50 - Allergic Rhinitis Flashcards Preview

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Flashcards in 50 - Allergic Rhinitis Deck (28):
1

non-pharms

avoid exposure to triggers, wash bedding, carpets, shower, don't have pets in the bedroom

2

Describe topical pharmacological options

-use saline nasal spray to wash out mucus and allergen
-lubricant eye drops or cold compresses can reduce conjunctival symptoms

3

What symptoms do antihistamines relieve?

relieve most symptoms such as sneezing, rhinorrhea, nasal itch and conjunctivitus

not congestion

4

Which antihistamine may relieve congestion?

desloratidine - may relieve congestion and is indicated for congestion

fexofenadine - may help but it is not indicated for this symptom

5

Antihistamines are most effective if used ______

prophylactically

*but onset of action is fast enough so they are still effective when used PRN

6

Of the less-sedating AH's, which one is more likely to cause some sedation, esp at higher doses?

cetirizine

7

Decongestants are _____ _____

alpha agonists

8

_______ (decongestant) effectiveness has not been well established

phenylephrine

9

Which decongestant is available as a single entity product or in combo with less-sedating AH's?

pseudoephedrine

10

Decongestants have _____ side effects

stimulant

11

Avoid decongestants if taking ____

MAOi

12

Who should you caution decongestants in?

in those with HTN, hyperthyroidism or ischemic heart disease, though evidence of risk is weak when used at recommended doses

13

What are topical decongestants?

-oxymetazoline
-xylometazoline

14

Use of topical decongestants for more than ____ days may result in rebound congestion

3-7

15

Concomitant use of an intranasal _____ may mitigate rebound congestion

corticosteroid (ex. fluticasone)

16

What is the mainstay of treatment for moderate-severe rhinitis symptoms?

intranasal corticosteroids

17

May need _____ week trial for corticosteroids to benefit

2-4

18

_____ is an intranasal corticotseroid that comes as DPI for those who don't like aqueous sprays

budesonide

19

Advantage of intranasal corticosteroids over oral corticosteroids?

does not cause adrenal suppression @ therapeutic doses

20

What is Levocabastine?

An antihistamine nasal spray
-less potent than INCS and is not effective for treatment of congestion

21

Intranasal ipratropium is only good for ______

rhinorrhea

22

What is a LTRA that has a modest effect on allergic rhinitis?

montelukast

23

points about ophthalmic mast cell stabilizers?

-require several days for onset of effect
-QID dosing

24

why is regular use of topical vasoconstrictors for the eyes not recommended?

bc of the development of rebound vasodilation

25

Immunotherapy is useful when symptoms caused by what?

pollen or dust mites

26

Immunotherapy is indicated when there is evidence of ____ sensitivity to a specific antigen

IgE

27

What is drug of choice in kids?

oral antihistamines

can also use intranasal corticosteroids

28

Choices in pregnancy?

-second gen AHs more safe than 1st gens
-montelukast safe
-INCS are also safe
-can use pseudoephedrine but avoid in 1st trimester

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