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Respiratory Conditions (JBR) > Rhinitis > Flashcards

Rhinitis Flashcards

1
Q

What is rhinitis?

A

Acute or chronic inflammation of nasal mucosa

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2
Q

What are the symptoms of rhinitis?

A 
Sneezing 
Rhinorrhea
Itching 
Nasal congestion
Obstruction
Difficulty breathing in
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3
Q

What causes obstruction in rhinitis?

A

Swelling of nasal mucosa (particularly in cavernous sinusoids) largely due to dilated blood vessels

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4
Q

What are the three types of rhinitis?

A

Allergic
Non-allergic
Mixed

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5
Q

Outline the immunology of allergic rhinitis on FIRST exposure

A

Inhale allergen
Increase (specific) IgE levels
IgE binds to receptors on mast cells and basophils

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6
Q

Outline the immunology of allergic rhinitis on SECOND exposure

A

Re-exposure
Mast cell and basophils degranualte
Release mediators (histamine, cyst Its, tryptase, prostaglandins)
Cause acute and delayed symptoms

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7
Q

What are the acute symptoms of allergic rhinitis?

A

Itching
Sneezing
Rhinorrhoea

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8
Q

What are the delayed symptoms of allergic rhinitis?

A

Congestion and obstruction

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9
Q

What causes the delayed symptoms of allergic rhinitis?

A

Lymphocyte and eosinophil recruitment to nasal mucosa

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10
Q

What re causes of non-allergic rhinitis?

A 
Infectious (mainly viral) 
Hormonal (pregnancy) 
Vasomotor disturbances
Eosinophilia syndrome 
Medication
Occupational (may be mixed)
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11
Q

What are the pharmacological agents used in Rhinitis?

A 
Glucocosteroids
Anti-histamines
Anti-cholinergic drugs Sodium cromoglicate
CysLT Receptor Antagonist 
Vasoconstrictors
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12
Q

What are examples of glucocosteroids?

A

Beclometasone
Fluticasone
Prednisolone (oral)

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13
Q

What is the effect of glucocosteroids?

A

Reduce vascular permeability, recruitment and activity of inflammatory cells and release of cytokines and mediators

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14
Q

What is the most common route of administration for glucocosteroids?

A

Spray to mucosa (usually OD)

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15
Q

Glucocosteroids are effective as a mono therapy but may be combined with _______ in moderate-severe rhinitis

A

Anti-histamines

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16
Q

What are the antihistamines used in rhinitis?

A

Competitive antagonists of H1 receptors

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17
Q

What is the effect of antihistamines?

A

Reduce mast cell derived histamine effects

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18
Q

Antihistamines are more effective in?

A

Allergic rhinitis

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19
Q

What are examples of antihistamines?

A

Loratidine
Fexofenadine
Cetirizine

20
Q

Which antihistamine also has a mild anti-inflammatory effect?

A

Cetirizine

21
Q

Antihistamines are effective as?

A

Monotherapy

22
Q

Which anticholinergic drug is used in rhinitis?

A

Ipratroprium

23
Q

What is the effect of ipratropium?

A

Block ACh release from postganglionic parasympathetics

24
Q

Anticholinergic drugs are also known as?

A

Muscarinic receptor antagonists

25
Q

Ipratroprium blocks the muscarinic receptors on nasal glands that cause?

A

A watery secretion (contributes to rhinorrhea)

26
Q

Ipratroprium reduces rhinorrhea but has no effect on?

A

Sneezing
Tiching
Congestion

27
Q

How is ipratroprium administered?

A

Nasal route

28
Q

What is the side effect of ipratroprium?

A

Dryness of nasal membranes

29
Q

What is sodium cromoglicate?

A

Mast cell stabiliser

30
Q

What is sodium cromoglicate used for?

A

Maintenance treatment of allergic rhinitis

31
Q

What is the onset of action of sodium cromoglicate?

A

4-7 days (may take weeks for full effect)

32
Q

How is sodium cromoglicate administered?

33
Q

Sodium cromoglicate is not effective as a nasal ..?

A

corticosteroid

34
Q

Which CysLT1 receptor antagonist is used?

A

Montelukast

35
Q

Montelukast reduces the effects of CysLTs on the?

A

Nasal mucosa

36
Q

Montelukast may show an additive effect with?

A

Anti-histamine

37
Q

Montelukast should be particularly considered if the patient has allergic rhinitis and ?

38
Q

How is montelukast administered?

39
Q

Vasoconstrictors are direct/indirect sympathomimetics to mimic the effects of?

A

Noradrenaline

40
Q

How do vasoconstrictors act?

A

Activate alpha-1-adrenoceptors to decrease swelling of vascular muscoa

41
Q

What is oxymetazoline?

A

Selective alpha-1-adrenoceptor agonist

42
Q

How is oxymetazoline administered?

A

Intranasally

43
Q

Oxymetazoline is effective short-term in reducing?

A

Congestion in allergic rhinitis

44
Q

Long-term nasal administration of oxymetazidine is not recommended because?

A

Rebound increase in nasal congestion upon discontinuation due to receptor desensitisation and down regulation

45
Q

What is rhinitis medicaments?

A

Rebound increase in nasal congestion upon discontinuation of medication such as oxymetazidine

Respiratory Conditions (JBR) (26 decks)

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