Allergy/Asthma

Question 1

Cetirizine (Zyrtec)

Answer 1

Group: Antihistamine
Mechanism: Blocks effects of histamine at peripheral H1 receptor sites; anticholinergic effects
Indication: Allergic rhinitis, allergic reactions, urticarial (hives)
SE: Dryness of the mouth, nose and throat, drowsiness, urinary retention, blurred vision, nightmares and headaches
Consideration: Reduce dose for patients with renal and hepatic dysfunction

Question 2

Fexofenadine (Allegra)

Answer 2

Group:Antihistamine
Mechanism:Blocks effects of histamine at peripheral H1 receptor sites; anticholinergic effects
Indication:Allergic rhinitis, allergic reactions, urticarial (hives)
Side Effects:Headache, back pain, myosis, or pinpoint pupils, drowsiness, menstrual cramps, hypotension
Considerations: Reduce dose for patients with renal and hepatic dysfunction;

Question 3

Hydroxyzine (Vistaril, Atarax)

Answer 3

Group:Antihistamine
Mechanism:Blocks effects of histamine at peripheral H1 receptor sites; anticholinergic effects
Indication:Antianxiety, antipsychotic, Allergic rhinitis, allergic reactions, urticarial (hives), motion sickness, opioid withdrawal
Side Effects:Drowsiness, ataxia, leukopenia, hypotension, tinnitus, anxiety and insomnia.
Considerations:No abuse; hallucinations or confusion due to overdose

Question 4

Loratadine (Claritin)

Answer 4

Group:Antihistamine
Mechanism:Blocks effects of histamine at peripheral H1 receptor sites; anticholinergic effects
Indication:Allergic rhinitis, allergic reactions, urticarial (hives)
Side Effects:Drowsiness, dry mouth, blurred vision, urinary retention
Considerations:Reduce dose for patients with renal and hepatic dysfunction

Question 5

Diphenhy dramine HCl (Benadryl)

Answer 5

Group:Antihistamine
Mechanism:Blocks effects of histamine at peripheral H1 receptor sites; anticholinergic effects
Indication:Allergic rhinitis, allergic reactions, urticarial
Side Effects:Drowsiness, dry mouth, nausea, photosensitivity, insomnia, headache
Considerations:No alcohol, give with food, use sunscreen, risk for confusion in elderly

Question 6

Beclomethasone (Vancenase, Alanase, Qnasl)

Answer 6

Group:Glucocorticosteroids
Mechanism:Stimulates formation of glucose and degreases use of glucose by body cells; increases formation and storage of fat in muscle tissue; alters normal immune response; prevents immune reactors
Indication:Addison’s disease, Crohn’s disease, COPD, lupus, leukemia, lymphomas, myelomas, head trauma, cerebral edema, adrenal insufficiency
Side Effects:Psychoses, depression, weight gain, hypokalemia, hypocalcemia, stunted growth, petechiae, buffalo hump (Cushing’s Syndrome), Addisonian crisis (abrupt withdrawal)
Considerations:Single dose before 9 am and multiple doses at evenly spaced intervals, nightmares, check weight, BP, I&O, electrolytes, decrease effectiveness of insulin, diuretics, hypoglycemic, protect from pathological fractures, administer with antacids, don’t stop abruptly

Question 7

Fluticasone Salmeterol (Advair, Seretide)

Answer 7

Group:Glucocorticosteroid & Beta 2 Agonist
Mechanism:Causing bronchodilator by relaxing the smooth muscle
Indication:Asthma, COPD, bronchospasm, bronchitis, emphysema
Side Effects:Dizziness, sinus infection, oral candidiasis, increased blood pressure, tremors, PE, irregular heartbeat, cataracts, glaucoma, and migraine headaches
Considerations:Used daily, monitor BP, aggravate diabetes and cause hyperglycemia

Question 8

Mometasone furoate (mometasone)

Answer 8

Group:Glucocorticosteroids
Mechanism:Reduce inflammation of the skin; increases formation and storage of fat in muscle tissue; alters normal immune response; prevents immune reactors
Indication:Skin disorders (eczema, psoriasis, allergic rhinitis, hay fever, asthma)
Side Effects:Psychoses, depression, weight gain, hypokalemia, hypocalcemia, stunted growth, petechiae, buffalo hump (Cushing’s Syndrome), Addisonian crisis (abrupt withdrawal)
Considerations:Single dose before 9 am and multiple doses at evenly spaced intervals, nightmares, check weight, BP, I&O, electrolytes, decrease effectiveness of insulin, diuretics, hypoglycemic, protect from pathological fractures, administer with antacids, don’t stop abruptly

Question 9

Triamcinolone

Answer 9

Group:Glucocorticosteroids
Mechanism:Reduce inflammation of the skin; increases formation and storage of fat in muscle tissue; alters normal immune response; prevents immune reactors
Indication:Treat skin diseases, arthritis, allergies, inflammation, prevents asthma attacks
Side Effects:Nosebleeds, sore throat, coughing, headache, and runny nose.
Considerations:Given by oral, injection, or topical ointment