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?

A

300mcg

23
Q

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

A

150mcg

24
Q

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

A

500mcg

25
Q

Is IV adrenaline recommended for the treatment of anaphylaxis?

A

No, should only be given by SLOW IV INJECTION by experienced staff

26
Q

If a patient experiences laryngeal oedema, how should this be treated?

A

As anaphylaxis

27
Q

For acute attacks of angiodema, which medicines used in anaphylaxis are INEFFECTIVE? (3)

How should it be treated?

A
  1. Adrenaline
  2. Antihistamine
  3. Steroid
    With fresh frozen plasma
28
Q

Which groups of people are more susceptible to sedation caused by antihistamine? (2)

A
  1. Children

2. Elderly

29
Q

At which age is chlorphenamine syrup licensed?

A

> 1 year

30
Q

At which age are chlorphenamine tablets licesed?

A

> 6 years

31
Q

What is the MHRA alert with hydroxizine?

A

QT Prolongation

32
Q

What are the risk factors of Torsade de Pointes?

A
  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
Q

What is the MHRA alert with promethazine?

A

Cough and cold preparations for children under 6