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Respiratory Pharm > Rhinitis > Flashcards

Rhinitis Flashcards

0
Q

What is Perennial Rhinitis?

A

Persistent indoor allergens (ex: House dust mites, Pet Dander, Mold, Cock roaches)

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1
Q

What is seasonal Rhinitis

A

Intermittent allergic rx in the Spring and Fall to outside allergens such as Pollen, Fungi. (Hay Fever, Rose Fever)

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2
Q

(General Glucocorticoids) What is the Route?

A

Nasal

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3
Q

(General Glucocorticoids) Action?

A

Prevent inflammatory Response

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4
Q

(General Glucocorticoids) Adverse Affects?

A

Nasal Irritation/ Possibly effects linear growth in children

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5
Q

General Antihistamines-Route?

A

Nasal/Oral

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6
Q

General Antihistamin- Action?

A

Block H1 receptors

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7
Q

General Antihistamine-Adverse Effects?

A

oral = sedation/Anticholergenic

nasal= bitter taste

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8
Q

General Cromolyn- Route?

A

Nasal

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9
Q

General Cromolyn-Action?

A

Prevents release of inflammatory mediators

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10
Q

General sympathomimetics- Route?

A

Oral/Nasal

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11
Q

General sympathomimetics- Action?

A

Activate vascular alpha 1 receptor

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12
Q

General sympathomimetics- Adverse Effects?

A

Oral- restless, insomnia, and increase in BP

Nasal= rebound nasal congestion

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13
Q

General Anticholinergics-Route?

A

Nasal

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14
Q

General Anticholinergics-Action?

A

Block nasal cholinergic receptors

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15
Q

General Anticholinergics- Adverse Effects?

A

Nasal drying/ irritation

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16
Q

General Antileukotrienes- Route?

A

Oral

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17
Q

General Antileuktrienes- Action?

A

Block leukotriene receptors

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18
Q

General Antileukotrienes- Adverse Effects?

A

RARE but neuropsychiatric effects

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19
Q

General Goal of Rhinitis meds?

A

Reduce inflammation/Nasal symptoms (Patient exhibits no adv effects and can sleep.

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20
Q

What drug is the most effective drug when treating both seasonal and perennial rhinitis? And a 1st line therapy?

A

Intranasal Glucocorticoid: “Rhinocort”; Fluticason (Flonase) Mometasone (Nasonex)

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21
Q

How is intranasal glucocorticoids admin? (Flonase, Nasonex, Rhinocort)

A

Using a metered dose spray

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22
Q

When should Intranasal glucocorticoids be started? (Flonase, Nasonex, Rhinocort)

A

Before the patient has symptoms

23
Q

Should intranasal glucorticoids (Flonase, Nasonex, Rhinocort) be used PRN?

A

No, best outcomes when used once daily

24
Q

What needs to be done before using intranasal glucorticoids?

A

Use a topical decongestant agent before spraying in the nose, we need to “unstuff the nose” so the medicine can get into the passage

25
Q

What is a first generation antihistamine?

A

diphenhydramine (Benadryl)

26
Q

Are first generation antihistamines sedating?

A

Yes

27
Q

What is an example of a 2nd generation antihistamine?

A

loratidine (Claritin, Alavert)

28
Q

Are second generation antihistamines sedating?

A

No

29
Q

What is the MOA of antihistamines?

A

Selectively blocks the effects of histamine at the histamine receptor site (H1 receptor antagonists)

30
Q

Do antihistamines help with nasal congestion?

A

No

31
Q

When are antihistamines most effecttive?

A

When they are taken prophalatically before symptoms appear

32
Q

Some 1st generation antihistamines cause anticholinergic effects, what would some of these effects look like?

A

Dry mouth
Constipation
Urinary hesitancy

33
Q

Side effects of intranasal antihistamines?

A

Solomnence (sleep), nosebleed, unpleasant taste

34
Q

What is the MOA of intranasal Cromolyn Sodium (Nasocrom)?

A

Suppresses release of histamine and other inflammatory mediators from mast cells

35
Q

What is Nasalcrom best for?

A

Prophylaxis-not treatment

36
Q

What is an advantage of nasalcrom?

A

Extremely safe

37
Q

What is a disadvantage of Nasalcrom?

A

It is only moderately effective

38
Q

What do we need to do prior to admin. Intranasal Cromlyn Sodium?

A

Use a topical decongestant prior to admin if nasal congestion present

39
Q

What is the dosage of the intranasal cormolyn sodium?

A

Should be dosed on a regular schedule throughout the allergy season

40
Q

Types of Sympathomimetics (Decongestants)

A

pseudoephedrine (Sudafed)

41
Q

MOA of sympathomimetic (Sudafed)?

A

Reduce nasal congestion by activating alpha 1-adrenergic receptors on nasal blood vessels, causing vasoconstriction, shrinking swollen membranes, followed by nasal drainage (ONLY RELIEVES STUFFINESS)

42
Q

What are the adverse effects of sympathomimetics (pseudophedrine?)

A 
Rebound congestion
CNS stimulation
Restlessness
Irritability
Anxiety
Insomnia
Cardiovascular effects- r/t widespread vasoconstriction
43
Q

How can we prevent rebound congestion with Sudafed?

A

Do not take for longer than 5 days

44
Q

How should the head be positioned with nasal drops?

A

tilted back

45
Q

How should the head be positioned with nasal sprays?

A

Nose to toes (NOT tilted back)

46
Q

What are the benefits of using sympathomimetics and antihistamines together?

A

Provides relief of itchy eyes, sneezing, and rhinorrhea, along with fixing nasal congestion

47
Q

What are the type of combo meds?

A

Claritin-D, Allegra-D

48
Q

MOA of Ipratropium and Anticholinergic agents? (Atrovent)

A

Blocks cholinergic receptors which inhibits glandular secretions, thereby decreasing rhinorrhea (runny nose)

49
Q

Side effects of anticholinergic agent?

A

Nasal drying and irritation

50
Q

What is the MOA of Leukotriene Antagonist (montelukast; singulair)?

A

Blocks the binding of leukotrienes to their receptor sites

51
Q

Adverse effects of Leukotriene Antagonist? (singulair)

A 
Rare, but serious neuropsychiatric effects such as:
agitation
aggression
hallucinations
depression
insomnia
restlessness
suicidal thoughts/behavior
52
Q

What is the MOA of Omalizamab (Xolair) injections?

A

Monoclomal anitbody that inhibits IgE response

53
Q

What is Omalizamab (Xolair) indicated for?

A

Ragweed induced allergy

54
Q

What is Xolair only approved for at this time?

A

Asthma

Respiratory Pharm (4 decks)

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