Asthma and Allergy Medication

Question 1

CETIRIZINE HCL

Zyrtec

Answer 1

Antihistmaine
◾Relief of seasonal allergic rhinitis symptoms
◾Relief of perennial allergic rhinitis caused by molds, animal
dander, and other allergens
◾Avoid alcohol during cetirizine therapy
◾Call physician immediately for difficulty breathing or swallowing
◾Notify physician for hydroxyzine (Vistaril) allergy
◾Rx; Preg Cat B

Side effects:
Drowsiness, Fatigue, Dry mouth, Stomach pain, Diarrhea, Vomiting

Question 2

FEXOFENADINE

Allegra

Answer 2

Antihistamine
Management of rhinitis, allergy symptoms, chronic idiopathic
urticaria
◾ Avoid alcohol, CNS depressants
◾ 60 mg tablet: onset within 1 hour, peak 2–3 hours, duration about
12 hours
◾180 mg tablet: duration 24 hours
◾ Notify physician if taking erythromycin or ketoconazole (Nizoral)
◾ If taking aluminum magnesium antacid, take antacid a few hours
before or after fexofenadine
◾ Rx; Preg Cat C

Side effects: Drowsiness, HA, dizzy, diarrhea, vomiting, pain, cough, hives, rash, itching, difficulty breathing, hoarseness, swelling

Question 3

Hydroxyzine

Atarax, Vistaril

Answer 3

Antihistamine
◾ Treatment of pruritus, pre-op anxiety, post-op nausea and
vomiting, to potentiate opioid analgesics, sedation
◾ PO: onset 15–30 minutes, duration 4–6 hours
◾ Avoid use with alcohol, CNS depressants
◾ Teach patient that dizziness/drowsiness may occur; use caution
inpotentially hazardous activities
◾ Treatment of symptoms of alcohol withdrawal
◾ Notify physician of diagnosis of glaucoma, ulcers, enlarged
prostate gland, liver disease, hypertension, seizures, or
hyperthyroidism
◾ Observe for difficulty breathing, Muscle weakness, Increased anxiety
◾ Rx; Preg Cat C

Side effects: Drowsiness, dry mouth, nose, throat, dizziness, HA, chest congestion, reddening of the skin

Question 4

Loratadine

Claritin, Alavert

Answer 4

Antihistamine
Management of seasonal rhinitis
◾ Avoid alcohol, CNS depressants
◾ Take on empty stomach 1 hour before or 2 hours after meals
◾ Onset 1–3 hours, peak 8–12 hours, duration ≥ 24 hours
◾ OTC, Rx; Preg Cat B

Side effects: HA, dry mouth, nosebleed, sore throat, diarrhea, rash, nervousness, weakness, stomach pain, wheezing, dysphagia, dyspnea, hives, swelling of face or extremities, hoarseness, mouth sores, insomnia

Question 5

BECLOMETHASONE

Beclovent, Beconase, Qvar

Answer 5

Corticosteriods
◾ Used in chronic asthma treatment, seasonal or perennial rhinitis
◾ Prevention of recurrence of nasal polyps after surgical removal
◾ Nasal spray: onset 5–7 days (up to 3 weeks in some patients),
peak up to 3 weeks
◾ Inhaler: onset 10 minutes
◾ Use regular peak flow monitoring to determine respiratory status
◾Rx; Preg Cat C

Side Effects: dysphonia, hoarseness, orophayngeal fungal infections, HA, sore throat, dyspepsia, unpleasant taste and smell, rhinitis, nausea, cough, back pain

Question 6

FLUNISOLIDE

Aerobid, Nasalide

Answer 6

Corticosteriods
◾ Used in chronic asthma treatment, seasonal or perennial rhinitis
◾ Onset: few days
◾ Use regular peak flow monitoring to determine respiratory status
◾ Rx; Preg Cat C

Side Effects: Dysphonia
Hoarseness
Oropharyngeal fungal infections
Headache, Sore throat
Nasal congestion, cold symptoms
Nausea, vomiting, diarrhea
Unpleasant taste, upset stomach
Epistaxis (nosebleed)

Question 7

FLUTICASONE

Flonase

Answer 7

Corticosteriod
Used in chronic asthma treatment, seasonal or perennial rhinitis
◾ Nasal spray: onset within 2 days, peak 1–2 weeks
◾ Use regular peak flow monitoring to determine respiratory status
◾ Rx; Preg Cat C

Side Effects: 
Dysphonia
Hoarseness
Oropharyngeal fungal infections
Headache
Sore throat
Nasal congestion, coldsymptoms
Nausea, vomiting, diarrhea
Unpleasant taste, upset stomach
Epistaxis (nosebleed), nasal 
irritation
Hives
Dyspnea
Dysphagia
Angioedema

Question 8

FLUTICASONE PROPIONATE
SALMETEROL
(Advair Diskus)

Answer 8

Corticosteriod
Used when asthma is not well controlled with long-term inhaled
corticosteroids; COPD
◾ Oral inhalation; rinse mouth with water after inhalation
◾ Twice-daily dosage, 12 hours apart; used long term
◾ Use regular peak flow monitoring to determine respiratory status
◾ Monitor growth of pediatric patient
◾ Monitor for glaucoma and cataracts
◾ May decrease bone mineral density
◾ Monitor for eosinophilic conditions, hypokalemia, and hyperglycemia
◾ May increase risk of pneumonia in patients with COPD
◾ May cause worsening of infections
◾ Check oral cavity for Candida albicans
◾ Rx; Preg Cat C

Side Effects:
Nausea, vomiting, diarrhea
Headache, Dysphonia, hoarseness, Throat irritation, cough
Oropharyngeal fungal infections, Muscle and bone pain, Viral respiratory infections, bronchitis

Question 9

MOMETASONE

Nasonex Spray

Answer 9

Corticosteriods
◾ Used in chronic asthma treatment, seasonal or perennial rhinitis
◾ Nasal spray: onset few days, peak up to 3 weeks
◾ Use regular peak flow monitoring to determine respiratory status
◾ Rx; Preg Cat C

Side Effects: 
Dysphonia, Hoarseness
Oropharyngeal fungal infections
Headache, Sore throat
Nasal congestion, cold 
symptoms
Nausea, vomiting, diarrhea
Unpleasant taste, upset stomach

Question 10

TRIAMCINOLONE

Nasacort AQ Spray

Answer 10

Corticosteriods
◾ Used in chronic asthma treatment, seasonal or perennial rhinitis
◾ Nasal spray: onset few days, peak 3–4 days
◾PO/IM: peak 1–2 hours
◾ Use regular peak flow monitoring to determine respiratory status
◾ Rx; Preg Cat C

Side Effects:
Dysphonia; hoarseness
Oropharyngeal fungal infections, Headache, Sore throat
Nasal congestion, cold
symptoms
Nausea, vomiting, diarrhea
Unpleasant taste, upset stomach, Epistaxis, Flu syndrome, Increased cough, Bronchitis