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PHARM > Allergic rhinitis (respiratory) > Flashcards

Allergic rhinitis (respiratory) Flashcards

1
Q

Therapeutic use for intranasal glucocorticoids?

A

Prevention and tx of seasonal and perennial (year round) rhinitis (sneezing, nasal itching, and rhinorrhea)

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2
Q

MOA of intranasal glucocorticoids?

A

acts on inflammatory cells and mediators

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3
Q

Adverse effects of intranasal glucocorticoids?

A

Drying of nasal mucosa, ST, epistaxis, and HA

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4
Q

Precautions to take with use of intranasal glucocorticoids?

A

adrenal suppression, delayed wound healing, and ocular disease

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5
Q

MOA of antihistamines?

A

act on H1 receptors blocking the histamine release in the small vessels, capillaries, and nerves during allergic rxns.

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6
Q

T/F. Antihistamines relieve itching, sneezing, rhinorrhea, and congestion.

A

False; do not relieve congestion

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7
Q

Example of a 1st generation H1 antagonist (antihistamine)?

A

Diphenhydramine (Benadryl)

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8
Q

Therapeutic uses of of Benadryl?

A
  • Hypersensitivity rxns (allergic rhinitis, conjunctivitis, dermatitis)
  • motion sickness
  • insomnia
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9
Q

MOA of Benadryl?

A

Antagonizes the effects on the histamine H1 receptor site

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10
Q

Adverse effects of Benadryl?

A

Drowsiness, dry mouth, anorexia, photosensitivity, paradoxical excitation (increased in children), confusion in older adults, urinary retention, constipation, blurred vision

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11
Q

Precautions with Benadryl?

A

Use caution if you have narrow-angled glaucoma, prostatic hyperplasia, peptic ulcer, and bladder neck obstruction

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12
Q

Onset of action and routes given for Benadryl?

A

onset: 30-60 min.
Route: PO, IV, IM

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13
Q

Example of a 2nd generation antihistamine?

A

Fexofenadine (Allegra)

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14
Q

Therapeutic use for Fexofenadine (Allegra)?

A

Relief of sx of seasonal allergic rhinitis

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15
Q

MOA of Fexofenadine?

A

antagonizes the effects of histamine at peripheral histamine (H1) receptors

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16
Q

Adverse effects of FexofenaDine?

A

sedation/Drowsiness, Fatigue, Dyspepsia, Dysmenorrhea

17
Q

Precautions with Fexofenadine?

A

impaired renal function

18
Q

Onset of action and route of Fexofenadine?

A

onset- within 1hr

route- PO

19
Q

Interactions with Fexofenadine?

A

magnesium and aluminum containing antacids which decrease absorption and may decrease effectiveness

20
Q

Therapeutic use of intranasal cromolyn sodium?

A

allergic rhinitis prophylaxis

21
Q

MOA of intranasal cromolyn sodium?

A

suppresses release of histamine and other inflammatory mediators from mast cells

22
Q

Adverse effects of Cromolyn Sodium?

A

Local irritation, Sneezing, Stinging, HA, and hOarseness

23
Q

Precautions for Cromolyn Sodium?

A

Do not use to treat Sinus infections, asthma, or URIs

24
Q

T/F. Histamines are not decongestants?

A

True

25
Q

What class of drugs are decongestants?

A

Sympathomimetics and alpha adrenergic agonist

26
Q

Example of a decongestant/sympathomimetic drug?

A

Pseudoephedrine (Sudafed)

27
Q

Therapeutic uses of Pseudoephedrine?

A

temporary relief of sx associated with acute viral URIs

28
Q

MOA of Pseudoephedrine?

A

Stimulates alpha and beta adrenergic receptors → Releases NE →Produces vasoconstriction in nasal mucous membranes → reduced inflammation in the nasal membranes.

29
Q

Adverse effects of Pseudoephedrine?

Hint: everything goes up

A

anxiety, nervousness, palpitations, anorexia, HTN, insomnia, urinary retention, seizures, and cardiovascular collapse

30
Q

Contraindications for Pseudoephedrine?

A
  • hypersensitivity to sympathomimetic amines
  • severe HTN
  • severe CAD
  • narrow angle glaucoma
  • use of tricyclic or monoamine oxidase inhibitor antidepressants
  • children <4
31
Q

Precautions with Pseudoephedrine?

A

cardiac dysrhythmias, hyperthyroidism, DM, glaucoma, and prostatic hyperplasia

32
Q

When should patients see provider if sx have not resolved with Pseudoephedrine use?

A

If sx last longer than 7 days

33
Q

Example of a nasal spray decongestant?

A

Oxymetazoline (Afrin)

34
Q

MOA of Oxymetazoline (Afrin)?

A

acts directly on alpha 2 receptors to produce vasoconstriction

35
Q

Why should Oxymetazoline (Afrin) be limited to 3 days?

A

rebound congestion aka “rhinitis medicamentosa”

36
Q

Is vasoconstriction and CNS stimulation common with topical decongestants?

A

No, but still possible

PHARM (35 decks)

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