Allergic Rhinitis, Cough And Cold Flashcards
Sx of AR
Sneezing
Itchy nose, eyes or throat
Watery eyes
Rhinorrhea
Nasal congestion
Postnasal drip
What is allergic rhinitis (hay fever)?
Inflammation of the membrane linings in the nose.
What’s the main environmental control of allergic rhinitis?
Avoiding exposure to allergens
List nasal wetting agents
Saline
Propylene
PEG sprays
Nasal irrigation agents
Warm saline (isotonic or hypertonic)
What’s the first line tx for Chronic, Moderate-to-Severe rhinitis?
Intranasal corticosteroids
What’s the tx for milder, intermittent sx of hay fever?
Oral antihistamines
List Intranasal corticosteroids (1st line for chronic mod-to-severe hayfever)
Beclomethasone (Qnasi, Beconase AQ)
Budesonide (Rhinocort Aqua)
Ciclesonide (Omnaris, Zetonna)
Triamcinolone (Nasacort AQ)
Flunks oldie
Fluticasone (Flonase, Veramyst)
Fluticasone + Azelastine (Dymista)
Mometasone (Nasonex)
Remember “NASO” on a med name means nose
Ok
What’s the brand name for mometasone?
Nasonex
What’s the brand name for Triamcinolone?
Nasacort AQ
What’s the main warning ass. with Intranasal corticosteroids?
Delayed wound healing
AVOID use if recent nasal septal ulcers, surgery, trauma until healing has occurred
Effect of Intranasal corticosteroids on peds?
May cause red in growth
Use lowest possible dose
Monitor dose
Which is the preferred IC in pregnacy?
Budesonide (Rhinocort Aqua) - preg cat B
What’s the first line agents for mild-mod hayfever?
Oral antihistamine
What sx are oral antihistamines effective in reducing?
Itching
Sneezing
Rhinorrhea
What sx are oral antihistamines NOT effective in reducing?
Nasal congestion
What’s the main first gen oral antihistamines?
Diphenhydramine (Benadryl)
All first gen. oral antihistamines are safe for preg, but which is considered first line?
Chlorpheniramine (Chlor-Trimeton)
What’s the dose for diphenhydramine (Benadryl)?
25-50 mg PO Q4-6H (max. 300 mg/day)
Which first gen AH can’t be used in children < 2 years?
Carbinoxamine ER (Karbunak ER)
Promethazine (Phenergan)
What’s the main SE of first gen AH?
Sedation
List the 2nd gen AH agents
Cetirizine (Zyrtec, Zyrtec D)
Desloratadine (Clarinex, Clarinex D, Clarinex RediTabs)
Fexofenadine (Allegra, Allegra D 12H;24H, children’s Allegra ODT)
Levocetirizine (Xyzal)
Loratadine (Claritin, Claritin-D 24 hr, Claritin RediTabs, Alavert
What’s the brand name of cetirizine?
Zyrtec, Zyrtec D
What’s the brand name of desloratadine?
Clarinex, Clarinex D, Clarinex RediTabs
What’s the brand name of Fexofenadine?
Allegra, Allegra D 12H; 24H, children’s Allegra ODT
What’s the brand name of Levocetirizine?
Xyzal
What’s the brand name of loratadine?
Claritin, Claritin-D 24 hr, Claritin RediTabs, Alavert
Which 2nd gen AH is sedation most common in (still less than 1st gen)?
Cetirizine (Zyrtec)
Levocetirizine (Xyzal)
Which 2nd gen AH works the fastest of the group?
Cetirizine (Zyrtec)
Levocetirizine (Xyzal)
Name the agents/food that LOWER GI absorption of Fexofenadine (Allegra)?
What’s the timeframe for separation?
Orange juice
Grapefruit juice
Apple juice
Antacids containing Al or Mg
Separate by 2 hrs
Name the agents/food that INCREASE GI absorption of Fexofenadine (Allegra)?
What’s the timeframe for separation?
Ketoconazole
Erythromycin
No timeframe! AVOID this combo