Drug Treatment

Question 1

first line for moderate to severe chronic symptoms

Answer 1

Intranasal steroid

Question 2

for mild, intermittent symptoms

Answer 2

Oral anti-histamines

Question 3

Intranasal steroids moa

Answer 3

Decrease inflammation

Question 4

Intranasal steroids

Answer 4

Budesonide (Rhinocort)
Fluticasone (Flonase)
Triamcinolone (Nasacort)

Question 5

SE for Budesonide (Rhinocort)
Fluticasone (Flonase)
Triamcinolone (Nasacort)

Answer 5

Epistaxis (nose bleeds)

Question 6

How long to get relief with
intranasal steroids

Answer 6

Can take up to one week to get full relief

Question 7

Budesonide and beclomethasone are the preferred nasal steroids in

Answer 7

Pregnancy

Question 8

Budesonide

Answer 8

Rhinocort

Question 9

Fluticasone

Answer 9

Flonase

Question 10

Triamcinolone

Answer 10

Nasacort

Question 11

For mild to moderate intermittent symptoms, use

Answer 11

Antihistamines

Question 12

Little effect on nasal congestion

Answer 12

Antihistamines

Question 13

Work by blocking Histamine-1 (H-1) receptor site

Answer 13

Antihistamines

Question 14

1st gen antihistamines cause more

Answer 14

Sedation

Question 15

1st gen antihistamines

Answer 15

Promethazine, hydroxizine, meclizine

Question 16

2nd gen preferred due to less

Answer 16

sedation/cognitive impairment

Question 17

Diphenhydramine (Benadryl)
- _____ gen antihistamine used for many conditions

Answer 17

First

Question 18

Diphenhydramine (Benadryl) used for:

Answer 18

• Acute allergic reactions (+/- epi)
• Prevention of allergic reactions (in - premedication regimens for high- – risk drugs)
• Allergic reactions
• Cough (antitissuve properties)
• Sleep (sedating)
• Dystonic reactions (involuntary
  contractions of muscles) since it
  has anticholinergic properties)
• Motion sickness

Question 19

Because of diphenhydramine’s (Benadryl’s) wide range of effects, can worsen some disease states such as

Answer 19

BPH, constipation, dementia, glaucoma

Question 20

Diphenhydramine (Benadryl) dosing

Answer 20

Adult: 25 mg PO Q4-6H or 50 mg PO Q6-8H
- max for adults: 300 mg/day

Max for children 6-11 years old: 150mg/day

Age <6 years: do not use OTC unless directed by HCP

Question 21

Select first gen oral antihistamines

Answer 21

Diphenhydramine (Benadryl)
Chlorpheniramine
Doxylamine

Question 22

Select first gen oral antihistamines
- Diphenhydramine (Benadryl)
- Chlorpheniramine
- Doxylamine

• Avoid in ____ due to strong anticholinergic effects (beers criteria) and in children < 2 years
• Use with caution in pts with
• SE
• 2nd gen preferred for
• Can cause photosensitivity:
• Contraindicated in:

Answer 22

• elderly
• prostate enlargement, glaucoma
• SE: somnolence/sedation, cognitive impairment, strong anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation)
• 2nd gen preferred for lactating women
• Can cause photosensitivity: wear sunscreen and protective clothing while taking
• CI: neonates/premature infants, breastfeeding