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Allergic Rhinitis Flashcards

1
Q

MOA of nasal irrigation

A

rinses out allergens and mucus
increases cilliary function
reduces swelling

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2
Q

What type of water should be used with a “neti pot’?

A

boiled or distilled water

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3
Q

First line treatment for mod-severe rhinitis:

A

intranasal steroids

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4
Q

First line treatment for mild, intermittent rhinitis

A

oral antihistamines

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5
Q

Intranasal steroids that are available OTC

A

fluticasone (Flonase)
triamcinolone (Nasacort)
Budesonide (Rhinocort)

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6
Q

Qnasal

A

beclomethasone

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7
Q

Qnasal dosing

A

Adults: 2 sprays each nostril daily

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8
Q

rhinocort dosing

A

Adults: max 4 sprays per nostril daily

Kids 6+ y/o: max 2 sprays per nostril daily

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9
Q

Omnaris

Zetonna

A

Ciclesonide

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10
Q

Flonase dosing

A

Adults: 1-2 sprays each daily

4-11 y/o: 1 spray each daily
2 + y/o: 1-2 sprays each daily (Flonase Sensimist formulation)

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11
Q

Dymista

A

Fluticasone + azelastine (nasal antihistamine)

1 spray each BID (6 years and older)

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12
Q

Nasonex

A

mometasone

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13
Q

Nasonex dosing

A

2 sprays each daily

2-11 y/o: 1 spray daily

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14
Q

Nasacort dosing

A

triamcinolone

1-2 sprays daily
Age 2-5 y/o: 1 spray daily

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15
Q

intranasal steroid side effects

A

HA
dry nose
nose bleeds
unpleasant tatse

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16
Q

Intranasal steroids have a quick onset of action (t/f)

A

FALSE

Take up to 1 week for full effect

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17
Q

preferred intranasal steroid in pregnancy

A

Budesonide (Rhinocort)

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18
Q

Oral antihistamine treat most symptoms of allergic rhinitis EXCEPT

A

nasal congestion

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19
Q

Tavist

Dayhist

A

Clemastine

1st gen antihistamine

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20
Q

Benadryl dosing for adults

A

25-50 mg q4-6 hrs

max 300 mg/day

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21
Q

Benadryl dosing for kids (self-care)

A

6-11 years old:
12.5 - 25 mg q4-6h (max 150 mg/day)

not recommended for < 6 y/o (self-care)

22
Q

Arbinoxa

Karbinal ER

A

Carbinoxamine
1st-gen antihistamine

approved for ages 2 +

23
Q

Chlor-trimeton

A

Chlorpheniramine

1st gen antihistamine

24
Q

Contraindications/warnings for 1st gen antihistamines

A 
lactating women (use 2nd gen)
narrow-angle glaucoma
asthma
BPH
bladder obstruction
25
Zyrtec dosing
cetirizine 5-10 mg daily 2-5 y/o: 2.5- 5 mg daily
26
Xyzal dosing
Levocetirizine 5 mg HS 6-11 y/O: 2.5 mg HS 6 mons-5 yrs: 1.25 mg HS
27
Allergra dosing
Fexofenadine 60 mg BID or 180 mg daily 2-11 y/o: 30 mg BID
28
Allergra clinical pearls
take w/ food | do not take with fruit juices --> decr absorption
29
Claritin dosing
loratadine 10 mg daily 2-5 y/o: 5 mg daily
30
Clarinex dosing
Desloratadine 5 mg daily 6-11 y/o: 2.5 mg daily 1-5 y/o: 1.25 mg daily 6-11 mons: 1 mg daily
31
Which 2nd gen antihistamine is NOT available in an ODT form?
levocetirizine
32
Which 2nd gen antihistamines can possibly cause sedation?
Cetirizine | levocetirizine
33
Astelin | Astepro
Azelastine | intranasal antihistamine
34
Patanase
Olopatadine | intranasal antihistamine
35
intranasal antihistamines CAN treat nasal congestion (t/f)
TRUE
36
Contraindication/warnings for systemic decongestants
``` use w/in 14 days of MAO inhibitors CV disease and uncontrolled HTN hyperthyroidism diabetes (incr BG) bowl obstruction glaucoma (incr IOP) BPH ```
37
Phenylephrine max dose
given q4-6h adults: 60 mg 6-11 yrs: 30 mg 4-5: 15 mg
38
Pseudoephedrine max dose
Adults: 240 mg daily 6-12: 120 mg 4-5: 60 mg
39
Onset of action for oral decongestants
15-60 mins
40
Afrin
oxymetazoline | 2-3 sprays q12h prn
41
Other brands for oxymetazoline
Neo-synephrine nighttime 12-hr | Vicks sinex
42
Neo-syndephrine 4 hours
Phenylephrine nasal spray
43
topical decongestant side effects
stinging burning sneezing nasal dryness
44
Recommended duration of action for topical decongestants:
3 days of less prevent rebound congestion
45
Privine
Naphazoline 0.05 % nasal spray
46
Tyzine
Tetrahydrozoline nasal spray | Rx- only
47
Intranasal cromolyn info
``` Nasalcrom MOA: mast cell stabilizer used for allergy tx and prophylaxis 1 spray every 6-8 hours (Not PRN) Max effects can take up to 2-4 weeks ```
48
Atrovent nasal spray
ipratropium nasal spray | used to treat rhinorrhea (runny nose)
49
Singulair use in allergys
montelukast similar efficacy to decongestants + antihistamines can be used as adjunctive therapy
50
Sublingual immunotherapy options:
Oralair (grass pollen) Grastek (grass pollen) Ragwitek (ragweed pollen) Odactra (dust mites)
51
What type of pseudophedrine does not need to be locked behind a counter?
single dose package | max of 60 mg
52
Limits for sudafed sales
3.6 grams per day | 9 grams w/in 30 days

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