Exam 2 - Allergic Rhinitis Flashcards

1
Q

By which age do we see allergic rhinitis begin to diminish

A

65+ years old

(Medicaid age)

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2
Q

Which of the following are risk factors for allergic rhinitis

Higher socioeconomic class
Eczema
Living in northeastern US
Family history

A

Higher socioeconomic class
Eczema
Family history

(Itchy, predisposed, rich)

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2
Q

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
A

All of them

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2
Q

List some ways to remove allergens from household

A
  • closing windows when pollen counts are high
  • having HEPA ventilation in house
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3
Q

Symptoms of allergic rhinitis

A

Congestion
Smell impaired
Nasal discharge
Itchy eyes
Sneezing

(Can’t Stop Sneezing N Itching)

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3
Q

Intermittent allergic rhinitis symptoms are defined by which duration

A

Symptoms persist ≤ 4 days per week OR ≤ 4 weeks

(Allergies 4 days, 4 weeks)

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3
Q

(T/F): persistent AR is more easily identifiable than intermittent AR

A

False

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4
Q

Alteration in which two factors define whether allergic rhinitis symptoms are classified as intermittent or persistent

A

Ability to perform daily activities
Ability to sleep

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4
Q

Intermittent allergic rhinitis is AKA

A

Hay fever

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5
Q

Causes of nonallergic rhinitis

A

Pregnancy
Taking beta blocker
Head trauma
NSAIDs

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6
Q

(T/F): when treating AR, using dual therapy is most appropriate

A

False

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6
Q

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
A

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)

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6
Q

What steps (in order) should be taken to treat allergic rhinitis

A

Omit allergen
Antihistamine
Steroid
Immunotherapy
Surgery

(OASIS)

(Going from minor to major treatments)

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7
Q

3 primary steps for treating AR in order

A

Avoid allergen
Single entity drugs first
Immunotherapy

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7
Q

Which of the following should be limited to 3 days use

Naphazoline
Ketotifen
Olopatadine
Alcaftadine

A

Naphazoline

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7
Q

What class of medication is MOST effective for treating ALL AR symptoms

A

Intranasal corticosteroids

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8
Q

What can happen if you use a topical decongestant for more than 3 days

A

Rebound congestion

8
Q

Which of the following are 1st generation antihistamines

Diphenhydramine
Clemastine
Cetirizine
Chlorpheniramine

A

Diphenhydramine
Clemastine
Chlorpheniramine

9
Q

Jordan has just finished law school and has horrible spring allergies with a cough. He wants to sleep. What do you recommend?

A

Diphenhydramine

(Because it is sedating, an antihistamine, and an antitussive)

9
Q

Which of the following are 2nd generation antihistamines

Brompheniramine
Fexofenadine
Cetirizine
Levocetirizine
Diphenhydramine
Loratadine

A

Fexofenadine
Levocetirizine
Cetirizine
Loratadine

(Ones you’d be okay taking in the morning because they’re non-sedating)

9
Q

Lisa has AR. She is a mom of 3 and a physician. She also takes Tums regularly. What do you recommend

A

Loratadine

10
Q

Which antihistamine is in Mucinex Allergy

A

Fexofenadine

11
Q

Tavist AI

A

Clemastine

12
Q

What antihistamine is in dimetapp

A

Brompheniramine

13
Q

Which of the following antihistamines are LEAST likely to cause sedation

Loratadine
Cetirizine
Fexofenadine
Diphenhydramine
Chlorpheniramine

A

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)

14
Q

Larie is working midnights this week. Her allergies are awful. What do you recommend?

A

Fexofenadine

15
Q

Which combo products are safe to treat AR symptoms. SATA

Chlorpheniramine + zyrtec
Flonase + benadryl
Claratin D + nasacort
Rhinocort + allegra
Flonase + triamcinolone
Astepro + fluticasone

A

Flonase + benadryl
Claratin D + nasacort
Rhinocort + allegra
Astepro + fluticasone

(Others are duplicate therapy)

16
Q

Mr. Rogers is a 70 yr old man w/ glaucoma. He needs something for allergies. What do you recommend

A

Fexofenadine

(1st gen and decongestants will worsen glaucoma)

17
Q

Which symptoms can 1st generation antihistamines cause? SATA

Dry mouth
Drooling
Urinary retention
Diarrhea
Somnolence (drowsy)
Blurred vision

A

Dry mouth
Urinary retention
Somnolence
Blurred vision

(Dry, drowsy, blurry)

18
Q

Which of the following are side effects of intranasal corticosteroids

Dry mouth
Unpleasant taste
Epistaxis (nosebleed)
Headache

A

Unpleasant taste
Epistaxis
Headache

19
Q

Budesonide is indicated in which age group

A

older than 6 years

20
Q

Which of the following are systemic decongestants

Pseudoephedrine
Fluticasone
Budesonide
Phenylephrine

A

PSE and phenylephrine

(Fluticasone and budesonide are steroids_

21
Q

Hilary is a 64 year old woman w/ a family history of HTN. Which would you recommend for congestion?

Phenylephrine
Dehumidifier
Nasalcrom
Humidifier

A

Humidifier

(PE could increase BP, dehumidifier and nasalcrom are for allergies)

22
Q

What class of drug do decongestants interact with

A

MAOIs

23
Q

Which of the following are contraindicated within 14 days of taking a MAOI? SATA

Phenylephrine
Guaifenesin
Azelastine
Dextromethorphan

A

PE and DM

24
Q

What symptom will oral antihistamines NOT help with

A

Nasal congestion

25
Q

Jo Jo is a 6 year old boy suffering from moderate to severe AR. What do you recommend?

A

Flonase

26
Q

What age group is fluticasone furoate indicated in

A

2 years and older

27
Q

What does cromolyn soidum interact with

A

Nothing

27
Q

Fluticasone propionate is indicated in which age group

A

> 4 years

28
Q

Which of the following include groups who should NOT receive OTC for AR? SATA

COPD patients
Pregnant/lactating
18 years and older
Asthma symptoms

A

COPD
Pregnant/lactating
Asthma