glaucoma, cataracts
What are some ADRs of the combo spray dymista?
bitter taste, epistaxis, somnolence, headache
How long should you use an intranasal corticosteroid/intranasal oxymetazoline combination?
less than 3 days (short term) bc pt can develop rhinitis medicmentosa
What cells produce leukotrienes?
mast cells, eosinophils, basophils, macrophages, and monocytes
When should leukotriene receptor antagonists be used?
only be used if antihistamines, intranasal corticosteroids, or combo are not tolerated
ADR of using leukotriene receptor antagonists
Upper respiratory tract infection and headache
What are some cons to taking intranasal cromolyn?
slow onset of action (4-7 days)
1 spray in each nostril 6 times daily
slight irritation of the mucosa
Should oral/intranasal decongestants be avoided in pregnancy?
yes
Role of anticholinergics?
block cholinergic receptors to decrease watery nasal secretions
What are some side effects of ipratropium nasal spray? (Atrovent)
nasal and oral dryness, irritation and burning
