Test 2 Questions Flashcards
Allergic Rhinitis…tell me about allergens and how they trigger histamine release
histamine in mast cells
what triggers histamine release?
forein substance activate WBC produce IGE , repeat exposure triger activation must cells and release histamin
can you have allergic reaction with first exposure to allergen?
no, Requires repeat exposure to allergen
What is first line for allergic rhinitis?
intranasal glucocorticoids
are intranasal glucocorticoids prn or daily?
daily
1st gen/2nd gen antihistamines
1st-sedation
1st- potential for anticholinergic effects
what are anticholinergic effects?
cant pee, cant see, cant shit
oral and intranasal decongestants…how do they work? Mechanism of action?
Use alpha1 adrenergic receptors (nervous system) to cause vasoconstriction:
Drugs like Phenylephrine, pseudoephedrine
systemic oral decongestants…what population should we be cautious in prescribing?
HTN
CVD
Intranasal decongestnts like Afrin…provide me with some education points for your patient?
rebound reaction, cannot use more than 5 day
Drugs for cough…talk to me about benzonatate (Tessalon Perles)…how do they work?
They are derivative of local aneshetic…numbs (decreases sensitivity) to stretch receptors that promote cough
benzonatate patient education
cant give to kids
must take whole, no sucking chewing, or dissolving med in mouth
what do we treat the inflammation with?
inhaled glucocorticoid
how do we treat bronchoconstriction?
bronchodilators
ICS therapy is critical part of asthma treatment. Tell me about these drugs…how do they work?
Suppress inflammation
ICS AE
1. Adrenal suppression Oropharyngeal candidiasis/Dysphonia 2↓bone 3.↑ hyperglycemia 4.↑ cataract/glaucoma 5. ↑peptic ulcer 6. young-growth suppression
pt education regarding med aministration to prevent thrush?:
rinse mouth out after each use
From a side effect standpoint, why is it beneficial take inhaled glucocorticoid versus systemic?
very effective, much safer, less AE
ICS daily or PRN
daily
If someone takes daily steroids and comes in with significant problem like infection or surgery, what would you need to do?
stress dose of steroids because their adrenals probably arent producing their own.
What education should provide parents whose kids are on ICS about growth?
Growth will be slower but they will reach their adult height
Black box warning for Omalizumab (Xolair)
anaphylatic reaction at anytime and cancer causing
Tell me about B2 agonist…how do they work?
use Beta 2 adrenergic receptors!
What is most useful in acute asthma attack?
SABA
