Pharma - rhinitis

Which of the following defines intermittent allergic rhinitis based on ARIA guidelines?

A. Symptoms ≥4 days/week and ≥4 consecutive weeks
B. Symptoms <4 days/week or <4 consecutive weeks
C. Symptoms for at least 6 months
D. Symptoms present only during winter

Symptoms <4 days/week or <4 consecutive weeks

Persistent allergic rhinitis is classified when symptoms occur:

A. Less than 2 days per week
B. Only during nighttime
C. ≥4 days/week and for ≥4 consecutive weeks
D. After exposure to cold air

≥4 days/week and for ≥4 consecutive weeks

Which of the following symptoms does NOT qualify as moderate to severe allergic rhinitis?

A. Sleep disturbance
B. Impairment of school/work
C. Sneezing only in the morning
D. Troublesome symptoms

Sneezing only in the morning

Which is the first-line treatment for mild intermittent allergic rhinitis?

A. Immunotherapy
B. Intranasal corticosteroids
C. Antihistamines and allergen avoidance
D. Montelukast

Antihistamines and allergen avoidance

What is the role of intranasal corticosteroids in the ARIA step-care approach?

A. Used only in mild cases
B. Reserved for severe bacterial infections
C. Mainstay for moderate to severe or persistent rhinitis
D. Contraindicated in seasonal rhinitis

Mainstay for moderate to severe or persistent rhinitis

According to the Hygiene Hypothesis, what is the primary cause of an increased risk of developing allergic rhinitis?

A. Overexposure to environmental allergens in early childhood
B. Reduced exposure to infections and microbes in early childhood
C. Excessive vaccination in early life
D. Genetic predisposition to allergies alone

Reduced exposure to infections and microbes in early childhood

Which of the following best explains the Hygiene Hypothesis in the context of allergic rhinitis?

A. Early childhood exposure to infections strengthens the immune system, reducing allergic disease risk.
B. Exposure to synthetic chemicals increases the risk of allergic rhinitis.
C. Lack of hygiene in early childhood directly causes allergic rhinitis.
D. An under-stimulated immune system due to reduced exposure to infections increases the risk of allergic diseases.

An under-stimulated immune system due to reduced exposure to infections increases the risk of allergic diseases

Which histamine receptor is primarily involved in smooth muscle contraction, endothelial cell function, and the central nervous system?

A. H1
B. H2
C. H3
D. H4

H1

Which of the following is a H1 receptor antagonist commonly used to treat allergic rhinitis?

A. Famotidine
B. Cetirizine
C. Cimetidine
D. Diphenhydramin

Cetirizine

The H2 receptor is primarily located in the gastric mucosa and is involved in the regulation of:

A. Bronchoconstriction
B. Gastric acid secretion
C. Immune cell function
D. Smooth muscle contraction

Gastric acid secretion

Which H2 receptor antagonist is commonly used to treat gastroesophageal reflux disease (GERD) and gastric ulcers?

A. Loratadine
B. Cetirizine
C. Famotidine
D. Hydroxyzine

Famotidine

The H4 receptor is predominantly found on eosinophils, neutrophils, and CD4 T cells, and is involved in regulating:

A. Histamine release from mast cells
B. Allergic responses and immune cell migration
C. Gastric acid production
D. Smooth muscle relaxation

Allergic responses and immune cell migration

Which of the following histamine receptors plays a role in regulating neurotransmitter release in the brain, particularly affecting appetite, sleep, and cognition?

A. H1
B. H2
C. H3
D. H4

H3

Which histamine receptor is found in cardiac muscle and is involved in regulating heart rate and force of contraction?

A. H1
B. H2
C. H3
D. H4

H2

Which histamine receptor is associated with immune cells, including eosinophils, neutrophils, and T cells, and is implicated in the regulation of inflammatory responses?

A. H1
B. H2
C. H3
D. H4

H4

What is the primary mechanism of action of antihistamines in the treatment of allergic rhinitis?

A. Inhibit production of inflammatory cytokines

B. Block H1 histamine receptors

C. Prevent leukotriene-mediated bronchoconstriction

D. Bind glucocorticoid receptors in nasal mucosa

Block H1 histamine receptors

Which of the following symptoms are antihistamines primarily used to treat in allergic rhinitis?

A. Nasal congestion and inflammation
B. Itching, sneezing, and rhinorrhea
C. Cough and bronchoconstriction
D. Mucus production and post-nasal drip

Itching, sneezing, and rhinorrhea

What is the primary action of intranasal corticosteroids (INCS) in allergic rhinitis treatment?

A. Block histamine receptors on nasal mucosa
B. Bind glucocorticoid receptors to reduce inflammation
C. Inhibit mast cell degranulation
D. Prevent bronchoconstriction by blocking leukotriene receptors

Bind glucocorticoid receptors to reduce inflammation

Which of the following effects is most associated with intranasal corticosteroids (INCS)?

A. Reduction in nasal congestion and inflammation
B. Suppression of eosinophils, mast cells, and T lymphocytes
C. Prevention of histamine release
D. Prevention of leukotriene-mediated symptoms

Reduction in nasal congestion and inflammation

Which drug class works by blocking cysteinyl leukotriene receptors to prevent bronchoconstriction and mucus production?

