Allergic Rhinitis Inhaled Corticosteroids, Leukotriene Receptor Antagonists, Miscellaneous Agents

Question 1

Inhaled Corticosteroids Mechanism of action

Answer 1

Inhaled corticosteroids reduces inflammation by reducing the release of mediators, though reducing both the formation and activity of these mediators

Inhaled corticosteroids reverses dilatation causing mild vasoconstriction

Inhaled corticosteroids inhibited mast cell mediated late phase reactions

Question 2

Inhaled Corticosteroids therapeutic benefit

Answer 2

it is not immediate, there will be a slight improvement in a few days, but peak response is in 2 to 3 weeks

Question 3

Inhaled Corticosteroids side effects

Answer 3

Inhaled Corticosteroids lack the side effects of systemic steroids including, HPA suppression, cataract formation, glaucoma, and bone mineral density changes

Question 4

what is a useful treatment for nasal polyps

Answer 4

Inhaled Corticosteroids

Question 5

Inhaled Corticosteroids

– Nasal and Inhaled Formulations list types (5)

Answer 5

Beclomethasone 
Budesonide 
Flunisolide
Fluticasone
Mometasone

Question 6

Nasal and ophthalmic corticosteroids

Answer 6

Triamcinolone

Question 7

Inhaled Corticosteroids contraindications

Answer 7

hypersensitivity

Question 8

Inhaled Corticosteroids drug interactions

Answer 8

none

Question 9

Inhaled Corticosteroids adverse reactions

Answer 9

headache
pharyngitis
cough
epistaxis (in the nasal formulation)

Question 10

What should you monitor in patients taking Inhaled Corticosteroids?

Answer 10

symptom control

Question 11

Leukotriene Receptor Antagonists Mechanism of action

Answer 11

Selective leukotriene receptor antagonist
Inhibits the cysteinyl leukotriene receptor

Cysteinyl leukotrienes are released from mast cells

Question 12

Selective Leukotriene Receptor Antagonists agents

Answer 12

Montelukast and Zafirlukast

Question 13

Leukotriene Receptor Antagonists – LOX inhibitor

agents

Answer 13

Zileuton

Question 14

Leukotriene Receptor Antagonists contraindications

Answer 14

hypersensitivity

Question 15

Leukotriene Receptor Antagonists drug interactions

Answer 15

CYP3A4 and CYP2C9 interactions

Question 16

What should you monitor in patients taking Leukotriene Receptor Antagonists?

Answer 16

mental status and allergy control

Question 17

Leukotriene Receptor Antagonists adverse reactions

Answer 17

Headache, mental status changes, dizziness and fatigue, dyspepsia

Question 18

Describe Cromolyn nasal spray

Answer 18

MOA is mast cell stabilizers, symptomatic relief may take 2 to 4 weeks and may cause some local irritation

Question 19

Describe Ipatropium nasal spray

Answer 19

MOA is anticholinergic and inhibits secretions
however safety and efficacy beyond 4 days is not established
but it may enhance anticholinergic effects of other agents

Question 20

Describe H-2 Receptor Antagonist mechanism of action

Answer 20

MOA competitively inhibits H2 receptor (which are prominent) in parietal cells
and prevents gastric acid secretion

Question 21

which H-2 Receptor Antagonist agent is the most effective

Answer 21

Cimetidine
However Ranitidine, Famotidine and Nizatidine
are likely effective

Evidence is limited

Question 22

which H-2 Receptor Antagonist agents have the fewest side effects and interactions

Answer 22

Famotidine, Ranitidine