Oxygenation- Allergic Rhinitis Flashcards
Drugs for allergic rhinitis are divided into what 2 categories?
Preventers (3) and Relievers
What are the 3 kinds of allergic rhinitis preventers
- Antihistamines
- Intranasal glucocorticoids
- Mast Cell Stabilizers
Antihistamines are divided into what 2 categories
1st gen and 2nd gen
How do antihistamines work?
Allergic Rhinitis Preventer
Work to block the actions of histamine at the H1 receptor
What are Antihistamines indicated for?
1st line therapy for mild/mod seasonal allergies
-Most effective when taken prophylactically
What class is diphenhydramine (Benadryl) and what is its side effect?
Prototype 1st generation Antihistamine
-Allergic Rhinitis Preventer
SE: sedation anticholinergic effects
What class is loratadine and what are its side effects?
Prototype 2nd generation Antihistamine
-Allergic Rhinitis Preventer
SE: sedation can occur
What class is fluticasone (flonase) and what is it used for?
Intranasal glucocorticoids
-Allergic Rhinitis Preventer
-MOST effective for seasonal allergies
What is are most effective treatment for seasonal allergies?
fluticasone (flonase)
Intranasal glucocorticoids
-Allergic Rhinitis Preventer
fluticasone (flonase) route?
Intranasal glucocorticoids
-Allergic Rhinitis Preventer
Route: Administered with a metered dose spray device
Patient education for fluticasone (flonase)
Intranasal glucocorticoids -Allergic Rhinitis Preventer
Education for using intranasal: opposite hand for nostril, point nose to toes, try to keep spray off of septum, gently sniff in
Side effects of fluticasone (Flonase)
Intranasal glucocorticoids -Allergic Rhinitis Preventer
SE: drying/burning sensation, epistaxis
fluticasone (Flonase)- does it have systemic or localized effects?
Intranasal glucocorticoids -Allergic Rhinitis Preventer
Action and SE limited to nasal passages
what class is Cromolyn (Intal) and what is its fxn?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer
Inhibits mast cells from releasing histamine and other chemical mediators of inflammation
Cromolyn (Intal) route and onset?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer
Route: Inhaler, nebulizer
Onset: several weeks
What can happen if you stop Cromolyn (Intal) suddenly? what are the side effects?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer
- Rebound bronchospasm is stopped abruptly
- SE: cough and bronchospasm
What are the two prototype for Allergic Rhinitis Relievers? What class do they fall under
pseudoephedrine (Sudafed)
oxymetazoline (Afrin)
–Sympathomimetics (Decongestants)
What class pseudoephedrine (Sudafed) and how does it fxn?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
Fxn: Stimulate the sympathetic nervous system to relieve nasal congestion
-Alpha 1 agonist , causes vasoconstriction
What route can pseudoephedrine (Sudafed) be given?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
Route: oral or intranasal
-Oral: slower onset of action
Side effects of pseudoephedrine (Sudafed)?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
HTN, CNS stimulation (insomnia)
Which patient population should avoid pseudoephedrine (Sudafed)?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
-Should not be used in cardiac patients
What class of drug is oxymetazoline (Afrin) and what is its route?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
What can happen with prolonged use of oxymetazoline (Afrin) and what we gonna do about it?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
–>Rebound congestion: prolonged use causes escalating congestion requiring more drug to
get the same results (build up tolerance)
Ways to come off of it:
1. cold turkey
2. use in 1 nostril at a time
3. use nasal glucocorticoid for 2-6 weeks, start it 1 week before coming off of Afrin
What is recommended duration of use for oxymetazoline (Afrin)
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
use no longer than 3-5 days lest ye end up with a case of the Rebound Congestion
