Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Allergic Rhinitiss
Pharm I
| Question | Answer |
|---|---|
| Major RF’s for Allergic Rhinitis | Fhx allergies, elevated IgE levels especially before 6yo, High SE class, +skin test, Emigration into western industrialized environment |
| Airborne pollen grains from trees, grasses and weeds/mold spores too | Seasonal Rhinitis |
| Mold spores, indoor allergens, Dust mite fecal proteins, animal dander, cockroaches | perennial rhinitis |
| How does the immune response occur | mast cells have IgE receptors/ab which will bind the allergens, signas mast cells to release histamine causing inflammatory response |
| Histamine, prostaglandin, and leukotrines causes hinorrhea, itching, sneezing, obstruction | 1st immune response to allergens: secs-mins post exposure |
| Cytokines release causes persistant sxs of allergic rhinitis, nasal congestion | 2nd immune phase usually 4-8hrs post exposure to allergen |
| Allergic Rhinitis tx | removal of allergen, pt/fm education, pharmacotherapy for sxs, specific immunotherapy |
| Gold standard for allergic rhinitis tx & dosing | Nasal Corticosteroids : fluticasone: 2sprays/nostril then 1 spray qd maintenance |
| AE’s of fluticasones | well tolerated, sneezing, HA, epistaxis, rare candida infx, |
| Onset of effect/peak for Nasal corticosteroids | start: 12 hrs, peak 1-2 weeks, educate pt |
| Things to avoid post nasal corticosteroid use | Sneezing blowing nose for 10 mins |
| First line therapies for allergic rhinitis | Nasal corticosteroids & antihistamines |
| AE’s of antihistamines and examples | Loratadine (claratin): sedation and anticholinergic effectsfor 1st generation, |
| Onset of antihistamines | 1-2 hrs PO, 30 mins intranasal |
| Second line therapy for allergic rhinitis | Decongestant: pseudoephedrine oral, Oxymetazoline (afrin) nasal, H1RA/Decon combo, Mast cell stabilizers, Leukotrien RA, Anticholinergics, Saline, Omalizumab |
| AE’s of decongestants | Nasal: rhinitis medicamentosa Oral: ^Bp and HR, cause mild CNS stimulation (insomnia) stroke, avoid pt’s HTN |
| Tx for Rhinitis Medicamentosa | Nasal corticosteroid up to 6wks taper over 2 wks, or 7day PO CS burst |
| Indications for leukotriene receptor antagonists | Montelukast: for pt’s w/ both asthma and AR |
| Indications for anticholingergics | ipratropium nasal spray, for sxs relief, doesn’t tx allergies |
| What will improve sneezing and nasal congestion and can be montherapy or adjunctive | Salin: neti pot |
| Indications for omalizumab | SEVERE allegic asthma, very expensive, approved for asthma but not AR |
| Slow gradual process of injecting increasing doses of antigens responsible for allergic sxs | Immunotherpy, skin testing, for those whose sever sxs cannot be controlled |
| Mild intermittent first line therapy for AR | Oral antihistamine: 2nd generation |
| Adjunctive/secondary therapy to mild AR | Add OTC oral decongestant, short-term intranasal decongestant, nasal irrigation, immunotherapy? |
| First line for persistent or moderate-severe AR | Intranasal corticosteroid, add oral antihistamine |
| Secondline for Mod-sever AR | add Short term OTC intranasal DC, nasal irrigation, ipratropium for uncontrolled rhinorrhea, could replace 1st line w/ montelukast |
| Tx for episodic AR | Intranasal cromolyn, antihistamine, corticosteroid |
| Monitoring perameters for AR | Efficacy and tolerability, adherence, effect of dz on pt's life, pt satisfaction |
Created by:
becker15
Popular Pharmacology sets