CHAPTER 3: Respiratory: Allergic Conditions Flashcards
Antihistamines are effective in rhinorrhoea and sneezing, which symptom of allergy are they less effective?
Nasal congestion
As well as being inhaled, where else can antihistamines be applied topically? (3)
- Skin
- Nose
- Eyes
Which antihistamines are used parenterally with adrenaline in the treatment of anaphylaxis and angioedema? (2)
- Chlorphenamine
2. Promethazine
Which antihisatmines are used to treat nausea and vomiting?
- Cinnarizine
- Cyclizine
- Promethazine
Which antihistamine is used as an anti-emetic in migraine?
Buclizine
What is a notable side effect of all older antihistamines?
Sedation
Why do newer antihistamines cause less sedation?
Penetrate the BBB to a lesser extent
Give 4 examples of newer antihistamines
- Loratidine
- Cetirizine
- Acrivastine
- Fexofenadine
What is allergen immunotherapy?
Using a vaccine containing allergen extracts to reduce symptoms of asthma and allergic rhinoconjunctivitis
What is the name of the oral preparation of grass pollen used to treat grass-pollen allergy?
Grasax
What is the name of the monoclonal antibody used in specialist treatment centres as additional therapy for people with proven IgE sensitivity?
Omulizumab
What is anaphylaxis?
A severe, life threatening, generalised or system hypersensitivity reaction
What is anaphylaxis characterised by? (2)
- Rapid onset of respiratory and/or circulatory problems
2. Usually associated with skin and mucosal changes
What can cause anaphylaxis? (4)
- Insect stings
- Latex
- Foods
- Medicinal products
Give 5 examples of drugs that can cause anaphylaxis
- NSAIDs
- Aspirin
- Antibiotics
- Blood products
- Vaccines
After which route of administration is anaphylaxis more likely?
Parenteral - resuscitation facilities must always be available for injections associated with risk
Which 2 topical products contain arachis oil (refined peanuts)? These products are unlikely to cause an allergic reaction
- Ceremol ear drops
2. Mupirocin (Bactroban)
Which agents are used in the treatment of anaphylaxis? (5)
- IM Adrenaline
- Antihistamine
- IV Fluids
- High flow oxygen
- IV hydrocortisone (in severe cases)
How often is adrenaline administered in response to anaphylaxis?
Every 5 minutes according to response
If after initial treatment of anaphylaxis, the patient is still experiencing continuing respiratory deterioration, what is given?
- Bronchodilators
- Oxygen
- Assisted ventilation
- Tracheotomy
After the patient has recovered from anaphylaxis, what must be considered for up to 3 days after?
Oral antihistamine and steroid
What is the adrenaline dose for a 6-11 year old?
300mcg
What is the adrenaline dose for a 1 month to 5 year old?
150mcg
What is the adrenaline dose for a >12 year old?
500mcg
Is IV adrenaline recommended for the treatment of anaphylaxis?
No, should only be given by SLOW IV INJECTION by experienced staff
If a patient experiences laryngeal oedema, how should this be treated?
As anaphylaxis
For acute attacks of angiodema, which medicines used in anaphylaxis are INEFFECTIVE? (3)
How should it be treated?
- Adrenaline
- Antihistamine
- Steroid
With fresh frozen plasma
Which groups of people are more susceptible to sedation caused by antihistamine? (2)
- Children
2. Elderly
At which age is chlorphenamine syrup licensed?
> 1 year
At which age are chlorphenamine tablets licesed?
> 6 years
What is the MHRA alert with hydroxizine?
QT Prolongation
What are the risk factors of Torsade de Pointes?
- Concomittant use of drugs that prolong QT
- Family history of sudden cardiac death
- Significant electrolyte imbalance (especially potassium and magnesium)
- Significant bradycardia
What is the MHRA alert with promethazine?
Cough and cold preparations for children under 6
