Exam 2 - Allergic Rhinitis Flashcards
By which age do we see allergic rhinitis begin to diminish
65+ years old
(Medicaid age)
Which of the following are risk factors for allergic rhinitis
Higher socioeconomic class
Eczema
Living in northeastern US
Family history
Higher socioeconomic class
Eczema
Family history
(Itchy, predisposed, rich)
Which of the following are common allergens
- molds that exist indoors and outdoors
- allergies to chemicals in household cleaners
- animal dander from pets
- plant components like pollen
All of them
List some ways to remove allergens from household
- closing windows when pollen counts are high
- having HEPA ventilation in house
Symptoms of allergic rhinitis
Congestion
Smell impaired
Nasal discharge
Itchy eyes
Sneezing
(Can’t Stop Sneezing N Itching)
Intermittent allergic rhinitis symptoms are defined by which duration
Symptoms persist ≤ 4 days per week OR ≤ 4 weeks
(Allergies 4 days, 4 weeks)
(T/F): persistent AR is more easily identifiable than intermittent AR
False
Alteration in which two factors define whether allergic rhinitis symptoms are classified as intermittent or persistent
Ability to perform daily activities
Ability to sleep
Intermittent allergic rhinitis is AKA
Hay fever
Causes of nonallergic rhinitis
Pregnancy
Taking beta blocker
Head trauma
NSAIDs
(T/F): when treating AR, using dual therapy is most appropriate
False
Which represent non-pharm measures for AR
- have rodents/roaches exterminated
- hand sanitizer w/ alcohol base after touching pets
- use humidifier to add moisture to air
- avoid cigarette smoke
Have roaches exterminated and avoid cigarette smoke
(Takes more than hand sanitizer to get rid of allergens and humidifiers should NOT be used for allergies - they can cause mold)
What steps (in order) should be taken to treat allergic rhinitis
Omit allergen
Antihistamine
Steroid
Immunotherapy
Surgery
(OASIS)
(Going from minor to major treatments)
3 primary steps for treating AR in order
Avoid allergen
Single entity drugs first
Immunotherapy
Which of the following should be limited to 3 days use
Naphazoline
Ketotifen
Olopatadine
Alcaftadine
Naphazoline
What class of medication is MOST effective for treating ALL AR symptoms
Intranasal corticosteroids
What can happen if you use a topical decongestant for more than 3 days
Rebound congestion
Which of the following are 1st generation antihistamines
Diphenhydramine
Clemastine
Cetirizine
Chlorpheniramine
Diphenhydramine
Clemastine
Chlorpheniramine
Jordan has just finished law school and has horrible spring allergies with a cough. He wants to sleep. What do you recommend?
Diphenhydramine
(Because it is sedating, an antihistamine, and an antitussive)
Which of the following are 2nd generation antihistamines
Brompheniramine
Fexofenadine
Cetirizine
Levocetirizine
Diphenhydramine
Loratadine
Fexofenadine
Levocetirizine
Cetirizine
Loratadine
(Ones you’d be okay taking in the morning because they’re non-sedating)
Lisa has AR. She is a mom of 3 and a physician. She also takes Tums regularly. What do you recommend
Loratadine
Which antihistamine is in Mucinex Allergy
Fexofenadine
Tavist AI
Clemastine
What antihistamine is in dimetapp
Brompheniramine
Which of the following antihistamines are LEAST likely to cause sedation
Loratadine
Cetirizine
Fexofenadine
Diphenhydramine
Chlorpheniramine
Loratadine
Fexofenadine
(L and F are 1st gen so they’re non-sedating; diphenhydramine is 1st gen so it’s sedating; cetirizine and chlorpheniramine are 1st gen BUT are most likely to cause sedation)
Larie is working midnights this week. Her allergies are awful. What do you recommend?
Fexofenadine
Which combo products are safe to treat AR symptoms. SATA
Chlorpheniramine + zyrtec
Flonase + benadryl
Claratin D + nasacort
Rhinocort + allegra
Flonase + triamcinolone
Astepro + fluticasone
Flonase + benadryl
Claratin D + nasacort
Rhinocort + allegra
Astepro + fluticasone
(Others are duplicate therapy)
Mr. Rogers is a 70 yr old man w/ glaucoma. He needs something for allergies. What do you recommend
Fexofenadine
(1st gen and decongestants will worsen glaucoma)
Which symptoms can 1st generation antihistamines cause? SATA
Dry mouth
Drooling
Urinary retention
Diarrhea
Somnolence (drowsy)
Blurred vision
Dry mouth
Urinary retention
Somnolence
Blurred vision
(Dry, drowsy, blurry)
Which of the following are side effects of intranasal corticosteroids
Dry mouth
Unpleasant taste
Epistaxis (nosebleed)
Headache
Unpleasant taste
Epistaxis
Headache
Budesonide is indicated in which age group
older than 6 years
Which of the following are systemic decongestants
Pseudoephedrine
Fluticasone
Budesonide
Phenylephrine
PSE and phenylephrine
(Fluticasone and budesonide are steroids_
Hilary is a 64 year old woman w/ a family history of HTN. Which would you recommend for congestion?
Phenylephrine
Dehumidifier
Nasalcrom
Humidifier
Humidifier
(PE could increase BP, dehumidifier and nasalcrom are for allergies)
What class of drug do decongestants interact with
MAOIs
Which of the following are contraindicated within 14 days of taking a MAOI? SATA
Phenylephrine
Guaifenesin
Azelastine
Dextromethorphan
PE and DM
What symptom will oral antihistamines NOT help with
Nasal congestion
Jo Jo is a 6 year old boy suffering from moderate to severe AR. What do you recommend?
Flonase
What age group is fluticasone furoate indicated in
2 years and older
What does cromolyn soidum interact with
Nothing
Fluticasone propionate is indicated in which age group
> 4 years
Which of the following include groups who should NOT receive OTC for AR? SATA
COPD patients
Pregnant/lactating
18 years and older
Asthma symptoms
COPD
Pregnant/lactating
Asthma
