Allergic Rhinitis Flashcards


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1

SEVEN major symptoms of Allergic Rhinitis (Hay fever, Allergies):

  1. Rhinorrhea (runny nose)
  2. Sneezing
  3. Sinus pressure
  4. Itchy eyes
  5. Red watery eyes
  6. Thin clear mucus
  7. Wheezing
2

T/F

Colds are caused by a virus, allergic rhinitis is caused by an allergen and symptoms can last for about week.

FALSE

Colds are caused by a virus, allergic rhinitis is caused by an allergen and symptoms can last for days or months after contact with allergen.

NOTE:

Cold symptoms take about three days to appear and usually last for about a week.

3

T/F

Allergic rhinitis symptoms can be intermittent or chronic.

TRUE

4

What can be used to determine patient specific allergens?

IgE-mediated skin prick test

5

List FOUR common allergens:

  1. Pollens
  2. Molds
  3. Dust Mites
  4. Animal dander
6

List SIX ways to reduce allergens:

  1. Vacuuming
  2. Removing carpets
  3. Upholstered furniture
  4. Encasing pillows
  5. Mattresses
  6. Washing items in hot water
7

Describe the Air Quality Index (AQI) rate:

Rates the local air as good to hazardous

8

T/F

Pollen counts can be monitored when pollen is a trigger.

TRUE

9

T/F
When children are raised in an overly-clean environment they lose the chance to build a healthy immune system.

TRUE

10

TWO agents that provide symptom relief by reducing nasal stuffiness, runny nose and sneezing:

  1. Nasal irrigations
  2. Wetting agents

NOTE:

Safe for children and pregnant patients.

11

Wetting Agents used for allergic rhinitis:

  1. Ocean
  2. Little Remidies
12

Nasal irrigations use a ___________ or ____________ saline solution made with salt and water to rinse out allergens and mucus, improve ciliary function, and reduce swelling.

Nasal irrigations use a isotonic or hypertonic saline solution made with salt and water to rinse out allergens and mucus, improve ciliary function, and reduce swelling.

13

T/F

Tap water can be used when preparing homemade saline solutions for nasal irrigation.

FALSE

NOTE:

Tap water should NOT be used, it contains organisms that are safe to ingest orally, but can cause infections when used for nasal irrigations.

14

What must a homemade or store bought saline mixture be combined with when preparing nasal irrigations?

Distilled sterile or previously boiled and cooled water

15

Name TWO ways nasal irrigations can be administered:

  1. Syringe
  2. Neti pot
16

Describe how nasal irrigations are administered through a neti-pot:

  1. The prepared solution is placed in the neti-pot
  2. Solution is poured into ONE nostril and drained into the other while breathing through the mouth
17

What is used first line for chronic moderate-severe symptoms of allergic rhinitis?

Intranasal steroids

18

What is used to treat milder intermittent symptoms of allergic rhinitis?

Oral antihistamines

19

What can be used if congestion if present?

Decongestants

20

Antihistamines and decongestants are available in what TWO formulations for allergic rhinitis.

  1. Oral
  2. Nasal
21

Intranasal Steroids used for allergic rhinitis for chronic moderate-severe symptoms:

  1. Budesonide (Rhinocort Allergy)
  2. Fluticasone (Flonase Allergy Relief, Flonase Sensimist, Children Flonase)
  3. Triamcinolone (Nasacort Allergy 24 hr, Nasacort Allergy 24H children)
  4. Beclomethasone (Beconase AQ, Qnasal)
  5. Ciclesonide (Omnaris, Zetonna)
  6. Flunisolide
  7. Mometasone (Nasonex)
22

Budesonide

  1. Rhinocort Allergy
23

Fluticasone

  1. Flonase Allergy Relief
  2. Flonase Sensimist
  3. Children Flonase
24

Triamcinolone

  1. Nasacort Allergy 24 HR
  2. Nasacort Allergy 24 HR children
25

Beclomethasone

  1. Beconase AQ
  2. Qnasal
26

Ciclesonide

  1. Omnaris
  2. Zetonna
27

Mometasone

  1. Nasonex
28

Intranasal Steroids Side Effects:

  1. Epistaxis
29

Intranasal Steroid Mechanism of Action:

Decrease inflammation

30

What type of symptoms do intranasal steroids treat in allergic rhinitis?

Moderate-severe symptoms

31

How long may it take to gain relief from allergic rhinitis when taking intranasal steroids?

ONE week

32

What are the preferred nasal steroids in pregnancy?

  1. Budesonide
  2. Beclomethasone
33

Oral Antihistamines used in allergic rhinitis:

  1. Diphenhydramine (Benadryl)
  2. Chlorpheniramine (Aller-Chlor, Chlor-Trimeton)
  3. Doxylamine
  4. Clemastine (Dayhist Allergy 12 HR Relief)
  5. Carbinoxamine (Karbinal ER)
34

Diphenhydramine (Benadryl) Adult Dose:

  1. 25 mg PO q4-6h
  2. 50 mg PO q6-8h
35

What age range does NOT use diphenhydramine OTC unless directed by a healthcare provider?

Age < 6 years

36

Diphenhydramine is a first-generation antihistamine and is used for many indications such as:

  1. Acute Allergic Reactions
  2. Prevention of allergic reactions
  3. Allergic Rhinitis
  4. Cough (antitussive properties)
  5. Sleep
  6. Dystonic reactions
  7. Motion sickness
37

Second Generation Oral Antihistamines:

  1. Cetirizine (Zyrtec, Zyrtec Allergy Children)
  2. Cetirizine + Pseudoephedrine (Zyrtec-D)
  3. Levocetirizine (Xyzal Allergy 24 HR, Xyzal Allergy 24 HR Children)
  4. Fexofenadine (Allegra Allergy, Allegra Allergy Children's)
  5. Fexofenadine + pseudoephedrine (Claritin D)
  6. Loratadine (Claritin, Claritin Children's)
  7. Loratadine + Pseudoephedrine
  8. Desloratadine
  9. Desloratadine + Pseudoephedrine
38

Which second generation oral antihistamines have a FAST onset?

  1. Cetirizine (Zyrtec, Zyrtec Allergy Children)
  2. Levocetirizine (Xyzal Allergy 24 HR, Xyzal Allergy 24 HR Children)
39

Which second generation oral antihistamines are MORE sedating?

  1. Cetirizine (Zyrtec, Zyrtec Allergy Children)
  2. Levocetirizine (Xyzal Allergy 24 HR, Xyzal Allergy 24 HR Children)
40

Which second generation oral antihistamines are LESS sedating?

  1. Fexofenadine (Allegra Allergy, Allegra Allergy Children's)
  2. Loratadine (Claritin, Claritin Children's)
41

Which second generation oral antihistamines are good for pregnancy?

  1. Loratadine (Claritin, Claritin Children's)
  2. Cetirizine (Zyrtec, Zyrtec Allergy Children)
42

Which second generation oral antihistamines should be taken with water due to decrease absorption when taken with juice?

  1. Fexofenadine (Allegra Allergy, Allegra Allergy Children's)
43

TWO Intranasal Antihistamines:

  1. Azelastine (Astelin Astepro)
  2. Olopatadine (Patanase)
44

Intranasal antihistamines can be combined with ___________________ to help with nasal congestion.

Intranasal antihistamines can be combined with intranasal steroid to help with nasal congestion.