Allergies

Question 1

Diphenhydramine Class

Answer 1

1st Gen antihistamine

Question 2

Loratadine Class

Answer 2

2nd Gen antihistamine

Question 3

Cromolyn Class

Answer 3

Mast Cell Stabilizer

Question 4

Fluticasone Class

Answer 4

Corticosteroid

Question 5

Which drug can prevent rhinitis?

1. Phenylephrine
2. Cromolyn
3. Fluticasone
4. Loratadine

Answer 5

Cromolyn

Question 6

What are the major kinds of allergic rhinitis?

Answer 6

Seasonal (intermittent) + Perennial (persistent)

Question 7

How would you diagnose allergic rhinitis?

Answer 7

1. Positive allergy test
2. Postive RAST
3. High lvls of IgE

Question 8

Is rhinitis due to allergy?

Answer 8

Not all the time. Can be caused by nasal congestion or throat pain

Question 9

Symptoms occur ≤4 times per week OR lasts for ≤4 weeks

1. Intermittent AR
2. Persistent AR

Answer 9

Intermittent AR

Question 10

Symptoms occur ≥4 times per week AND lasts for ≥4 weeks

1. Intermittent AR
2. Persistent AR

Answer 10

Persistent AR

Question 11

To classify mild allergic rhinitis, what kind of symptoms occur?

Answer 11

Symptoms that are not troublesome

Question 12

To classify moderate to severe allergic rhinitis, what kind of symptoms occur?

Answer 12

Symptoms that ARE troublesome

Question 13

What are some exclusions for self-care of rhinitis?

Answer 13

Children <12 yrs old

Question 14

How would you treat mild intermittent AR?

Answer 14

Oral antihistamine and if possible, add decongestant (if no cardio problem)

Question 15

How would you treat moderate to severe intermittent AR?

Answer 15

Intranasal corticosteroid or oral antihistamine and if possible, add decongestant (if no cardio problem)

Question 16

How would you treat mild persistent AR?

Answer 16

Intranasal corticosteroid or oral antihistamine and if possible, add decongestant (if no cardio problem)

Question 17

How would you treat moderate to severe persistent AR?

Answer 17

Intranasal corticosteroid (preferred)*** or oral antihistamine and if possible, add decongestant (if no cardio problem)

Question 18

If AR symptoms are controlled, what should you do with the pt?

Answer 18

Reassess in one month

Question 19

If AR symptoms are NOT controlled, what should you do with the pt?

Answer 19

Check for adherence (up the dose, different RX), then reassess in month

Question 20

For intranasal corticosteroid, how long before you may see maximal effect?

Answer 20

2wks +

Question 21

1st Gen vs 2nd Gen antihistamines

Extremely sedating

Answer 21

1st Gen

Question 22

1st Gen vs 2nd Gen antihistamines

May produce excitation in children

Answer 22

1st Gen

Question 23

1st Gen vs 2nd Gen antihistamines

Drying effect

Answer 23

1st Gen

Question 24

1st Gen vs 2nd Gen antihistamines

Less effective on nasal secretion

Answer 24

2nd Gen

Question 25

1st Gen vs 2nd Gen antihistamines Most beneficial w/ itching and sneezing

Answer 25

2nd Gen

Question 26

When is the best time to use antihistamines?

Answer 26

Before Sx begin

Question 27

Fluticasone is approved for use in....

Answer 27

Adults + children <4yrs old

Question 28

(T/F) Most of what is administered intra-nasally is swallowed.

Answer 28

True

Question 29

(T/F) There is a lot of systemic absorption of fluticasone + triamcinolone

Answer 29

False; very minimal absorption

Question 30

What kind of RX is most effective in Tx of AR?

Answer 30

Intranasal coricosteroids

Question 31

Intranasal corticosteroid MOA

Answer 31

Inhibits allergic cascade and blocks histamine production and other inflammatory mediators

Question 32

Cromolyn MOA

Answer 32

Prevents degranulation of mast cells, an initial event in allergy cascade

Question 33

(T/F) Cromolyn is somewhat effective if given after Sx begin?

Answer 33

False; ineffective if given after Sx begin

Question 34

Which has a lower efficacy, Cromolyn or Intranasal corticosteroids?

Answer 34

Cromolyn

Question 35

First Gen antihistamines can treat all symptoms of allergic rhinitis except what?

Answer 35

Congestion