Allergy drugs

Question 1

1st gen antihistamines?

Answer 1

diphenhydramine (Benardryl)
chlorpheniramine (chlor-trimeton)
can cross BBB leading to CNS effects
dizziness, sedation, etc
anticholenergic

Question 2

2nd gen antihistamines?

Answer 2

fexofendadine (Allegra)
cetirizine (Zyrtec)
loratadine/ desloratadine (claritin/clarinex)
Low sedation
Lower anticholinergic effects

Question 3

Rhinitis medicamentosa

Answer 3

rebound nasal congestion from use of alpha-adrenergic agonists delivered in aerosol form

• have rapid onset and few systemic effects but should not be used long term because of rebound
• educate pt. not to use long-term
• may prescribe nasal steriods while weening off.
• Afrin (oxymetazoline)

Question 4

anticholinergics (ipratropium)

inhalation; nebulizer; oral

Answer 4

idications: COPD and nasal dischage
Contraindications: HS to atropine or ipratropiib bromide

AE: glacoma (narrow angle)
intraocular pressure
paradoxical bronhospasm

MOA: cholnergic antagonist of ACH.
Drug Interactions: don’t mix with morphine or oxymorphine

Question 5

mast cell stabilizers

cromolyn (nasalcrom)

Answer 5

indications: allergic rhinitis
AE: bad taste in mouth, bring sensation eye, cough, throat, epistaxis, risk of bronchospasm
MOA: Inhibits mast cell degranulation
Usually adjunctive

Question 6

Low potency intranasal steroid

Answer 6

Triamcinolone -nasacort AQ,

Mometasone - Nasonex.

Question 7

Medium potency intranasal steroid

Answer 7

Beclomethasone - Beconase AQ,

Fluisolide - Nasalide

Question 8

High potency intranasal steroid

Answer 8

Fluticasone -Flonase

Budesonide - Rhinocort

Question 9

Intranasal steroids

Answer 9

For: anti inflammatory properties reduce nasal obstruction, rhinorrhea, sneeaing and pruritis

AE: epistasix, cataracts, growth velocity changes, HPA axis

Question 10

Intranasal antihistamines: indications and CI?

Answer 10

Indications: allergic rhinitis, allergic conjunctivis, vasomotor rhinitis

AE: contact dermatitis, headache, somnolence, fatigue

Question 11

Intranasal antihistamines: MOA and Drug interactions

Answer 11

MOA: selective H1 receptor antagonist that blocks the release of histamine

Drug Ix: fatigue, lack of alertness, avoid alcohol

Question 12

aspirin with asthma and nasal polyposis

Answer 12

aspirin should be avoided as it may precipitate a severe episode of bronchospasm,

• known as triad asthma
• immunologic salicylate sensitivity

Question 13

epinephrine (epi pen)

Indications and CI:

Answer 13

Indications: hypersensitivity reactions (anaphylaxis)

CI: no absolute CI in a life threatening situation

Question 14

epinephrine MOA and AE

Answer 14

MOA: stimulates alpha and beta adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree cardiac stimulation (increasing myocardial oxygen consumption)

AE: may induce arrhythmias, pulmonary edema, renal imparment, anxiety, headache, dizziness

Admin: anterolateral aspect of middle third of thigh