CHAPTER 3: Respiratory: Allergic Conditions Flashcards

1
Q

Antihistamines are effective in rhinorrhoea and sneezing, which symptom of allergy are they less effective?

A

Nasal congestion

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2
Q

As well as being inhaled, where else can antihistamines be applied topically? (3)

A
  1. Skin
  2. Nose
  3. Eyes
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3
Q

Which antihistamines are used parenterally with adrenaline in the treatment of anaphylaxis and angioedema? (2)

A
  1. Chlorphenamine

2. Promethazine

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4
Q

Which antihisatmines are used to treat nausea and vomiting?

A
  1. Cinnarizine
  2. Cyclizine
  3. Promethazine
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5
Q

Which antihistamine is used as an anti-emetic in migraine?

A

Buclizine

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6
Q

What is a notable side effect of all older antihistamines?

A

Sedation

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7
Q

Why do newer antihistamines cause less sedation?

A

Penetrate the BBB to a lesser extent

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8
Q

Give 4 examples of newer antihistamines

A
  1. Loratidine
  2. Cetirizine
  3. Acrivastine
  4. Fexofenadine
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9
Q

What is allergen immunotherapy?

A

Using a vaccine containing allergen extracts to reduce symptoms of asthma and allergic rhinoconjunctivitis

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10
Q

What is the name of the oral preparation of grass pollen used to treat grass-pollen allergy?

A

Grasax

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11
Q

What is the name of the monoclonal antibody used in specialist treatment centres as additional therapy for people with proven IgE sensitivity?

A

Omulizumab

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12
Q

What is anaphylaxis?

A

A severe, life threatening, generalised or system hypersensitivity reaction

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13
Q

What is anaphylaxis characterised by? (2)

A
  1. Rapid onset of respiratory and/or circulatory problems

2. Usually associated with skin and mucosal changes

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14
Q

What can cause anaphylaxis? (4)

A
  1. Insect stings
  2. Latex
  3. Foods
  4. Medicinal products
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15
Q

Give 5 examples of drugs that can cause anaphylaxis

A
  1. NSAIDs
  2. Aspirin
  3. Antibiotics
  4. Blood products
  5. Vaccines
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16
Q

After which route of administration is anaphylaxis more likely?

A

Parenteral - resuscitation facilities must always be available for injections associated with risk

17
Q

Which 2 topical products contain arachis oil (refined peanuts)? These products are unlikely to cause an allergic reaction

A
  1. Ceremol ear drops

2. Mupirocin (Bactroban)

18
Q

Which agents are used in the treatment of anaphylaxis? (5)

A
  1. IM Adrenaline
  2. Antihistamine
  3. IV Fluids
  4. High flow oxygen
  5. IV hydrocortisone (in severe cases)
19
Q

How often is adrenaline administered in response to anaphylaxis?

A

Every 5 minutes according to response

20
Q

If after initial treatment of anaphylaxis, the patient is still experiencing continuing respiratory deterioration, what is given?

A
  1. Bronchodilators
  2. Oxygen
  3. Assisted ventilation
  4. Tracheotomy
21
Q

After the patient has recovered from anaphylaxis, what must be considered for up to 3 days after?

A

Oral antihistamine and steroid

22
Q

What is the adrenaline dose for a 6-11 year old?

23
Q

What is the adrenaline dose for a 1 month to 5 year old?

24
Q

What is the adrenaline dose for a >12 year old?

25
Is IV adrenaline recommended for the treatment of anaphylaxis?
No, should only be given by SLOW IV INJECTION by experienced staff
26
If a patient experiences laryngeal oedema, how should this be treated?
As anaphylaxis
27
For acute attacks of angiodema, which medicines used in anaphylaxis are INEFFECTIVE? (3) How should it be treated?
1. Adrenaline 2. Antihistamine 3. Steroid With fresh frozen plasma
28
Which groups of people are more susceptible to sedation caused by antihistamine? (2)
1. Children | 2. Elderly
29
At which age is chlorphenamine syrup licensed?
>1 year
30
At which age are chlorphenamine tablets licesed?
>6 years
31
What is the MHRA alert with hydroxizine?
QT Prolongation
32
What are the risk factors of Torsade de Pointes?
1. Concomittant use of drugs that prolong QT 2. Family history of sudden cardiac death 3. Significant electrolyte imbalance (especially potassium and magnesium) 4. Significant bradycardia
33
What is the MHRA alert with promethazine?
Cough and cold preparations for children under 6