Eyes, Ears, Nose & Skin Conditions:Allergic Rhinitis, Cough & Cold

Question 1

Cold vs Allergies

Answer 1

Cold:
Sneezing, runny nose, thick/dark mucus, sore throat, body aches, 3 days to appear last about 1 week

Allergy:
Sneezing, runny nose. thin/clear mucus, wheezing, red/watery eyes, last days/months

Question 2

Nose wetting agents provide….

Answer 2

moisture and reduce irritation to the nasal passages

Question 3

Nasal irrigation are….

Answer 3

isotonic or hypertonic solution that can rinse out allergens and mucus, improve ciliary function and reduce swelling.

Question 4

Can you use tap water for nasal irrigation?

Answer 4

no its got organisms, only use distilled

Question 5

Intranasal steroids are first line for….

Answer 5

moderate-severe symptoms

Question 6

Intranasal steroid side effects

Answer 6

Nose bleeds
headache
dry nose
unpleasant taste
localized infection

Question 7

Intranasal steroid notes

Answer 7

Can take up to 1 week to get full relief

Question 8

Preferred nasal steroids in pregnancy

Answer 8

Budesonide and beclomethasone

Question 9

1st gen antihistamine warnings

Answer 9

avoid in elderly and children < 2
caution in prostate enlargement, glaucoma

Question 10

1st gen antihistamine side effects

Answer 10

somnolence
cognitive impairment
strong anticholinergic effects

Question 11

which antihistamines should lactating women take?

Answer 11

2nd gen preferred

Question 12

2nd gen antihistamine

Answer 12

Cetirizine = Zyrtec
Levocetirizine = Xyzal
Fexofenadine = allegra
Loratadine = Claritin

Question 13

which 2nd gen antihistamine preferred in pregnancy?

Answer 13

Loratadine and cetirizine

Question 14

which 2nd gen antihistamine are more sedating

Answer 14

cetirizine and levocetirizine

Question 15

which 2nd gen antihistamine are less sedating

Answer 15

fexofenadine and loratadine

Question 16

which 2nd gene anti histamine has fast onset?

Answer 16

cetirizine and levocetirizine

Question 17

max amount of pseudoephedrine that can be bought

Answer 17

3.6g per day
9g per 30 days

Question 18

Pseudoephedrine CI

Answer 18

dont use within 14 days of MAO inhibitors

Question 19

Pseudoephedrine warnings

Answer 19

Avoid in children < 2 per FDA, < 4 per package labeling

caution in pts with CV disease and HTN (dont use)

Question 20

Can you use oral decongestants during pregnancy?

Answer 20

should be avoided during the 1st trimester

Question 21

intranasal decongestant

Answer 21

Oxymetazoline - rebound congestion is side effect if used for more than 3 days.

Question 22

Intranasal cromolyn

Answer 22

OTC mast cell stabilizer
has to be started at start of allergy season and used regularly to be effective
safe in children and pregnancy

Question 23

Montelukast info

Answer 23

boxed warning for serious neuropsychiatric side effects

Question 24

Zinc use in colds

Answer 24

nasal shouldn’t be used due to causing loss of smell

might decrease cold duration if used correctly

Question 25

Vitamin C use in colds

Answer 25

can maybe decrease cold duration

but little to no efficacy in prevention

high dose (4g/day) can cause diarrhea and possibly kidney stones

Question 26

Dextromethorphan CI and Warnings

Answer 26

CI: dont use within 14 hours of an MAOi

Warnings: Serotonin syndrome

Question 27

Codeine Boxed warings

Answer 27

Respiratory depression and death in ultra-rapid metabolizers

Question 28

Codeine CI

Answer 28

dont use in children < 12yrs old or children < 18yrs after tonsillectomy and/or adenoidectomy

** FDA recommends avoiding codeine containing products in < 18yrs old **

Question 29

If child is < 2 years old can they use anything thats OTC for cold?

Answer 29

Nah

Question 30

Which topical rubs can and cant be used?

Answer 30

Vicks Babyrub = yes

Vicks VapoRub = cant be used. anything with camphor or menthol shouldn’t be used