Allergic Rhinitis, Cough & Cold

Question 1

What is hay fever?

Answer 1

Allergic rhinitis, or simply “allergies”

Question 2

While colds are caused by a virus, allergic rhinitis is caused by?

Answer 2

an allergen (pollen dust, pet dander)

Question 3

Non-drug treatment for allergic rhinitis?

Answer 3

Avoiding exposure to known or suspected allergens

an IgE-mediated skin prick test or blood test can determine patient-specific allergens

Question 4

Common allergens (4)

Answer 4

Pollens

Molds

Dust mites

Animal dander

Question 5

What is the name of the index that rates the local air as good to hazardous?

Answer 5

AQI - air quality index

Question 6

Nasal irrigation uses what types of saline solution?

Answer 6

isotonic and hypertonic (2-3.5%)

Question 7

What is first line for chronic, mod-severe symptoms of allergic rhinitis?

Answer 7

intranasal steroids

especially effective in reducing the nasal symptoms of allergic rhinitis, congestion

Question 8

What is first line for milder, intermittent symptoms?

Answer 8

oral antihistamines

little effect on nasal congestion

Question 9

Brand: Rhinocort Allergy

Answer 9

Generic: budesonide

Question 10

Brand: Flonase Allergy Relief, Flonase Sensimist, Children’s Flonase

Answer 10

Generic: fluticasone

Question 11

Brand: Nasacort Allergy 24H & in children’s

Answer 11

Generic: triamsinolone

Question 12

What is a common side effect from intranasal steroids?

Answer 12

epistaxis (nose bleeds)

Question 13

How long can it take for nasal steroids to work?

Answer 13

1 week

Question 14

What are the preferred nasal steroids in pregnancy?

Answer 14

budesonide and beclomethasone (Beconase AQ)

Question 15

Antihistamines work by blocking histamine at the ___ receptor site

Answer 15

H1

first gen- more sedative

second gen- less

Question 16

diphenhydramine
chlorpheniramine
doxylamine
clemastine

drug class?

Answer 16

First gen oral antihistamines

Question 17

Brand: Aller-Chlor, Chlor-trimeton

Answer 17

Generic: Chlorpheniramine

Question 18

Benadryl dose for adults

Answer 18

25-50mg PO Q4-6h (max 300mg/day)

Question 19

Benadyl <6 y dose

Answer 19

do not use OTC, unless directed by PCP

Question 20

Which drug class?

avoid in elderly
prostate enlargement
glaucoma
somnolence, cognitive impairment

Answer 20

first-get antihistamines

Question 21

cetirizine
levocetrizine
fexofenadine
loratadine

drug class?

Answer 21

second gen antihistamines

Question 22

Brand: Zyrtec

Answer 22

Generic: cetirizine

Question 23

Brand: Xyzal Allergy

Answer 23

Generic: levocetirizine

Question 24

Brand: Allegra Allergy

Answer 24

Generic: fexofenadine

*don’t take with juice

Question 25

Brand: Claritin

Answer 25

Generic: loratadine

Question 26

What second gen drugs are preferred in preg?

Answer 26

loratadine, cetirizine

Question 27

Cetirizine and levocetirizine more or less sedating?

Answer 27

MORE less= fexofenadine, loratadine

Question 28

Can intranasal antihistamines be combined with intranasal steroids?

Answer 28

yes dymista, patanase

Question 29

alpha-adrenergic agonists that cause vasoconstriction which decreases sinus vessel engorgement and mucosal edema

Answer 29

decongestants

Question 30

Oral decongestants include

Answer 30

phenylephrine | pseudoephedrine

Question 31

Which drug class? C/IL within 14 days of MAO inhibitors avoid in children <2 (FDA) caution with CVD, BPH, urinary retention inc HP, BP

Answer 31

Oral decongestants

Question 32

oxymetazoline (afrin) is a ..

Answer 32

intranasal/topical decongestant

Question 33

An OTC mast cell stabilizer used for treatment and prophylaxis of allergic rhinitis

Answer 33

Intranasal cromolyn (NasalCrom) used regularly, not PRN to be effective; safe in kids and preg

Question 34

the only leukotriene modifying agent indicated for the treatment of both allergic rhinitis and asthma

Answer 34

montelukast (Singulair) FDA- BW for neuropsychiatric effects

Question 35

contains 5 different grass pollen extracts

Answer 35

Oralair

Question 36

contains Timothy grass pollen extract

Answer 36

Grastek

Question 37

contains ragweed pollen extract

Answer 37

Ragwitek

Question 38

Contains house dust mite allergen extract

Answer 38

Odactra

Question 39

Natural products used for colds?

Answer 39

Zinc Vitamin C Echinacea Airborne/Emergen-C

Question 40

acts as a serotonin reuptake inhibitor, at high doses it acts as an NMDA-receptor blocker leading to euphoria and hallucinations similar to PCP

Answer 40

dextromethorphan "DM" many states ban the sale to minors

Question 41

Codeine listed as a CII used for:

Answer 41

pain

Question 42

Codeine listed as a C-V used for:

Answer 42

cough and cold

Question 43

BW: respiratory depression and death have occurred in children who have received this drug following tonsillectomy and or adenoidectomy and have evidence of being ultra-rapid metabolizers due to a 2D6 polymorphism

Answer 43

Codeine do not use in children <12 or <18 for said surgeries

Question 44

The FDA recommends to avoid codeine-containing cough and cold products for patients

Answer 44

<18

Question 45

Brand: Tessalon Perles

Answer 45

benzonatate

Question 46

Brand: Bromfed DM

Answer 46

Generic: Brompheniramine/psueoephedrine/dextromethoprphan

Question 47

AC means what is inside?

Answer 47

codeine

Question 48

Brand: TussiCapsm

Answer 48

Generic: Chlorpheniramine/hydrocodone | C-II

Question 49

Promethazine/codeine control?

Answer 49

C-V

Question 50

guafenensin/codeine control?

Answer 50

C-V

Question 51

Guafenesin/codeine/pseudoephdrine control?

Answer 51

C-V

Question 52

What products need to be avoided in children <2?

Answer 52

OTC cough and cold products promethazine topical menthol and camphor (Vicks)