Oxygenation- Allergic Rhinitis

Question 1

Drugs for allergic rhinitis are divided into what 2 categories?

Answer 1

Preventers (3) and Relievers

Question 2

What are the 3 kinds of allergic rhinitis preventers

Answer 2

1. Antihistamines
2. Intranasal glucocorticoids
3. Mast Cell Stabilizers

Question 3

Antihistamines are divided into what 2 categories

Answer 3

1st gen and 2nd gen

Question 4

How do antihistamines work?

Answer 4

Allergic Rhinitis Preventer

Work to block the actions of histamine at the H1 receptor

Question 5

What are Antihistamines indicated for?

Answer 5

1st line therapy for mild/mod seasonal allergies

-Most effective when taken prophylactically

Question 6

What class is diphenhydramine (Benadryl) and what is its side effect?

Answer 6

Prototype 1st generation Antihistamine
-Allergic Rhinitis Preventer

SE: sedation anticholinergic effects

Question 7

What class is loratadine and what are its side effects?

Answer 7

Prototype 2nd generation Antihistamine
-Allergic Rhinitis Preventer
SE: sedation can occur

Question 8

What class is fluticasone (flonase) and what is it used for?

Answer 8

Intranasal glucocorticoids
-Allergic Rhinitis Preventer

-MOST effective for seasonal allergies

Question 9

What is are most effective treatment for seasonal allergies?

Answer 9

fluticasone (flonase)
Intranasal glucocorticoids
-Allergic Rhinitis Preventer

Question 10

fluticasone (flonase) route?

Answer 10

Intranasal glucocorticoids
-Allergic Rhinitis Preventer

Route: Administered with a metered dose spray device

Question 11

Patient education for fluticasone (flonase)

Answer 11

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

Question 12

Side effects of fluticasone (Flonase)

Answer 12

Intranasal glucocorticoids -Allergic Rhinitis Preventer

SE: drying/burning sensation, epistaxis

Question 13

fluticasone (Flonase)- does it have systemic or localized effects?

Answer 13

Intranasal glucocorticoids -Allergic Rhinitis Preventer

Action and SE limited to nasal passages

Question 14

what class is Cromolyn (Intal) and what is its fxn?

Answer 14

Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer

Inhibits mast cells from releasing histamine and other chemical mediators of inflammation

Question 15

Cromolyn (Intal) route and onset?

Answer 15

Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer

Route: Inhaler, nebulizer
Onset: several weeks

Question 16

What can happen if you stop Cromolyn (Intal) suddenly? what are the side effects?

Answer 16

Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer

• Rebound bronchospasm is stopped abruptly
• SE: cough and bronchospasm

Question 17

What are the two prototype for Allergic Rhinitis Relievers? What class do they fall under

Answer 17

pseudoephedrine (Sudafed)
oxymetazoline (Afrin)

–Sympathomimetics (Decongestants)

Question 18

What class pseudoephedrine (Sudafed) and how does it fxn?

Answer 18

Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever

Fxn: Stimulate the sympathetic nervous system to relieve nasal congestion
-Alpha 1 agonist , causes vasoconstriction

Question 19

What route can pseudoephedrine (Sudafed) be given?

Answer 19

Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever

Route: oral or intranasal
-Oral: slower onset of action

Question 20

Side effects of pseudoephedrine (Sudafed)?

Answer 20

Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever

HTN, CNS stimulation (insomnia)

Question 21

Which patient population should avoid pseudoephedrine (Sudafed)?

Answer 21

Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever

-Should not be used in cardiac patients

Question 22

What class of drug is oxymetazoline (Afrin) and what is its route?

Answer 22

Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever

Question 23

What can happen with prolonged use of oxymetazoline (Afrin) and what we gonna do about it?

Answer 23

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

Question 24

What is recommended duration of use for oxymetazoline (Afrin)

Answer 24

Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
use no longer than 3-5 days lest ye end up with a case of the Rebound Congestion