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Flashcards in Allergy drugs Deck (14):

1st gen antihistamines?

diphenhydramine (Benardryl)
chlorpheniramine (chlor-trimeton)
can cross BBB leading to CNS effects
dizziness, sedation, etc


2nd gen antihistamines?

fexofendadine (Allegra)
cetirizine (Zyrtec)
loratadine/ desloratadine (claritin/clarinex)
Low sedation
Lower anticholinergic effects


Rhinitis medicamentosa

rebound nasal congestion from use of alpha-adrenergic agonists delivered in aerosol form
- have rapid onset and few systemic effects but should not be used long term because of rebound
- educate pt. not to use long-term
-may prescribe nasal steriods while weening off.
-Afrin (oxymetazoline)


anticholinergics (ipratropium)
inhalation; nebulizer; oral

idications: COPD and nasal dischage
Contraindications: HS to atropine or ipratropiib bromide

AE: glacoma (narrow angle)
intraocular pressure
paradoxical bronhospasm

MOA: cholnergic antagonist of ACH.
Drug Interactions: don't mix with morphine or oxymorphine


mast cell stabilizers
cromolyn (nasalcrom)

indications: allergic rhinitis
AE: bad taste in mouth, bring sensation eye, cough, throat, epistaxis, risk of bronchospasm
MOA: Inhibits mast cell degranulation
Usually adjunctive


Low potency intranasal steroid

Triamcinolone -nasacort AQ,
Mometasone - Nasonex.


Medium potency intranasal steroid

Beclomethasone - Beconase AQ,
Fluisolide - Nasalide


High potency intranasal steroid

Fluticasone -Flonase
Budesonide - Rhinocort


Intranasal steroids

For: anti inflammatory properties reduce nasal obstruction, rhinorrhea, sneeaing and pruritis

AE: epistasix, cataracts, growth velocity changes, HPA axis


Intranasal antihistamines: indications and CI?

Indications: allergic rhinitis, allergic conjunctivis, vasomotor rhinitis

AE: contact dermatitis, headache, somnolence, fatigue


Intranasal antihistamines: MOA and Drug interactions

MOA: selective H1 receptor antagonist that blocks the release of histamine

Drug Ix: fatigue, lack of alertness, avoid alcohol


aspirin with asthma and nasal polyposis

aspirin should be avoided as it may precipitate a severe episode of bronchospasm,
-known as triad asthma
- immunologic salicylate sensitivity


epinephrine (epi pen)
Indications and CI:

Indications: hypersensitivity reactions (anaphylaxis)

CI: no absolute CI in a life threatening situation


epinephrine MOA and AE

MOA: stimulates alpha and beta adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree cardiac stimulation (increasing myocardial oxygen consumption)

AE: may induce arrhythmias, pulmonary edema, renal imparment, anxiety, headache, dizziness

Admin: anterolateral aspect of middle third of thigh