Rhinitis

Question 1

What is the nasal spray technique counselling for intranasal antihistamines?

Answer 1

1) shake and look down
2) aim for outside wall of the nose
3) do not sniff

Question 2

What is the nasal drop technique for intranasal antihistamines?

Answer 2

1) blow nose
2) tilt head back
3) place drops in the nose
4) tilt head back and sniff

Question 3

Which intranasal corticosteroid has the highest systemic absorption?

Answer 3

betamethasone

Question 4

Which intranasal corticosteroid has the lowest systemic absorption?

Answer 4

fluticasone

Question 5

What are the THREE contraindications for nasal corticosteroids?

Answer 5

1) untreated nasal infection
2) recent nasal surgery/trauma
3) pulmonary TB

Question 6

What are the TWO MHRA alerts for nasal corticosteroids?

Answer 6

1) Risk of central serous chorioretinopathy

2) Patient safety alert emergency card

Question 7

What are the side effects of nasal corticosteroids?

Answer 7

altered smell, epistaxis, headache, altered taste, throat irritation

Question 8

How do we avoid systemic administration of nasal corticosteroids?

Answer 8

The head down position and breathe in slowly do not sniff

Question 9

What is the dose of ephedrine hydrochloride 0.5% nasal drops 12yrs+?

Answer 9

1-2 drops up to QDS for max 7 days (max 180mg otc)

Question 10

What is the age group allowed Xylometazoline?

Answer 10

6yrs+ but from 6-12yrs max 5 day duration

Question 11

What is the max duration of xylometazoline for 12yrs+?

Answer 11

maximum 7 days because of rebound nasal congestion (rhinitis medicamentosa)

Question 12

Which medications should you not use xylometazoline with?

Answer 12

MAOIs because of hypertensive crisis