Week 4: Allergic Rhinitis (Bolded/Underlined Terms) Flashcards
The mechanism of action for antihistamines is ___.
blocks H1 receptor
The mechanism of action for decongestants is ___.
alpha-adrenergic agonist
The mechanism of action for mast cell stabilizer is ___.
prevents release of histamine and leukotriene from mast cells
The mechanism of action for steroid is ___.
- reduces inflammation
2. inhibits production or secretion of histamine and leukotriene
The _____ antihistamines are sedative.
first generation
The _____ antihistamines are non-sedative or less sedative.
second generation
The _____ antihistamines are peripherally selective.
second generation
The _____ antihistamines are non-selective.
first generation
The _____ antihistamines are LIPOPHILIC.
first generation
The _____ antihistamines are LIPOPHOBIC.
second generation
The _____ antihistamines competitively block histamine (H1) receptor AND inhibit the release of mast cell mediators (histamine and leukotrienes)
second generation
The _____ antihistamines competitively blocks histamine (H1) AND cholinergic receptors.
first generation
The second generation antihistamines competitively block histamine (H1) receptor AND ____.
inhibit the release of mast cell mediators (histamine and leukotrienes)
The first generation antihistamines competitively blocks histamine (H1) receptor AND ____ receptors.
cholinergic
The _____ antihistamines activates serotonin and alpha adrenergic receptors.
first generation
The first generation antihistamines are usually _____ dosing.
Q4-6 hrs
The second generation antihistamines are _____ dosing.
once daily
The _____ antihistamines are usually Q4-6 hrs dosing.
first generation
The ____ antihistamines are once daily dosing.
second generation
The antihistamine class _____ has a HIGH level of sedation.
ethanolamines
The antihistamine class _____ has a MODERATE level of sedation.
alkylamines
The antihistamine class _____ has a MIN-MODERATE level of sedation.
piperazine
The antihistamine class _____ has a NON-SEDATING level of sedation.
piperidines
The antihistamine class ETHANOLAMINES has a ___ level of sedation.
high
The antihistamine class PIPERAZINE has a ___ level of sedation.
min-moderate
The antihistamine class ALKYLAMINES has a ___ level of sedation.
moderate
The antihistamine class PIPERIDINES has a ___ level of sedation.
non-sedating
The combination product Brompheniramine + Phenylephrine (Dimetapp) are _____ antihistamines.
1st generation
The combination product Triprolidine + Pseudoephedrine (Actifed) are _____ antihistamines.
1st generation
_____ is a 1st generation antihistamine that requires higher doses for treatment of allergic rhinitis (max of 300 mg) vs cough (max of 150 mg).
diphenhydramine
Diphenhydramine is a 1st generation antihistamine that requires higher doses for treatment of _____.
allergic rhinitis (vs cough)
The max dose of diphenhydramine for allergic rhinitis is _____. This is a higher dose than what is used for a cough because you need to block the histamines all over for allergic rhinitis.
300 mg
cough has a max of 150 mg
____ and ____ are 2nd generation antihistamines that are dosed at 10 mg each day (Max/day is 10 mg) for adults and children 12 years and over.
Loratadine
Cetirizine
____ is a 2nd generation antihistamine that is dosed at 60 mg every 12 hours and 180 mg every 24 hours (if more severe) for adults and children 12 years and over. The max/day is 180 mg.
Fexofenadine
_____ is the MOST sedating 2nd generation antihistamine.
Cetirizine
What are the 4 side effects of using antihistamines?
- blurry vision
- constipation
- urinary retention
- dry mouth
What are 8 symptoms of overdose of antihistamines?
- hallucinations
- agitation
- lethargy
- tremor
- insomnia
- seizures
- mydriasis (pupil dilation)
- diarrhea
For patient counseling, you should tell the patient to avoid taking fexofenadine with ____. Because it decreases bioavailability, you should separate by at least 2 hours.
fruit juice
For patient counseling, you should tell the patient to ______ when taking fexofenadine suspension.
shake well before using
For patient counseling on Fexofenadine and/or Cetirizine Oral Disintegrating Tablet (ODT), tell the patient to _____ and ____.
- take on an empty stomach
2. remove from the blister pack using dry hands and place on the tongue immediately
______ is a mast cell stabilizer used for prophylaxis and treatment of symptoms associated with allergic rhinitis. It is approved for patients at least 5 years and older and is more effective if started at least 1 week prior to contact with an allergen.
Cromolyn (NasalCrom Spray)
Cromolyn (NasalCrom Spray) is used to prevent and treat symptoms associated with allergic rhinitis. The best method for PREVENTION of the symptoms is to ______.
start at least 1 week prior to contact with allergen
_____ is a 1st generation antihistamine and mast cell stabilizer that is the drug of choice in pregnancy (category B) for a faster effect.
chlorpheniramine
__1__ and __2__ are topical steroid used for temporary relief of nasal symptoms of allergic rhinitis (nasal congestion, runny nose, sneezing, itchy nose).
- triamcinolone (Nasacort)
2. budesonide (Rhinocort)
Triamcinolone (Nasacort) is a _____.
topical steroid
Triamcinolone (Nasacort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis and has a dose of ____.
55 mcg/spray
Triamcinolone (Nasacort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis and should NOT be used in children _____ of age.
less than 2 years
_____ is a topical steroid used for temporary relief of NASAL AND OCULAR symptoms of allergic rhinitis.
Fluticasone (Flonase)
Fluticasone (Flonase) is a ____.
topical steroid
Fluticasone (Flonase) is a topical steroid used for temporary relief of NASAL AND OCULAR symptoms of allergic rhinitis and has a dose of ____.
50 mcg/spray
Fluticasone (Flonase) is a topical steroid used for temporary relief of NASAL AND OCULAR symptoms of allergic rhinitis and should NOT be used in children ___ of age.
less than 4 years of age
The following topical steroids __1__ is dosed at 55 mcg/spray, __2__ is dosed at 50 mcg/spray, and __3__ is dosed at 32 mcg/spray.
- Triamcinolone (Nasacort)
- Fluticasone (Flonase)
- Budesonide (Rhinocort)
Budesonide (Rhinocort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis and has a dose of ____.
32 mcg/spray
Budesonide (Rhinocort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis and should NOT be used in children ____ of age.
less than 6 years
Budesonide (Rhinocort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis. For children ages 6-12, the dose is _____ with supervision.
1 spray per nostril/day
Budesonide (Rhinocort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis. For ages 12 years and over, the dose is _____ .
instill 2 sprays in each nostril every 24 hours
you can decrease to 1 spray per nostril per day if the symptoms improve
As one of the topical steroid counseling points, tell the patient that it may take _____ for a full effect, that it is best to use before exposure to the allergen and is good for prevention and treatment.
2 weeks
As one of the topical steroid counseling points, recommend a ______ if having a long term use of these steroids.
regular eye exam
Nasal sprays do NOT treat _____.
asthma (which are treated with inhalation sprays)
nasal sprays are used for allergies (topical steroids)
The topical steroid warning is that the growth rate of children can be slower. Counsel your patients not to use topical steroids for _____.
longer than 2 months without talking to the child’s doctor
For patient counseling on nasal sprays, you should first blow the nose before use and then ____.
prime the pump before using it for the 1st time or if the bottle is not used for 2 weeks