A. Antihistamines
B. Intranasal corticosteroids (INCS)
C. Leukotriene receptor antagonists (LTRAs)
D. Mast cell stabilizers

Leukotriene receptor antagonists (LTRAs)

Leukotriene receptor antagonists (LTRAs) are most effective in preventing:

A. Histamine-induced itching and sneezing
B. Nasal congestion and post-nasal drip
C. Bronchoconstriction and eosinophilic inflammation
D. Mast cell degranulation

Bronchoconstriction and eosinophilic inflammation

Which of the following is the mechanism of action of mast cell stabilizers?

A. Block histamine receptors on nasal mucosa
B. Prevent degranulation of mast cells
C. Inhibit leukotriene receptor activation
D. Bind glucocorticoid receptors in the nasal mucosa

Prevent degranulation of mast cells

Mast cell stabilizers are considered most effective when used as:

A. As-needed treatment for acute symptoms
B. Preventive agents to avoid allergic reactions
C. Second-line therapy after antihistamines
D. Primary treatment for chronic rhinitis

Preventive agents to avoid allergic reactions

Which of the following medications primarily targets H1 histamine receptors to reduce symptoms of allergic rhinitis?

A. Mometasone (INCS)
B. Loratadine (antihistamine)
C. Montelukast (LTRAs)
D. Cromolyn sodium (mast cell stabilizer)

Loratadine (antihistamine)

What is the main purpose of using intranasal corticosteroids (INCS) in patients with allergic rhinitis?

A. To block histamine-induced symptoms like sneezing and itching
B. To reduce the production of inflammatory mediators like prostaglandins
C. To prevent mast cell degranulation
D. To block leukotriene-induced bronchoconstriction

To reduce the production of inflammatory mediators like prostaglandins

Which of the following antihistamine drugs is commonly used for seasonal allergic rhinitis and has minimal sedative effects?

A. Diphenhydramine
B. Cetirizine
C. Promethazine
D. Hydroxyzine

Cetirizine

Which antihistamine is often preferred for allergic conjunctivitis due to its topical application form and effective symptom relief?

A. Loratadine
B. Olopatadine
C. Chlorpheniramine
D. Fexofenadine

Olopatadine

Which first-generation antihistamine is commonly used for acute allergic reactions and has a strong sedative effect, making it useful for insomnia?

A. Cetirizine
B. Diphenhydramine
C. Fexofenadine
D. Desloratadine

Diphenhydramine

For patients with urticaria (hives), which of the following antihistamines is typically recommended for chronic management due to its long duration of action and low sedative effects?

A. Hydroxyzine
B. Loratadine
C. Diphenhydramine
D. Brompheniramine

Loratadine

Which antihistamine is often used for motion sickness due to its antiemetic properties and sedative effects?

A. Cetirizine
B. Meclizine
C. Levocetirizine
D. Desloratadine

Meclizine

Which of the following antihistamine drugs is preferred for treating seasonal allergies due to its non-sedating properties?

A. Diphenhydramine
B. Fexofenadine
C. Hydroxyzine
D. Chlorpheniramine

Fexofenadine

Which antihistamine is commonly used for managing acute allergic reactions such as anaphylaxis and angioedema, particularly when sedation is desired?

A. Promethazine
B. Fexofenadine
C. Olopatadine
D. Desloratadine

Promethazine

Which of the following drug interactions can increase the sedative effects of first-generation antihistamines such as diphenhydramine?

A. Antidepressants like fluoxetine
B. Alcohol
C. Antacids like ranitidine
D. Beta-blockers like metoprolol

Alcohol

When antihistamines are taken with monoamine oxidase inhibitors (MAOIs), the risk of sedation and anticholinergic side effects is:

A. Increased
B. Decreased
C. Unaffected
D. Neutralized

Increased

Which of the following antihistamines is most likely to interact with CYP450 enzyme inhibitors like ketoconazole, leading to an increased concentration of the antihistamine in the blood?

A. Cetirizine
B. Loratadine
C. Diphenhydramine
D. Fexofenadine

Loratadine

Cimetidine, an H2 receptor antagonist, can interact with antihistamines to:

A. Increase the metabolism of antihistamines
B. Decrease antihistamine absorption
C. Increase the sedative effects of antihistamines
D. Block the action of antihistamines

Increase the sedative effects of antihistamines

Fexofenadine, a second-generation antihistamine, should be taken cautiously with fruit juices like orange juice and apple juice, as they can:

A. Increase absorption and efficacy of the drug
B. Decrease absorption and efficacy of the drug
C. Cause allergic reactions
D. Improve metabolism and clearance

Decrease absorption and efficacy of the drug

Which of the following drugs can increase the sedative effect of first-generation antihistamines like diphenhydramine?

A. Beta-blockers
B. Antidepressants (e.g., SSRIs)
C. Opioids
D. Proton pump inhibitors (e.g., omeprazole)

Opioids

Which class of drugs can increase the blood levels of loratadine, a second-generation antihistamine, due to its effect on CYP450 enzymes?

Antifungal drugs like ketoconazole

A. Antifungal drugs like ketoconazole
B. Beta-blockers like atenolol
C. Antidepressants like sertraline
D. Antacids like ranitidine

Antifungal drugs like ketoconazole