OTC Allergy and Rhinitis

Allergic rhinitis

Allergic rhinitis is an inflammatory condition of the nasal mucous membranes triggered by exposure to allergens, leading to both local and systemic symptoms

What are allergens?

Allergens are substances—often found indoors (e.g., dust mites, pet dander) or outdoors (e.g., pollen)—that trigger an immune response in susceptible individuals.

Allergic rhinitis only causes nasal symptoms

False

1 multiple choice option

What role does the mast cell play in allergic rhinitis?

Mast cells release histamine and other mediators when activated by allergens, which leads to many of the symptoms seen in allergic rhinitis

Select all that apply: Examples of Allergens

1. Pollen

2. Pets

3. Dust

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Select all that apply: Common Symptoms of Allergic Rhinitis

1. Itchy nose

2. Runny Nose

3. Sneeze

4. Stuffy Nose

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Select all that apply: Exclusion for Self-treatment of allergic rhinitis

1. Children <12 years

2. Pregnant/Lactating women

3. Non-allergic rhinitis

4. Symptoms of upper and/or lower respiratory tract infection

5. Undiagnosed or Uncontrolled asthma

6. COPD

7. Lower respiratory Disorders

8. Severe side effects of treatments

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Nasal Saline

May relieve nasal irritation and dryness

Antihistamines MOA

Competitively binds to H1-receptor → Prevents histamine binding and its action

Select all that apply: Antihistamines relieve what symptoms?

1. Sneezing

2. Runny Nose

3. Itchy Nose

4. Conjunctivitis

1 multiple choice option

Select all that apply: First Gen antihistamines

1. Chlorpheniramine

2. Diphenhydramine (Benadryl)

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Select all that apply: First Gen Antihistamine Side effects (Adults)

1. Drowsiness

2. sedation

3. impaired performance

4. Dryness

5. Blurred vision

6. Urinary hesitancy/retention

7. Constipation

2 multiple choice options

Select all that apply: First Gen Antihistamine Side effects (Children)

1. Insomnia

2. anxiety

3. hallucinations

4. increase in appetite

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Select all that apply: Second Gen antihistamines

1. Cetirizine (Zyrtec)

2. Levocetirizine (Xyzal)

3. Fexofenadine (Allegra)

4. Loratadine (Claritin)

2 multiple choice options

Select all that apply: Second Gen antihistamines Side Effects

1. Headache

2. GI Upset

3. Drowsiness

3 multiple choice options

Oral antihistamines geriatrics key points

1. Avoid 1st generation

2. Use 2nd generation with caution

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Decongestants

Act on adrenergic receptors -> Vasoconstriction

Select all that apply: Decongestants relieve what symptoms?

Stuffy Nose

3 multiple choice options

Is phenylephrine effective?

No

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Example of Decongestant

Pseudoephedrine (Sudafed)

Select all that apply: Examples of Topical decongestants

1. Phenylephrine

2. Oxymetazoline

2 multiple choice options

Select all that apply: Side effects of topical decongestants

1. Rebound congestion

2. Burning,

3. Stinging

4. Dryness

5. Sneezing

How long should a patient use topical decongestants?

No more than 3 days

3 multiple choice options

Select all that apply: Examples of Intranasal Corticosteroids (INCS)

1. Budesonide

2. Nasacort

3. Flonase

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Intranasal Corticosteroids (INCS) MOA

Various

↓ multiple cell types and mediator release → ↓ inflammation

Select all that apply: INCS's relieve what symptoms?

1. Sneezing

2. Runny Nose

3. Stuffy Nose

4. Itchy Nose

1 multiple choice option

Select all that apply: INCS Side Effects

1. Nasal Discomfort

2. Nasal Bleeding

3. Cough

4. Pharyngitis

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Select all that apply: INCS counseling points

1. Shake bottle well before use

2. Prime pump before first use or if not used for certain amount of time

3. Blow nose before use

4. Essential to counsel on the proper use of the spray

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Mast cell stabilizer MOA

Decreases mast cell degranulation and release of mediators, including histamine

Mast Cell stabilizer Example

Cromolyn

Mast cell stabilizer symptom relief

Prevents all symptoms