Chapter 37 - Allergic rhinitis, cough & cold Flashcards
Allergic Rhinitis Sx
Cold-like symptoms
- Congestion
- Rhinorrhea (runny nose)
- Sneezing
- Sinus pressure
- Itchy eyes
- Thin, clear mucus
Can be intermittent or chronic
Inflammatory reaction
Non Drug Treatment
- Avoid Exposure when possible
- IgE skin test or blood test to determine allergen
- Ventilation systems with high efficiency particulate air (HEPA) (expensive)
- Vacuuming with HEPA vacuum cleaner
- Air quality index (AQI)
- Pollen counts
- Nasal irrigation or wetting agents
Common Allergens
- Pollen
- Mold
- Dust mites
- Animal Dander
Budesonide
brand
dose
Rhinocort Allergy
1 spray in each nostril daily
adult: max 4 sprays
>= 6 yo: max 2 sprays
(the nude one/ original one to aktar brand khassa bl ttmt w condition)
Fluticasone
brand
dose
- Flonase Allergy Relief
- Flonase Sensimist
- Children flonase
- Xhance (X got a chance mn baaed ma il fluuutt (harab)
Adult and children 2 - 12 yrs: 1-2 sprays per nostril daily
Age 2 - 11yrs: 1 spray per nostril daily
otc or rx
Fluticasone + Azelastine brand
Dymista
(Intranasal steroids + Antihistamine)
il fluuuttt (byehrub) la2an Eze Last sooo Dieee mistaaa
Triamcinolone
- Nasacort Allergy 24HR
- Nasacort Allergy 24HR Children
- Nasal Allergy 24HR
at 3 am alone (olone) bl nasa –> nasacort
Beclomethasone
- Beconase AQ
Adult: 1-2 sprays daily - Qnasl
- Qnasl children
Adult: 2 sprays per nostril daily
Ciclesonide
brand
- Omnaris (om nar 7emle 2 fires b idaya so 2 sprays)
Adult: 2 sprays per nostril daily - Zetonna (b zet 7alo la 7alo so 1 spray)
Adult: 1 spray per nostril daily
Flunisolide
Adult: 2 sprays per nostril BID or TID
Mometasone
Nasonex
Nasal implant: Sinuva
Adult: 2 sprays per nostril daily
preferred intranasal steroid in pregnancy?
budesonide (nude)
beclomethasone (beclo)
Side effects, warnings and monitoring of intranasal steroids
SE:
- Epistaxis (nose bleeds)
- headache
- dry nose
- unpleasant taste
- localized infection
Warnings:
Avoid use
- recent nasal septal ulcers,
- nasal surgery,
- recent nasal trauma
due to delayed wound healing
High doses for prolonged periods can cause:
- adrenal suppression,
- dec growth velocity (pediatrics)
- immunosuppression
Use in caution:
- pt with cataract
- inc intraocular pressure
- open angle glaucoma
Monitor:
- Growth (pediatrics),
- vision changes,
- eye exams in long-term use,
- signs/symptoms of oral thrush
- Sx of adrenal suppression
- If using regularly for several months, recommend periodic nasal exams to evaluate for nasal septal perforation or ulcers
Side effects, warnings and monitoring of intranasal steroids
SE:
- Epistaxis (nose bleeds)
- headache
- dry nose
- unpleasant taste
- localized infection
Warnings:
Avoid use
- recent nasal septal ulcers,
- nasal surgery,
- recent nasal trauma
due to delayed wound healing
High doses for prolonged periods can cause:
- adrenal suppression,
- dec growth velocity (pediatrics)
- immunosuppression
Use in caution:
- pt with cataract
- inc intraocular pressure
- open angle glaucoma
Monitor:
- Growth (pediatrics),
- vision changes,
- eye exams in long-term use,
- signs/symptoms of oral thrush
- Sx of adrenal suppression
- If using regularly for several months, recommend periodic nasal exams to evaluate for nasal septal perforation or ulcers
antihistamines indication
mild - mod
intermittent se
has little effect on congestion
mainly for itching, sneezing rhinorrhea
blocks H1 receptors