Allergies and Allergic Conjuntivitis

Question 1

what are the three non-sedating antihistamines?

Answer 1

loratidine, fexofenadine, and cetirizine

Question 2

what are the 6 sedating antihistamines?

Answer 2

Brompheniramine, Doxylamine, Pheniramine, Diphenhydramine, Chlorpheniramine, and Clemastine

Question 3

which group of drugs competes with histamine at central and peripheral histamine1-receptor sites; prevent mediator release. Block cholinergic receptors.

Answer 3

sedating antihistamines

Question 4

which group of drugs selectively blocks peripheral histamine1- receptor sites/activity; prevent mediator release.
Inhibit the release of mast cell mediators and may decrease cellular recruitment.

Answer 4

non-sedating antihistamines

Question 5

can the non-sedating antihistamines cross the BBB?

Answer 5

no

Question 6

what drug is a mast cell stabilizer?

Answer 6

Cromolyn

Question 7

which group of drugs has an exact MOA that is unknown.
Stabilizes mast cells, preventing mediator release by protecting mast cells from immune-mediated and non-immune-mediated triggers.

Answer 7

mast cell stabilizer-cromolyn

Question 8

what are the OTC decongestants used for allergic rhinitis?

Answer 8

pseudoephedrine and phenylephrine

Question 9

how long does it take for the sedating antihistamines to begin working?

Answer 9

within 1.5-3 hours

Question 10

how long does it take for the sedating non-antihistamines to begin working?

Answer 10

1-3 hours

Question 11

do the sedating or non-sedating antihistamines have a better max benefit after several days?

Answer 11

sedating

Question 12

SLUDGE stands for what?

Answer 12

Salivation, Lacrimation, Urination, Defecation, Gastrointestinal upset, and Emesis

Question 13

what are the big side effects of the sedating antihistamines (other than sedation)?

Answer 13

anti-cholinergic effects (anti-SLUDGE) Dry eyes, nose, mouth, vagina; blurred vision, urinary hesitancy or retention; constipation; tachycardia

Question 14

which class of drugs causes photo-sensitivity?

Answer 14

sedating antihistamines

Question 15

which class of drugs causes paradoxical CNS stimulation?

Answer 15

sedating antihistamines

Question 16

are the sedating antihistamines contraindicated in newborns and premies?

Answer 16

yes

Question 17

can lactating women take sedating antihistamines?

Answer 17

no

Question 18

Loratadine/PSE 12- and 24-hr SR are contraindicated in what disorders?

Answer 18

esophageal disorders

Question 19

define somnolence

Answer 19

the state of being sleeping, feeling drowsy, ready to fall asleep

Question 20

what is an advantage in terms of side effects of the non-sedating antihistamines (other than less sedation)?

Answer 20

less anti-SLUDGE effects

Question 21

what are three types of drugs that the sedating anti-histamines are contraindicated to be used with?

Answer 21

CNS depressants, MAOI’s, and other drugs with anticholinergic effects

Question 22

what is considered the first line Tx for allergic rhinitis and why?

Answer 22

the non-sedating antihistamines b/c of less side-effects and effectiveness

Question 23

which one of the non-sedating antihistamines is associated with more sedation side effects than the others?

Answer 23

cetirizine

Question 24

the non-sedating antihistamines have drug interactions what two drugs?

Answer 24

ketoconazole and erythromycon

Question 25

what drug causes an interaction with loratadine to increase loratadine's plasma concentration?

Answer 25

cimetidine

Question 26

how long does it take for cromolyn to start working?

Answer 26

3-7 days for initial, 2-4 weeks for max

Question 27

side effects of cromolyn?

Answer 27

sneezing, nasal stinging and brungin

Question 28

what drug interactions are there with cromolyn?

Answer 28

none

Question 29

how does a PT need to be to use cromolyn?

Answer 29

5 or older

Question 30

what is the first line Tx for allergic rhinits in pregnant women?

Answer 30

cromolyn

Question 31

what drug class has a MOA that stimulates α-adrenergic receptors to constrict blood vessels, decrease sinusoid vessel engorgement, and mucosal edema?

Answer 31

decongestants

Question 32

when do decongestants start working?

Answer 32

0.5-2 hours

Question 33

what is rhinitis medicamentosa?

Answer 33

rebound congestion

Question 34

when does medicamentosa occur?

Answer 34

if a decongestant is used loner than 3-5 days

Question 35

what is the 2 major side-effects of decongestants?

Answer 35

CV and CNS stimulation

Question 36

what drug class may worsen HTN, hyperthyroidism, DM, coronary heart disease, ischemic heart disease, elevated intraocular pressure, BPH?

Answer 36

decongestants

Question 37

what drug class are decongestants contraindicated with?

Answer 37

MAOI's

Question 38

MAOI's, methyldopa, and TCA's can cause increased BP with what drug class?

Answer 38

decongestants

Question 39

what are the two corticosteroids that can be used for OTC allergic rhinitis?

Answer 39

triamcinolone and fluticasone

Question 40

``` what drug class has the MOA that Suppresses immune system by reducing activity and volume of the lymphatic system. It also inhibits multiple cell types and mediators, including histamine, and effectively stop the “allergic cascade.” ```

Answer 40

nasal corticosteroids

Question 41

which nasal corticosteroid also has anti-inflammatory properties?

Answer 41

fluticasone

Question 42

what nasal spray is indicated for both nasal and eye-related allergy symptoms?

Answer 42

fluticasone

Question 43

what are the 2 OTC ophthalmic antihistamines?

Answer 43

pheniramine and antazoline

Question 44

what is the only ophthalmic antihistamine that is also a mast cell stabilizer?

Answer 44

ketotifen fumurate

Question 45

what 4 drugs can be used as OTC ophthalmic decongestants?

Answer 45

Phenylephrine Naphazoline Tetrahydrozoline Oxymetazoline

Question 46

what ophthalmic drug classes are contraindicated with angle-closure glaucoma?

Answer 46

all of them

Question 47

what is the first line pharm Tx for allergic conjunctivitis?

Answer 47

ketotifen fumurate

Question 48

what age does a PT need to be to use ketotifen fumurate?

Answer 48

3 years or older