RxPrep Allergic Rhinitis, Cough, & Cold

rhinorrhea

runny nose

allergic rhinitis

________ causes rhinorrhea, sneezing, and itchy eyes.

allergen

Allergic rhinitis is caused by exposure to a(n) (allergen/virus).

cold; allergy

A(n) (allergy/cold) has thick, dark mucus while a(n) (allergy/cold) has thin, clear mucus.

cold

With a(n) (allergy/cold), symptoms take about 3 days to appear and usually last for about a week.

IgE-mediated skin prick test

What test can determine patient-specific allergens?

animal dander, dust mites, mold, pollen

What are 4 common allergens?

air quality index

rates local air as good to hazardous

pollen counts

What is something that can be monitored to reduce pollen exposure when it's an allergic rhinitis trigger?

nasal irrigation, wetting agent

What are 2 non-drug treatments for allergic rhinitis that provide symptom relief by reducing nasal stuffiness, runny nose, and sneezing?

true

True or False: Nasal gels with petrolatum are considered safe for most populations, including children and pregnant women.

Little Remedies, Ocean

What are 2 commercially available wetting agents used in allergic rhinitis?

b; c

Nasal irrigation uses a(n) ________ saline solution made with salt and water to rinse out allergens and mucus, improve ciliary function, and reduce swelling. (select all that apply)

a) hypotonic

b) isotonic

c) hypertonic

0.9

Isotonic nasal irrigations used in allergic rhinitis are usually ________%.

2 - 3.5

Hypertonic nasal irrigations used in allergic rhinitis are usually ________%.

false (contains organisms that can cause infections when used nasally)

True or False: Tap water is commonly used in homemade nasal irrigations.

neti pot

What can be used to administer nasal irrigations for allergic rhinitis?

intranasal steroid

What is first line for chronic, moderate-to-severe allergic rhinitis symptoms?

oral antihistamine

What is first line for milder, intermittent allergic rhinitis symptoms?

decongestant

What can be used to treat allergic rhinitis if congestion is present?

decrease inflammation

How do intranasal steroids work to treat allergic rhinitis?

Rhinocort Allergy

What is the brand name for intranasal budesonide?

Flonase

What is the brand name for intranasal fluticasone?

Nasacort

What is the brand name for intranasal triamcinolone?

epistaxis

nose bleed

epistaxis

What is a side effect associated with intranasal steroids?

1 week

It may take up to ________ to get full relief of allergic rhinitis symptoms from intranasal steroids.

beclomethasone, budesonide

What are the 2 preferred intranasal steroids in pregnancy?

true

True or False: Oral antihistamines have little effect on nasal congestion.

H1

Antihistamines work by blocking histamine at the ________ receptor site.

more

First-generation antihistamines are (less/more) sedating than second-generation.

second

(First/Second)-generation antihistamines are generally preferred when treating allergic rhinitis.

Benadryl

What is the brand name for diphenhydramine?

25 mg PO Q4-6H, 50 mg PO Q6-8H

What are 2 adult dosing regimens for diphenhydramine for allergic rhinitis?

<6 years

Patients who are ________ old should not use diphenhydramine OTC unless directed by a healthcare provider.

chlorpheniramine, diphenhydramine, doxylamine

What are 3 first-generation antihistamines used in allergic rhinitis?

avoid in elderly,

glaucoma,

prostate enlargement

What are 3 warnings associated with first-generation antihistamines?

anticholinergic effects,

cognitive impairment,

somnolence

What are 3 side effects associated with first-generation antihistamines?

cetirizine, fexofenadine, levocetirizine, loratadine

What are 4 second-generation antihistamines used in allergic rhinitis?

Zyrtec

What is the brand name for cetirizine?

Xyzal

What is the brand name for levocetirizine?

Allegra

What is the brand name for fexofenadine?

Claritin

What is the brand name for loratadine?

fexofenadine

What second-generation antihistamine shouldn't be taken with fruit juice?

cetirizine, loratadine

What 2 second-generation antihistamines are preferred in pregnancy?

cetirizine, levocetirizine

What 2 second-generation antihistamines have a fast onset and may work best for some patients?

a, c

What second-generation antihistamines are more sedating? (select all that apply)

a) cetirizine

b) fexofenadine

c) levocetirizine

d) loratadine

intranasal antihistamines

________ can be combined with intranasal steroids to treat allergic rhinitis.

alpha agonist

Decongestants are a type of ________.

vasoconstriction

Decongestants cause (vasoconstriction/vasodilation).

phenylephrine

What decongestant has poor oral absorption?

oxymetazoline

Phenylephrine nasal spray lasts for a shorter time and causes more side effects than the popular ________ spray.

pseudoephedrine

________ is an effective systemic decongestant.

methamphetamine

What is pseudoephedrine a precursor to?

a

To combat the methamphetamine epidemic, there are restricted sales of ________ products containing pseudoephedrine, phenylpropanolamine, and ephedrine.

a) non-prescription

b) prescription

c) both A and B

3.6 g; 9 g

Under federal law, the maximum amount of pseudoephedrine allowed for purchase is ________ per day and ________ in a 30-day period.

systemic decongestants

Phenylephrine and pseudoephedrine are examples of ________.

topical decongestants

Oxymetazoline and phenylephrine are examples of ________.

