Allergic Rhinitis and Cough Flashcards
What are adverse reactions to inhaled corticosteroids (4) ?
- headaches
- cough
- epistaxis
- pharyngitis
What is MOA of inhaled corticosteroids (3)?
- vasoconstriction
- inhibits mast cell mediated late phase rxn
- reduces inflammation by inhibit mediator release
What is the AAAAI recommendation for tx of allergic rhinitis?
monotherapy of inhaled corticosteroid in patients 12 y/o and older
When should tx with intranasal corticosteroid therapy and intranasal antihistamine medication be considered?
when patient is 12 years or older and moderate to severe allergic rhinitis is present
what side effects are present with systemic corticosteroids (4)?
-HPA suppression
-glaucoma
cataracts
-changes in bone mineral density
What does SNS input do to nasal mucosa (2)?
- vasoconstricts
- opens/widens airways
What does PNS input do to nasal mucosa (2)?
- increases mucus
- vasodilates/inflamed closes airway
What are the effects of histamine (4)?
- itching
- increased vasopermeability
- mucous production
- smooth muscle contraction
name intranasal corticosteroids (4) ?
- beclomethasone
- flunisolide
- budesonide
- fluticasone
How long for the intranasal corticosteroid to take effect?
-2-3 weeks
What is MOA for H1-receptor antagonists?
- competitive antagonist of histamine-binds receptor but does not activate it
- binds H1 receptor and blocks it from histamine
- best used as a prophylactic
- reversal effects largely due to anticholinergic properties
Name 1st generation H1- receptor antagonist (3)?
Which can you use in pregnant women?
Do they have anticholinergic and sedative effects?
-diphenhydramine/benadryl
-hydroxyzine
chlorpheniramine (lowest sedative and anti cholinergic effects ) use in pregnant women
** quick effect, last 6-8 hours
-yes,
Name 2nd generation H1 Receptor Antagonist (3)?
- Loratadine/ Claritin
- fexofenadine/allegra
- cetirizine/Zyrtec
- *long duration for effect, longer duration
- no anticholinergic or sedative effects
Drug interaction of H1 receptor antagonists?
- CNS depressants/benzos
- anticholinergics/ ipratropium
Adverse effects of H1-receptor antagonists (8)?
- CNS depression
- temp dysregulation
- flushing
- dilated pupils
- psychosis
- urinary retention
- constipation
- dry mouth (xerostomia)
What are some intranasal and ophthalmic H1 receptor antagonists (2)?
- Azelastine
- Olopatadine
What is a topical H1 receptor antagonist?
-diphenhydramine
Why are H1 receptor drugs classified as “dirty drugs”?
-because they bind to many receptors
What is MOA for decongestants?
- stimulate alpha receptors and cause vasoconstriction
- pseudoephedrine stimulates beta receptors and relaxes bronchioles and increases HR and contractility
What is rebound congestion?
-overuse of intranasal decongestants (more than three to four days) can lead to vasodilation and mucous production (overstimulation of SNS mechanism)
Name oral decongestants (2)?
- phenylephrine
- pseudoephedrine
Name intranasal decongestants (4)?
- naphazoline
- oxymetazoline
- phenylephrine
- tetrahydrozoline
What are adverse rxns to decongestants?
-rebound congestion
Why should you monitor BP and heart rate for people taking decongestants ?
-decongestants can increase HR and contractility and may present complication to patients with heart issues
