Allergic Rhinitis Inhaled Corticosteroids, Leukotriene Receptor Antagonists, Miscellaneous Agents Flashcards
Inhaled Corticosteroids Mechanism of action
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
Inhaled Corticosteroids therapeutic benefit
it is not immediate, there will be a slight improvement in a few days, but peak response is in 2 to 3 weeks
Inhaled Corticosteroids side effects
Inhaled Corticosteroids lack the side effects of systemic steroids including, HPA suppression, cataract formation, glaucoma, and bone mineral density changes
what is a useful treatment for nasal polyps
Inhaled Corticosteroids
Inhaled Corticosteroids
– Nasal and Inhaled Formulations list types (5)
Beclomethasone Budesonide Flunisolide Fluticasone Mometasone
Nasal and ophthalmic corticosteroids
Triamcinolone
Inhaled Corticosteroids contraindications
hypersensitivity
Inhaled Corticosteroids drug interactions
none
Inhaled Corticosteroids adverse reactions
headache
pharyngitis
cough
epistaxis (in the nasal formulation)
What should you monitor in patients taking Inhaled Corticosteroids?
symptom control
Leukotriene Receptor Antagonists Mechanism of action
Selective leukotriene receptor antagonist
Inhibits the cysteinyl leukotriene receptor
Cysteinyl leukotrienes are released from mast cells
Selective Leukotriene Receptor Antagonists agents
Montelukast and Zafirlukast
Leukotriene Receptor Antagonists – LOX inhibitor
agents
Zileuton
Leukotriene Receptor Antagonists contraindications
hypersensitivity
Leukotriene Receptor Antagonists drug interactions
CYP3A4 and CYP2C9 interactions
What should you monitor in patients taking Leukotriene Receptor Antagonists?
mental status and allergy control
Leukotriene Receptor Antagonists adverse reactions
Headache, mental status changes, dizziness and fatigue, dyspepsia
Describe Cromolyn nasal spray
MOA is mast cell stabilizers, symptomatic relief may take 2 to 4 weeks and may cause some local irritation
Describe Ipatropium nasal spray
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
Describe H-2 Receptor Antagonist mechanism of action
MOA competitively inhibits H2 receptor (which are prominent) in parietal cells
and prevents gastric acid secretion
which H-2 Receptor Antagonist agent is the most effective
Cimetidine
However Ranitidine, Famotidine and Nizatidine
are likely effective
Evidence is limited
which H-2 Receptor Antagonist agents have the fewest side effects and interactions
Famotidine, Ranitidine
