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Allergic Rhinitis, Cough & Cold Flashcards

Chapter 37

1
Q

What is the difference between Allergic Rhinitis and Common Cold?

and symptoms?

A
  • Allergic Rhinitis: caused by “allergies” [symptoms - runny nose, sneezing, itchy eyes…]
  • Cold: caused by viruses [symptoms - runny nose, thick mucus, body aches, sore throat…]
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2
Q

What are some of the non-drug treatments used for Allergic Rhinitis?

A
  • Avoiding exposure [duh]
  • Better ventilation systems [pollen/mold], vacuuming [pet dander]…
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3
Q

What do Nasal Irrigation & Wetting Agents do to help with Allergic Rhinitis?

A
  • Provides symptomatic relief by reducing nasal stuffiness
  • Best to use in childern and pregnancy
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4
Q

What is important to know about Wetting Agents used in Allergic Rhinitis?

What are some of the products?

A
  • “Ocean, Little Remedies”
  • Contain saline to moisturize and reduce irritation to the nasal passage.
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5
Q

What is important to know about Nasal Irrigation in Allergic Rhinitis?

A
  • Uses isotonic & hypertonic saline to rinse out the allergens and mucus, improve ciliary function, and reduce swelling
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6
Q

Should Tap Water be used as a Nasal Irrigate or Wetting Agent?

A
  • NO could increase risk of infections
  • Needs to be saline with distilled, sterile or previously boiled water
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7
Q

What is considered to be First Line drug treatment for Allergic Rhinitis?

Other Treatments?

A
  • Intranasal Steriods [for chronic, mod-severe symptoms]
  • Oral Antihistamines [more used in mild symptoms]
  • Decongestants [if congested]
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8
Q

What is the way that Intranasal Steroids work for Allergic Rhinitis?

A
  • Decrease Inflammation - considered first line for mod-severe symptoms

Same as for Asthma just different brand names

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9
Q

What are some of the Intranasal Steroids that are used for Allergic Rhinitis?

A
  • Budesonide [Rhinocort]
  • Fluticasone [Flonase]
  • Triamcinolone [Nasacort]
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10
Q

What are some of the Side Effects for the Intranasal Steroids for Allergic Rhinitis?

A
  • Epistaxis [Nose Bleeds], headache, dry nose, bad taste, localized infection
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11
Q

What are some of the other additional Notes for the Intranasal Steriods for Allergic Rhinitis?

A
  • One week to see effects
  • Budesonide & Beclomethasone are best in pregnancy
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12
Q

What is the way that the Antihistamines work in Allergic Rhinitis?

A
  • Block histamine at Hitamine-1 receptor - best for mild symptom
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13
Q

What is the big difference of the Antihistamine Generations for Allergic Rhinitis?

A
  • 1st gen are more sedating
  • 2nd gen are more preferred
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14
Q

What are some of the 1st Gen Antihistamines that are used for Allergic Rhinitis?

A
  • Diphenhydramine [Benadryl]
  • Chlorpheniramine
  • Doxylamine
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15
Q

What are some of the warnings for the 1st gen Antihistamines in Allergic Rhintis?

A
  • AVOID in elderly [anticholinergic effects]
  • Caution in those with cardio diseases, prostate enlargement, glaucoma
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16
Q

What are some of the side effects for the 1st gen Antihistamines for Allergic Rhinitis?

A
  • Somnolence, Cognitive Impairment, Anticholinergic Effects [Dry mouth, constipation, urinary retention, blurred vision]
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17
Q

What are some of the other things that Benadryl can be used for other than Allergic Rhinitis?

A
  • Prevention of allergic reaction
  • Cough
  • Sleep [sedating]
  • Motion Sickness
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18
Q

What are the 2nd Gen Antihisitamines that are used for Allergic Rhinitis?

A
  • Cetirizine [Zytrec]
  • Levocetirizine [Xyzal]
  • Fenofexadine [Allegra]
  • Loratadine [Claritin]

+ Pseudoephedrine makes it the “D” version

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19
Q

What are some of the important notes for the 2nd Gen Antihistamines for Allergic Rhinitis?

A
  • Allerga: Take with water [NOT Grapefruit juice]
  • Claritin & Zytrec: Best in pregnancy
  • Zytre & Xyzal have fast onset
  • Zytrec & Xyzal are MORE sedating and Claritin & Allerga are LESS sedating
20
Q

What are the Intranasal Antihistamines that are used for Allergic Rhinitis?

A
  • Azelastine
  • Olopatadine
21
Q

What is the way that Decongestants work for Allergic Rhinitis?

