Allergic Rhinitis, Asthma, COPD, Viral Rhinitis Flashcards
(56 cards)
Differentiating factors between URTI and allergies
URTI- more episodic, sore throat or fever often, no itch. Allergies nasal obstruction and rhinorrhea common, with itching and eye sx often and sneeze
non drug choices in allergies
saline nose spray, irrigation systems, lubricant eye drops, avoid triggers, use air ocnditioning,
antihistamines help with congestion T or F
F- not usually recommended-desloratidine may be the only one that has some partial benefit. Work for sneeze rhinorrhea, itch, conjuntivitis
when should antihistamines be started for allergies
prophylactically- but can be used prn too
which 2nd gen antihistamine is most likley to cause sedation
cetirizine
treat mild to moderate allergy sx
allergen avoidance and antihistamine with or without prn decongestant. DOesn’t work? try intranasal steroid regularly
treat mod to severe allergy sx
allergen avoidance and intranasal steroid with or without: antihistamine, decongestant prn, eye drops for eye sx
when should decongestants be used with caution
uncontrolled blood pressure, hyperthyroidism, ischemic heart disease and not at all in those receiving MOAIs
how long can topical nasal decongestsants be used
3-7 days to prevent rebound congestion
how long can topical nasal steroids be used
as long as needed- qd or prn for allergy sx is fine, probably best daily
which intransasl steroids are safe for kids
mometasone, fluticasone furoate and propionate die to low oral F and absence of growth suppression long term
first line choice for allergies in kids
2nd gen antihistamines
what can/can’t you use for allergies in preg
can use 2nd gen antihistamines, montelukast, intranasal steroids. Can’t use oral decongestants in first trimester of preg
SE of decongestants
insomnia, tremor, irritable, HA, tachycardia, urinary retention
SE of 1st gen antihistamines
sedation, fatigue, dizzy, impaired cog, antichol.
steps in asthma therapy (adult)? How does it change in kids under 6?
saba prn, add ics, add laba, add leukotriene/increase ics/theophylline. Change in kids? reverse LTRA and laba
name SABAs- SE?
salbutamol, terbutaline- tremor, tachy, nervousness
name LABAs-how often are they used, when are they given in asthma? Which one is only for COPD?
salmetorol, formoterol- use BID. Given only with ICS. Indacterol also one but only for COPD. Vilanterol too.
when are anticholinergics used in asthma. SE?
not routinely- maybe if very susceptible to tremor or tachy from BAs, or for BB indued bronchospasm (ipra only, not tio it doesn’t act fast enough). SE= dry mouth, metallic taste
short term and long term side effects from high dose systemic CS therapy (ie for acute asthma exacerbation, etc)
short; fluid retention, glucose intolerance (hyperglycemia) , HTN, increased appetite, mood alterations, weight gain. Long; adrenal axis suppression, cataracts, dermal thinning, diabetes, glaucoma, HTN, myopathy, OP
asthma and preg
use meds! all safe. Uncontrolled asthma much higher risk (pre term birth, low BW< congenital anomalies, pre eclampsia, etc)
how soon to use a SABA before exercise and how long does it last?
5-10 minutes, lasts 2-4 hours
diagnostic criteria for COPD
FEV1 less than 80% and FEV1/FVC ration less than 0.7
COPD treatment
start with SABA or SAAC (ie a short acting bronchodilator) (combo of the 2 even better, long acting bronchodilator if sx persistent, LABA/LAMA combo, add ICS, add O2
