Allergies Flashcards
Diphenhydramine Class
1st Gen antihistamine
Loratadine Class
2nd Gen antihistamine
Cromolyn Class
Mast Cell Stabilizer
Fluticasone Class
Corticosteroid
Which drug can prevent rhinitis?
- Phenylephrine
- Cromolyn
- Fluticasone
- Loratadine
Cromolyn
What are the major kinds of allergic rhinitis?
Seasonal (intermittent) + Perennial (persistent)
How would you diagnose allergic rhinitis?
- Positive allergy test
- Postive RAST
- High lvls of IgE
Is rhinitis due to allergy?
Not all the time. Can be caused by nasal congestion or throat pain
Symptoms occur ≤4 times per week OR lasts for ≤4 weeks
- Intermittent AR
- Persistent AR
Intermittent AR
Symptoms occur ≥4 times per week AND lasts for ≥4 weeks
- Intermittent AR
- Persistent AR
Persistent AR
To classify mild allergic rhinitis, what kind of symptoms occur?
Symptoms that are not troublesome
To classify moderate to severe allergic rhinitis, what kind of symptoms occur?
Symptoms that ARE troublesome
What are some exclusions for self-care of rhinitis?
Children <12 yrs old
How would you treat mild intermittent AR?
Oral antihistamine and if possible, add decongestant (if no cardio problem)
How would you treat moderate to severe intermittent AR?
Intranasal corticosteroid or oral antihistamine and if possible, add decongestant (if no cardio problem)
How would you treat mild persistent AR?
Intranasal corticosteroid or oral antihistamine and if possible, add decongestant (if no cardio problem)
How would you treat moderate to severe persistent AR?
Intranasal corticosteroid (preferred)*** or oral antihistamine and if possible, add decongestant (if no cardio problem)
If AR symptoms are controlled, what should you do with the pt?
Reassess in one month
If AR symptoms are NOT controlled, what should you do with the pt?
Check for adherence (up the dose, different RX), then reassess in month
For intranasal corticosteroid, how long before you may see maximal effect?
2wks +
1st Gen vs 2nd Gen antihistamines
Extremely sedating
1st Gen
1st Gen vs 2nd Gen antihistamines
May produce excitation in children
1st Gen
1st Gen vs 2nd Gen antihistamines
Drying effect
1st Gen
1st Gen vs 2nd Gen antihistamines
Less effective on nasal secretion
2nd Gen
1st Gen vs 2nd Gen antihistamines
Most beneficial w/ itching and sneezing
2nd Gen
When is the best time to use antihistamines?
Before Sx begin
Fluticasone is approved for use in….
Adults + children <4yrs old
(T/F) Most of what is administered intra-nasally is swallowed.
True
(T/F) There is a lot of systemic absorption of fluticasone + triamcinolone
False; very minimal absorption
What kind of RX is most effective in Tx of AR?
Intranasal coricosteroids
Intranasal corticosteroid MOA
Inhibits allergic cascade and blocks histamine production and other inflammatory mediators
Cromolyn MOA
Prevents degranulation of mast cells, an initial event in allergy cascade
(T/F) Cromolyn is somewhat effective if given after Sx begin?
False; ineffective if given after Sx begin
Which has a lower efficacy, Cromolyn or Intranasal corticosteroids?
Cromolyn
First Gen antihistamines can treat all symptoms of allergic rhinitis except what?
Congestion