A
  • Alpha-adrenergic agonist that cause vasoconstriction; decreasing sinus engorgment and edema = decrease congestion
22
Q

What is important to know about a D after the products name for ANY of the drugs in Allergic Rhinitis?

A
  • Contains Phenylephrine or Pseudoephrine
  • Phenylephrine: poor absorption
  • Pseudoephrine: more effective; precursor to METH
23
Q

How much Pseudoephrine is allowed per day or per 30 days?

A
  • 3.6 g per day
  • 9 g per 30 days
24
Q

What are the Systemic Decongestants that are used in Allergic Rhinitis?

A
  • Phenylephrine [Sudafed PE]
  • Pseudoephrine [Sudafed}
25
What are some of the **contraindiactions** for the **Systemic Decongestants**?
- DO NOT use within 14 days fof MAOi
26
What are some of the **warnings** for the **systemic Decongestants** in **Allergic Rhinitis**?
- AVOID in childern < 2y - Caution in patients with CV disease, hypertension [worsen], diabetse [increase BG], BPH [urinary retention]
27
What are some of the **side effects** for the **systemic Decongestants** used in **Allergic Rhinitis**?
- Tachycardia, Palpitation, Increase BP, Insomnia, Decreased Appetite
28
What are some of the other important **notes** for **systemic Decongestants** in **Allergic Rhinitis**?
- Avoid in the 1st tri of pregnancy
29
What are some of the **topical decongestants** used in **Allergic Rhinitis**?
- Oxymetazoline
30
What are some of the **side effects** of the **topical decongestants** in **allergic rhinitis**?
- Rhinitis Medicamentosa [rebound congestation if used for longer than 3 days]
31
What are some of the other **additional allergy medications** that are used for **allergic rhinitis**?
- Intranasal Cromolyn - Montelukast - Intranasal Ipratropium - Immunotherapy
32
What is important to know about **intranasal cromolyn** in **allergic rhinitis**?
- OTC mast cell stabilizer for the treatment/prophylaxis of allergic rhinitis - Started at **onset** of allergy season [NOT **PRN**] - Safe in childern and pregnancy
33
What is important to know about **Montelukast** in **allergic rhinitis**?
- Only leukotriene agent for treatment of **allergic rhinitis or asthma** - Commonly used in childern - Best for those that have failed other treatments
34
What is important to know about **Immunotherapy** for **Allergic Rhinitis**?
- Prevention for allergies either SubQ or SubL
35
What is a Cold?
- Viral infection of the **Upper Respiratory Tract** - Transmitted via **Mucas** or **Air**
36
What are some of the **Natural Products** that can help with the **Common Cold**?
- Zinc: prevention/treatment; may decrease duration if used at the start - Vitamin C: Decrease duration
37
What is that way that **Expectorants** work for the **Common Cold**?
- If productive cough is present, they thin mucus helping it get coughed out
38
What are some of the **expectorants** that are used for the **Common Cold**?
- Guaifenesin [Mucinex, Robitussin] + Dextromethorpharm [Robitussin DM]
39
What is the way that **cough suppressants** work for the **common cold**?
- Suppress cough reflex
40
What are the **Cough Suppressants** that are used for the **common cold**?
- Dextromethorphan [Delsym, Robitussin Cough] + Guaifensin [Robitussin DM] - Co dine [C-II for pain; C-V for Cough] - Benzontate [Tessalon perles] - Diphenhydramine [Benadryl]
41
What is important to know about **dextromethorphan** when used for the **Common Cold**?
- Acts as a serotonin reuptake inhibitor [watch for Serotonin Syndrome] and at HIGH doses is an NMDA-receptor block [causing hallucination or euphoria (like PCP)]
42
What are the **contraindications** for **Dextromethorphan** when used for the **common Cold**/
- DO NOT use within 14 days of MAOi
43
What are the **warnings** for **Dextromethorphan** when used for the **Common Cold**?
- Serotonin Syndrome
44
What are some of the **Boxed warnings** for **Codeine** in those taking it for the **common cold**?
- Possible respiratory depression & death in children following tonsillectomy and.or adenodectomy [ultra-rapid metabolizers]
45
What are some of the **Contraindications** for **Codiene** when used for the **Common Cold**?
- DO NOT used in childern < 12y or childern < 18y after tonsillectomy and/or adenodectomy
46
What is important to know about the **naming** of cough and cold combination products?
- **D** = Decongestant - **PE** = **P**henyl**e**hrine - **DM** = **D**extro**m**ethorphan - **AC** = contains codiene - **Guaifenesin** thins mucus - **Analgesic** = tylenol - **Antihistamines**

Naplex 2025 (57 decks)

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