Pharm 4 Resp pt1 Flashcards
Only drug that treats anaphylaxis is
Epinephrine
Dual-Phase Allergic Reaction:
What triggers immediate reaction?
What triggers the late reaction?
The immediate allergic reaction is triggered by reexposure to an antigen
The late reaction occurs in50% of persons with seasonal allergic rhinitis who have been exposed to a nasal challenge.
What happening during the Immediate-reaction (of the Dual-Phase Allergic Reaction)?
The mast cells degranulate, basophils are activated, and both release inflammatory mediators, which collectively produce the nasal end-organ changes appearing clinically as itching, sneezing, rhinorrhea, congestion, and hives.
What happening during the late reaction (of the Dual-Phase Allergic Reaction)?
The late reaction is initiated with an influx of eosinophils, neutrophils, basophils, and mononuclear cells into the nasal mucosa
Late inflammatory events include further release of mediators, hyper- responsiveness to irritants, and priming – heightened sensitivity to antigen
URIs are primarily __ in etiology
Viral
2 common complications of allergic rhinitis
Acute sinusitis
Otitis media
All year-around allergies, such as cat & dog allergies are known as:
Perennial
Most ppl have already tried otc drugs before they came to you. They’re here b/c it didn’t work for them. So you wouldn’t want to ___
Wouldn’t want to prescribe a drug in that same class . It’d fail too.
Seasonal allergic rhinitis is usually caused by allergy to:
Spring? Summer? Fall?
Pollen
Spring: Trees
Summer: Grasses
Fall: Ragweed
Perennial allergic rhinitis is usually caused by allergy to (3)
dust, molds, or mites
What are the symptoms of Perennial allergic rhinitis like?
very similar to URI symptoms except that they may be more severe, more persistent and can be related to exposure to allergens
Vasomotor rhinitis is an allergy to what?
commonly caused by perfumes, fragrances, smoke, pollution
6 classes of URI & Allergic Rhinitis Meds
Decongestants Antihistamines Intranasal Steroids Intranasal cromolyn Antitussives Expectorants
Antitussives & Expectorants are for:
coughs.
How does the body get an allergic reaction?
Allergens are cumulative. You must reach a threshold to have an allergic reaction, and 2 different minor allergies simultaneously can reach that threshold.
(2 different allergies below threshold can stack together to reach allergy threshold)
alpha-adrenergic Activities (4)
Vasoconstriction of arterioles, leading to increased blood pressure
Dilation of pupils
Intestinal relaxation
Bladder sphincter contraction
beta-adrenergic important info:
Just because a drug is beta-2, it still has some beta-1 properties.
Rainbow analogy: Tell me where the purple becomes blue.. you can’t it spills over into the other receptor.
Beta-1 adrenergic Activities (2)
Cardio-acceleration
Increased myocardial contractility
Beta-2 adrenergic Activities (4)
Vasodilation of skeletal muscle
Bronchodilation
Uterine relaxation
Bladder relaxation
Sympathomimetics amines that act to: (biological)
Decongrestant effects:
stimulate a-adrenergic receptors of vascular smooth muscle causing vasoconstriction, have pressor effects, nasal decongestion, contraction of GI and urinary sphincters, pupil dilation, and decreased pancreatic b-cell secretion
Pseudoepheddrine has _-adgrenergic properties
Primarily Alpha and also Beta-adrenergic properties
Sympathomimetics would NOT be prescribed in patients with what? (4), due to its effects.
Benign prosthetic hypertrophy – they will go into urinary retension and will need catheterization.
Cardiac problems
Hypertension
Glaucoma, or glaucoma-like sx
*Which of the following classes of drugs might cause (glaucoma-like) symptoms?
Pseudophedrine
Prototypical Nasal Decongestant
Indication, Preg Category, Other info
Azelastine HCl Indications: seasonal allergic rhinitis Avoid eyes Pregnancy Cat. C Nursing mothers Potentiates CNS depression w/ ETOH Serum levels increased by cimetidine Not recommended in peds Bitter taste, Somnolence (drowsy), Headache, Weight increase - "no idea why", Nasal mucosa burning, Sneezing, Nausea
What is Azelastine?
An anthistamine with decongestant properties
