Week 4: Allergic Rhinitis (Bolded/Underlined Terms) Flashcards

1
Q

The mechanism of action for antihistamines is ___.

A

blocks H1 receptor

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2
Q

The mechanism of action for decongestants is ___.

A

alpha-adrenergic agonist

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3
Q

The mechanism of action for mast cell stabilizer is ___.

A

prevents release of histamine and leukotriene from mast cells

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4
Q

The mechanism of action for steroid is ___.

A
  1. reduces inflammation

2. inhibits production or secretion of histamine and leukotriene

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5
Q

The _____ antihistamines are sedative.

A

first generation

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6
Q

The _____ antihistamines are non-sedative or less sedative.

A

second generation

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7
Q

The _____ antihistamines are peripherally selective.

A

second generation

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8
Q

The _____ antihistamines are non-selective.

A

first generation

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9
Q

The _____ antihistamines are LIPOPHILIC.

A

first generation

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10
Q

The _____ antihistamines are LIPOPHOBIC.

A

second generation

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11
Q

The _____ antihistamines competitively block histamine (H1) receptor AND inhibit the release of mast cell mediators (histamine and leukotrienes)

A

second generation

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12
Q

The _____ antihistamines competitively blocks histamine (H1) AND cholinergic receptors.

A

first generation

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13
Q

The second generation antihistamines competitively block histamine (H1) receptor AND ____.

A

inhibit the release of mast cell mediators (histamine and leukotrienes)

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14
Q

The first generation antihistamines competitively blocks histamine (H1) receptor AND ____ receptors.

A

cholinergic

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15
Q

The _____ antihistamines activates serotonin and alpha adrenergic receptors.

A

first generation

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16
Q

The first generation antihistamines are usually _____ dosing.

A

Q4-6 hrs

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17
Q

The second generation antihistamines are _____ dosing.

A

once daily

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18
Q

The _____ antihistamines are usually Q4-6 hrs dosing.

A

first generation

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19
Q

The ____ antihistamines are once daily dosing.

A

second generation

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20
Q

The antihistamine class _____ has a HIGH level of sedation.

A

ethanolamines

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21
Q

The antihistamine class _____ has a MODERATE level of sedation.

A

alkylamines

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22
Q

The antihistamine class _____ has a MIN-MODERATE level of sedation.

A

piperazine

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23
Q

The antihistamine class _____ has a NON-SEDATING level of sedation.

A

piperidines

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24
Q

The antihistamine class ETHANOLAMINES has a ___ level of sedation.

A

high

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25
Q

The antihistamine class PIPERAZINE has a ___ level of sedation.

A

min-moderate

26
Q

The antihistamine class ALKYLAMINES has a ___ level of sedation.

A

moderate

27
Q

The antihistamine class PIPERIDINES has a ___ level of sedation.

A

non-sedating

28
Q

The combination product Brompheniramine + Phenylephrine (Dimetapp) are _____ antihistamines.

A

1st generation

29
Q

The combination product Triprolidine + Pseudoephedrine (Actifed) are _____ antihistamines.

A

1st generation

30
Q

_____ is a 1st generation antihistamine that requires higher doses for treatment of allergic rhinitis (max of 300 mg) vs cough (max of 150 mg).

A

diphenhydramine

31
Q

Diphenhydramine is a 1st generation antihistamine that requires higher doses for treatment of _____.

A

allergic rhinitis (vs cough)

32
Q

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.

A

300 mg

cough has a max of 150 mg

33
Q

____ 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.

A

Loratadine

Cetirizine

34
Q

____ 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.

A

Fexofenadine

35
Q

_____ is the MOST sedating 2nd generation antihistamine.

A

Cetirizine

36
Q

What are the 4 side effects of using antihistamines?

A
  1. blurry vision
  2. constipation
  3. urinary retention
  4. dry mouth
37
Q

What are 8 symptoms of overdose of antihistamines?

A
  1. hallucinations
  2. agitation
  3. lethargy
  4. tremor
  5. insomnia
  6. seizures
  7. mydriasis (pupil dilation)
  8. diarrhea
38
Q

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.

A

fruit juice

39
Q

For patient counseling, you should tell the patient to ______ when taking fexofenadine suspension.

A

shake well before using

40
Q

For patient counseling on Fexofenadine and/or Cetirizine Oral Disintegrating Tablet (ODT), tell the patient to _____ and ____.

A
  1. take on an empty stomach

2. remove from the blister pack using dry hands and place on the tongue immediately

41
Q

______ 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.

A

Cromolyn (NasalCrom Spray)

42
Q

Cromolyn (NasalCrom Spray) is used to prevent and treat symptoms associated with allergic rhinitis. The best method for PREVENTION of the symptoms is to ______.

A

start at least 1 week prior to contact with allergen

43
Q

_____ is a 1st generation antihistamine and mast cell stabilizer that is the drug of choice in pregnancy (category B) for a faster effect.

A

chlorpheniramine

44
Q

__1__ and __2__ are topical steroid used for temporary relief of nasal symptoms of allergic rhinitis (nasal congestion, runny nose, sneezing, itchy nose).

A
  1. triamcinolone (Nasacort)

2. budesonide (Rhinocort)

45
Q

Triamcinolone (Nasacort) is a _____.

A

topical steroid

46
Q

Triamcinolone (Nasacort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis and has a dose of ____.

A

55 mcg/spray

47
Q

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.

A

less than 2 years

48
Q

_____ is a topical steroid used for temporary relief of NASAL AND OCULAR symptoms of allergic rhinitis.

A

Fluticasone (Flonase)

49
Q

Fluticasone (Flonase) is a ____.

A

topical steroid

50
Q

Fluticasone (Flonase) is a topical steroid used for temporary relief of NASAL AND OCULAR symptoms of allergic rhinitis and has a dose of ____.

A

50 mcg/spray

51
Q

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.

A

less than 4 years of age

52
Q

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.

A
  1. Triamcinolone (Nasacort)
  2. Fluticasone (Flonase)
  3. Budesonide (Rhinocort)
53
Q

Budesonide (Rhinocort) is a topical steroid used for temporary relief of nasal symptoms of allergic rhinitis and has a dose of ____.

A

32 mcg/spray

54
Q

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.

A

less than 6 years

55
Q

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.

A

1 spray per nostril/day

56
Q

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 _____ .

A

instill 2 sprays in each nostril every 24 hours

you can decrease to 1 spray per nostril per day if the symptoms improve

57
Q

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.

A

2 weeks

58
Q

As one of the topical steroid counseling points, recommend a ______ if having a long term use of these steroids.

A

regular eye exam

59
Q

Nasal sprays do NOT treat _____.

A

asthma (which are treated with inhalation sprays)

nasal sprays are used for allergies (topical steroids)

60
Q

The topical steroid warning is that the growth rate of children can be slower. Counsel your patients not to use topical steroids for _____.

A

longer than 2 months without talking to the child’s doctor

61
Q

For patient counseling on nasal sprays, you should first blow the nose before use and then ____.

A

prime the pump before using it for the 1st time or if the bottle is not used for 2 weeks