Drug Treatment Flashcards
first line for moderate to severe chronic symptoms
Intranasal steroid
for mild, intermittent symptoms
Oral anti-histamines
Intranasal steroids moa
Decrease inflammation
Intranasal steroids
Budesonide (Rhinocort)
Fluticasone (Flonase)
Triamcinolone (Nasacort)
SE for Budesonide (Rhinocort)
Fluticasone (Flonase)
Triamcinolone (Nasacort)
Epistaxis (nose bleeds)
How long to get relief with
intranasal steroids
Can take up to one week to get full relief
Budesonide and beclomethasone are the preferred nasal steroids in
Pregnancy
Budesonide
Rhinocort
Fluticasone
Flonase
Triamcinolone
Nasacort
For mild to moderate intermittent symptoms, use
Antihistamines
Little effect on nasal congestion
Antihistamines
Work by blocking Histamine-1 (H-1) receptor site
Antihistamines
1st gen antihistamines cause more
Sedation
1st gen antihistamines
Promethazine, hydroxizine, meclizine
2nd gen preferred due to less
sedation/cognitive impairment
Diphenhydramine (Benadryl)
- _____ gen antihistamine used for many conditions
First
Diphenhydramine (Benadryl) used for:
- 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
Because of diphenhydramine’s (Benadryl’s) wide range of effects, can worsen some disease states such as
BPH, constipation, dementia, glaucoma
Diphenhydramine (Benadryl) dosing
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
Select first gen oral antihistamines
Diphenhydramine (Benadryl)
Chlorpheniramine
Doxylamine
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:
- 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