Sudafed PE

What is the brand name for oral phenylephrine?

Nexafed, Sudafed, Zephrex-D

What are 3 brand names for pseudoephedrine?

14 days; MAO inhibitor

Systemic decongestants should not be used within ________ of a(n) ________.

<2 years

According to the FDA, systemic decongestants should be avoided in children who are ________ old.

<4 years

According to package labeling, systemic decongestants should be avoided in children who are ________ old.

BPH, CV disease, urinary retention

Systemic decongestants should be used with caution in patients with what 3 conditions?

decreased appetite, increased BP, insomnia, palpitations, tachycardia

What are 5 side effects of systemic decongestants?

first

In what trimester should oral decongestants be avoided?

Afrin

What is the brand name for intranasal oxymetazoline?

BPH

Intranasal decongestants should be avoided in what condition?

rhinitis medicamentosa

rebound nasal congestion commonly associated with overuse of over-the-counter intranasal decongestants

3 days

Rhinitis medicamentosa can occur if intranasal decongestants are used longer than ________.

rhinitis medicamentosa

What is a side effect associated with intranasal decongestants?

NasalCrom

What's the brand name for intranasal cromolyn?

intranasal cromolyn

OTC mast cell stabilizer used for treatment and prophylaxis of allergic rhinitis

false

(must be started at onset of allergy season and used regularly to be effective)

True or False: Intranasal cromolyn is used as needed for allergic rhinitis.

true

True or False: Intranasal cromolyn is safe to use during pregnancy.

≥2 years

Intranasal cromolyn is safe to use in children who are ________ old.

Singulair

What's the brand name for montelukast?

montelukast

What is the only leukotriene modifying agent indicated for the treatment of both allergic rhinitis and asthma?

children

Montelukast is commonly used in (adults/children).

intranasal ipratropium

What drug is effective for decreasing rhinorrhea by causing nasal dryness?

immunotherapy

________ is a preventative treatment for allergies that works by slowly increasing exposure to the allergen, making the immune system less sensitive to the substance.

specific allergens

The four FDA-approved sublingual immunotherapy treatments for allergic rhinitis are tailored to ________.

medical office; 30 minutes

The first dose of an FDA approved sublingual immunotherapy treatment for allergic rhinitis should be given in a(n) ________ where the patient can be monitored for at least ________ afterward for signs of an allergic reaction.

false

(if first dose tolerated, subsequent doses can be administered at home)

True or False: All doses of FDA approved sublingual immunotherapy treatments for allergic rhinitis must be administered in a medical office.

epinephrine auto-injector

All patients on sublingual immunotherapy for allergic rhinitis should have a(n) ________.

common cold

viral infection of the upper respiratory tract

air, mucus secretions

Through what 2 things is the common cold transmitted?

hand washing

What is the best way to prevent transmission of the common cold?

ascorbic acid

What's another term for vitamin C?

echinacea, vitamin C, zinc

What are 3 natural products used for cold treatment/prevention?

Airborne, Emergen-C

What are 2 popular products that contain a variety of ingredients, including vitamin C, vitamin E, zinc, and echinacea?

expectorant

If a productive cough is present, a(n) ________ can be used to thin mucus and move secretions up and out of the respiratory tract.

expectorant

Guaifenesin is an example of a(n) ________.

Mucinex, Robafen, Robitussin Mucus + Chest Congestion

What are 3 brand names for guaifenesin?

Robafen DM, Robitussin DM

What are 2 brand names for guaifenesin + dextromethorphan?

codeine, dextromethorphan

What are 2 drugs that suppress the cough reflex?

dextromethorphan

What cough suppressant acts as a serotonin reuptake inhibitor?

high

At (high/low) doses, dextromethorphan acts as an NMDA-receptor blocker leading to euphoria and hallucinations similar to the illicit substance PCP.

true

True or False: Due to its abuse potential, many states ban the sale of dextromethorphan to minors.

cough suppressants

Dextromethorphan, codeine, benzonatate, and diphenhydramine are examples of ________.