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PHARM II TEST 2 > Allergic Rhinitis & Conjunctivitis > Flashcards

Allergic Rhinitis & Conjunctivitis Flashcards

1
Q

What types of drugs can be associated with causing acute rhinitis symptoms

A

Vasodilators

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2
Q

This group of drugs inhibits prostaglandins

A

NSAIDs

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3
Q

Two older classifications of allergies:

A

Seasonal vs perennial (year round)

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4
Q

Intermittent symptoms = how many days a week or how many weeks?

Same for persistent…

A

Intermittent is <4 days/wk or <4 weeks

Persistent is > or = 4 days/wk and > or = 4 weeks

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5
Q

Allergic rhinitis gets to the moderate/severe range when:

A
  • sleep disorder
  • disturb daily life, sport, leisure
  • symptoms occur at work or school
  • troublesome symptoms
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6
Q

Are intranasal CS used with intermittent mild AR symptoms?

A

No

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7
Q

When do intranasal CS become the preferred agent?

A

With persistent symptoms classification

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8
Q

Treatment steps for mild intermittent symptoms

A

Oral antihistamine or

IN antihistamine +/- decongestant or

LTRA (leukotriene receptor antagonist)

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9
Q

Treatment for moderate/severe intermittent symptoms

A

Oral antihistamine or

IN antihistamine +/- decongestant, or

LTRA, or

INS (intranasal steroid)

These are all allergen specific and combo INS and IN antihistamine were more effective than monotherapy

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10
Q

Treatment steps for mild persistent symptoms

A

…

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11
Q

Treatment for moderate/severe persistent symptoms…

A

…

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12
Q

Competitive H1 antagonist, or an inverse agonist, of the early response

A

Antihistamines

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13
Q

AEs for 1st generation antihistamines

A

Sedation, anticholinergic effects, hypotension (a-block), paradoxical excitement in children

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14
Q

AEs for 2nd generation AHs

A

HA

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15
Q

Intranasal AHs tend to improve congestion more than oral, but come with what AE?

A

Bitter taste

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16
Q

Preferred by ACOG in pregnancy, but maybe not the one that does get used

A

Chlorpheniramine

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17
Q

Pregnancy cat B; used as OTC sleep aid?

A

Diphenhydramine (Benadryl)

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18
Q

Good 2nd gen AHs that he says get used mostly in pregnancy

A

Loratadine and Cetirizine

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19
Q

2nd gen AHs are generally preferred why?

A

Less sedation, performance impairment, and/or anti-cholinergic SEs

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20
Q

What are the two IN AHs?

A

Azelastine and Olopatadine

Better than oral AHs

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21
Q

MoA of decongestants?

A

Direct and indirect a1 agonists that produce vasoconstriction of resp mucosa

22
Q

Need to be careful with these meds and people who already have arrhythmias, HTN, hyperthyroidism b/c they cause increased BP and HR and stroke risk

A

Decongestants

23
Q

Other SEs of decongestants besides the CV stuff…

A

CNS stimulation, urinary retention (careful in BPH), increased BG (careful in DM), rebound congestion, increased ICP, nasal irritation

24
Q

His favorite decongestant

A

Oxymetazoline IN

25
Q

Synthetic a1-agonist used mainly for relief of eye redness, hemorrhoids, and nasal congestion

A

Phenylephrine

can cause extravasation/tissue necrosis when used IV

26
Q

Direct-acting a1-a2 agonist used for ocular and nasal vasoconstriction

A

Oxymetazoline (Afrin; Visine LR)

27
Q

Direct-acting a and B agonist (a>b) while also displacing NE from storage sites, used for nasal congestion

A

Pseudoephedrine

28
Q

PSE is limited daily to 3.6g of PSE base and 30-day purchase limit to 9g PSE base, what’s PSE?

A

Pseudoephedrine

29
Q

Decongestant DOC in pregnancy 2nd trimester or later (oral)

A

Pseudoephedrine (PSE)

30
Q

Decongestant alternative marketed for people who are unable to take decongestants b/c HBP

A

Coricidin HBP

Dextromethorphan and Chlorpheniramine…aka AHs, but fail to target obstruction of nasal passages

31
Q

Inhibits cysteinyl leukotriene, inflammatory mediator released by mast cells, on target cells…comparable efficacy to AHs, but less than IN steroids

A

Leukotriene Antagonist

Montelukast (Singulair)

32
Q

Care with this type of med in people with suicidal thoughts

A

Leukotriene antagonists like singulair

33
Q

Anti-infl agents that inhibits the mediators of both the early and late phase reaction…MOST EFFECTIVE DRUGS FOR AR RELIEVING ALL FOUR SYMPTOMS

A

Intranasal Steroids

34
Q

INSs are effective but how long do they tend to take to work?

A

Onset is just 1-2 days but max effects occur in 1-2 weeks

35
Q

AEs of INSs are mild: drying, stinging, epistaxis, after taste, except one bigger concern in peds, which is?

Also tell pts to spray away from nasal septum

A

Growth suppression

36
Q

The three most important INSs to know are:

A

Fluticasone Propionate (Flonase)

Fluticasone Furoate (Veramyst)

Mometasone (Nasonex)

B/c they are all the least lipophilic

37
Q

Dymista

A

…

38
Q

Muscarinic antagonist resulting in decreased nasal mucous secretion, and preg cat B…

A

Ipratropium nasal (Atrovent)

39
Q

Initial DOC during pregnancy for rhinorrhea and sneezing are?

A

Mast cell stabilizers like Cromolyn Sodium (Nasalcrom)

40
Q

Chart from slide 52

A

…

41
Q

The most effective class of meds across the board for AR symptoms are?

A

INSs

42
Q

Triad of symptoms in allergic conjunctivitis (pinkeye not from virus/bacteria)

A

Itching, conjunctival injection (redness), chemosis (conjunctiva swelling w/ or w/o watery discharge

43
Q

Treatment steps for mild allergic conjunctivitis…

A

…

44
Q

Treatment steps for moderate allergic conjunctivitis…

A

…

45
Q

Treatment steps for severe allergic conjunctivitis…

A

…

46
Q

Nonselective ocular AHs (H1 antagonists) that decrease itching and vasodilation

A

Azelastine (optivar) and Levocabastine (Livostin)

47
Q

2nd gen ocular AHs

A

Ketotifen (Zaditor) and Olopatadine (Patanol)

48
Q

Ocular decongestants include:

A

Naphazoline (Vasocon) is most potent

Oxymetazoline (Visine LR)

Tetrahydrozoline (Visine original)

49
Q

Ocular mast cell stabilizers include

A

Cromolyn, lodoxamide, nedocromil (best b/c can do twice per day which is the least frequent dosing)

50
Q

Ocular NSAID

A

Ketoralac (ASA so not for kids)

51
Q

Ocular steroids, for more severe/chronic allergic conjunctivitis (specialist), ONLY ONE APPROVED FOR USE IN SEASONAL ALLERGIC CONJUNCTIVITIS:

A

Loteprednol

AEs include cataracts, increase IOP, increase risk for ocular infection

52
Q

Eye drop administration steps:

A

Wash hands -> tilt head black and pull lower lid down -> hold dropper close to eye, brace with hand -> squeeze dropper so single drop falls into pocket made by lower eyelid -> close eye for 2-3 min, tip head down, don’t blink/squeeze eyelid, place finger on tear duct and apply pressure, wipe excess, wait 5 min

PHARM II TEST 2 (7 decks)

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