Rhinitis Drugs

Question 1

Intranasal Corticosteroids

Answer 1

Ex:
Mometasone
Budesonide
Fluticasone

MOA: Activates GRs on many different immune cells (including mast cells)
- decreases PLA2, COX-2 –> decreases LTs, PGs –> decreases inflammation

Days to weeks for maximal effect

AEs:
Local irritation (dryness, burning)
Perforation of nasal septum (spray away from septum)
Dysphonia (thins focal cords)
Oral thrush (fungal infections)
Possible systemic AEs

Question 2

Antihistamines

Answer 2

Ex:
1st gen: Diphenhydramine, Chlorpheniramine
2nd gen: Fexofenadine, Loratidine, Desloratidine

(Oral)
MOA:
block H1 receptors
block muscarinic receptors (1st generation > 2nd generation)
*cross blood brain barrier (1st generation > 2nd generation)

AEs:
antimuscarinic
sedation
weight gain

Question 3

Leukotriene Modifiers

Answer 3

Ex: Montelukast (Cys LT receptor antagonists)

(Oral)
MOA: block CysLT1 receptors
–> bronchodilation –> inflammation

AEs: Neuropsychiatric

Question 4

Cromolyns

Answer 4

Ex: Cromolyns

(Intranasal)
MOA: inhibits mast cells (takes weeks)
*prevention prior to exposure or exercise

AEs: minimal

Question 5

Muscarinic Antagonists

Answer 5

Ex: Ipratropium

(Intranasal)
MOA:
nonselective muscarinic antagonist
block M3 mediated nasal glandular
secretions –> decreases rhinorrhea

AEs: antimuscarinic