Allergic Rhinitis and Common Cold

Question 1

Another word for allergic rhinitis

Answer 1

hay fever

Question 2

Allergic Rhinitis

Answer 2

Inflammation of nasal mucosa due to exposure to allergens

Question 3

Allergic Rhinitis S/S

Answer 3

Tearing of eyes, sneezing, nasal congestions, post-nasal drip, & itching of the throat

Question 4

Allergic rhinitis Complications

Answer 4

can include loss of smell, sinusitis, chronic cough, hoarseness.

Question 5

Allergens for Allergic Rhinitis

Answer 5

Pollens
Mold spores
Dust mites
Certain foods
Animal Dander

Question 6

Non-Allergen factors for Allergic Rhinitis

Answer 6

Chemical fumes
Tobacco smoke
Air pollutants

Question 7

Exposure to an allergen provides

Answer 7

a response from the body’s defense symptoms

Question 8

Allergic rhinitis can lead to

Answer 8

middle ear infections in children

Question 9

Number one treatment for allergic rhinitis and the number two treatment

Answer 9

avoidance

medications

Question 10

There are three pollen season sin MN what are they

Answer 10

Tree Pollen
Grass Pollen
Weed Pollen/Ragweed

Question 11

Tree Pollen

Answer 11

early April until the end of may

Question 12

Grass pollen

Answer 12

early June until mid July

Question 13

weed/ragweed

Answer 13

mid June until hard frost. Ragweed early august through mid-October

Question 14

In MN what is most commonly seen and when do you start medications

Answer 14

Ragweed.

Recommend they start in early July to get ahead of symptoms

Question 15

Animal Dander

Answer 15

remove from house. or keep animal out of patient’s bedroom. HEPA room air filter. seal or put filter on air ducts that leave to the individuals bedroom

Question 16

house mites

Answer 16

encase pillows and mattress in DM cover, wash bedding in hot water weekly (>130 degrees). Remove carpet from bedrooms

Question 17

cockroaches

Answer 17

professional exterminations, vacuum and wet wash home, use poison bait or traps, no food or garbage exposed, repair pluming leaks, cracks, crevices.

Question 18

indoor mold

Answer 18

reduce indoor humidity to 50%, are condition, fix all leaks and eliminate water sources, clean moldy surfaces.

Question 19

pollens

Answer 19

trees, grass or weeks, outdoor mold - say indoors windows closed, monitor pollen counts, don’t hang laundry outside, shower before going to bed

Question 20

H1 Receptor Antagonists

Answer 20

Antihistamines

Question 21

H1 Receptor MOA

Answer 21

Block actions of histamine at the H1 receptor
Can be combined with decongestants and anti-tussives
Anti-cholinergic effects – increased HR, urinary retention, constipation, blurred vision; drying of mucous membranes

Question 22

1st generation antihistamine example and SE

Answer 22

Benadryl - significant drowsiness

Question 23

2nd and 3d generation example and reason for prefered use

Answer 23

Zyrtec - less tendency to cause sedation (preferred fewer CNS effects)

Question 24

antihistamine routes

Answer 24

Oral, intransal route, ophthalmic drops

Question 25

1st-generation limited because of

Answer 25

anticholinergic effects

Question 26

Nasal sprays

Answer 26

anti-inflammatory effects, rapid onset of action (less than 15 minutes)

Question 27

eyedrop example

Answer 27

pataday

Question 28

antihistamine first generation ADR

Answer 28

sedation and fatigue, dizziness, headaches, blurred visions, irritably, constipation, diarrhea, dry mouth, urinary retention

Question 29

antihistamine second generation ADR

Answer 29

drowsiness greatly reduced, dry mouth (5% or less)

Question 30

Intranasal Corticosteroids

Answer 30

First line therapy, single effective maintenance therapy – effective nasal congestion

Question 31

Intranasal Corticosteroids

MOA

Answer 31

inhibit allergic inflammation, downregulate inflammatory response by binding to intracellular glucocorticoid receptors in the cytoplasm of inflammatory cells.

Question 32

Intranasal Corticosteroids ADR

Answer 32

Few adverse effects

Question 33

Intranasal Corticosteroids

Decrease secretion of

Answer 33

inflammatory mediators, reduce tissue edema, cause mild vasoconstriction

Question 34

Intranasal Corticosteroids

Meter-spray device

Answer 34

few SE if used right

Question 35

Intranasal Corticosteroids

Onset of action

Answer 35

few hours but can take 1 to 3 weeks to achieve peak response

Question 36

Intranasal Corticosteroids

Side effects

Answer 36

intense burning sensation in nose, epistaxis

Question 37

Intranasal Corticosteroids

Directed away from the

Answer 37

septum (rare=nasal septal perforation)

Question 38

Intranasal Corticosteroids examples

Answer 38

Fluticasone, Flonase or Nasonex

Question 39

Additional treatment options for Allergic Rhinitis

Answer 39

Second line drugs:

Mast Cell Stabilizers - inhibits release of histamine from mast cells - Cromolyn
Montelukast (Singulair)
Ipratropium (Atrovent) -

Question 40

Ipratropium (Atrovent)

Answer 40

rhinorrhea and sneezing (does not help with congestion) - local application to infection helps with secretions

Question 41

Decongestants

Answer 41

Relieve nasal congestion in allergies or the common cold

Oral or Intranasal

Question 42

Decongestants can be combined with

Answer 42

antihistamines

Question 43

Decongestants are

Answer 43

sympathomimetics

Question 44

Intranasal Afrin (Decongestents)

Answer 44

few side effects – rebound congestion (limit use 3 to 5 days)

Question 45

Decongestants oral

Answer 45

onset of action slower than intranasal, less effective at relieving nasal congestion

Question 46

Decongestants oral side effects

Answer 46

HTN and CNS stimulation – insomnia and anxiety