PHRD5975 Self-Care - Allergic Rhinitis

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Author:
daynuhmay
ID:
272359
Filename:
PHRD5975 Self-Care - Allergic Rhinitis
Updated:
2014-04-29 06:17:54
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Allergic Rhinitis
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Description:
Allergic Rhinitis
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  1. common indoor aeroallergens (5)
    • 1) house-dust mites
    • 2) cockroaches
    • 3) mold spores
    • 4) cigarette smoke
    • 5) pet dander
  2. intermittent allergic rhinits
    sx occur 4days/week OR 4weeks
  3. persistent allergic rhinitis
    sx occur >4days/week AND >4weeks
  4. sx differentiating from non-allergic rhinitis
    • bilateral
    • worse upon waking
    • improves during day
    • frequent sneezing, pruritus
    • sinus pain
    • allergic crease
    • NO nasal obstruction, anosmia, epistaxis
  5. EXCLUSIONS for allergic rhinitis self-tx
    • 1) <12yo (unless already dx'd by dr)
    • 2) pregnant/lactating
    • 3) nonallergic rhinitis sx
    • 4) infection
    • 5) undx'd lower respiratory disorder
    • 6) mod-severe persistent AR
    • 7) severe SE's of tx
  6. non-pharm tx for allergic rhinits
    • 1) ***allergen avoidance
    • 2) lower humidity
    • 3) apply acaricides
    • 4) wash bedding weekly in hot (130F) water
    • 5) weekly cat baths
    • 6) nasal wetting agents/nasal irrigation (saline)
  7. purpose of nasal irrigation in allergic rhinitis tx
    • may relieve mucosal irrtation/dryness -> decreases nasal stuffiness, rhinirrhea, sneezing
    • aids in removal of dried, thick mucus from nose
  8. MOA of antihistamines
    highly selective H1 receptor antagonists compete w/ HA, preventing binding and mediator release
  9. when to expect relief w/ antihistamines
    some relief in 3-4days, but complete relief may take 2-4 weeks
  10. least sedating 1st-gen AH
    chlorpheniramine
  11. benefits of using chlorpheniramine over other 1st-gen AH's
    • 1) least sedating
    • 2) can be dosed less frequently (q12h)
  12. 2 AH's most preferred for tx of pregnant women
    • loratadine
    • cetirizine
  13. least sedating of all AH's
    cetirizine
  14. why shouldn't fexofenadine be taken with fruit juice or separated by 2hrs?
    thought to reduce absorption of fexo. by directly inhibiting intestintal organic anion transporting polypeptides
  15. age to safely use 2nd-gen AH's
    >2yo
  16. MOA of intranasal cromolyn
    • stabilizes mast cells, preventing mediator release
    • protects mast cells from triggers
  17. age to safely use cromolyn
    >5yo
  18. first-line option for pregnant & lactating women w/ AR
    intranasal cromolyn (pregnancy cat b)
  19. MOA of oral decongestants (PSE, PE)
    stimulate a-adrenergic R's to constrict blood vessels
  20. onset of action of oral decongestants
    30-60min
  21. how long can you use oxymetazoline for?
    3-5 days
  22. MOA of ketotifen
    topical AH & mast cell stabilizer
  23. age ketotifen can be safely used in
    >3yo
  24. most effective agent currently available to treat rhinitis
    intranasal OTC CCS (Nasacort)
  25. first line tx for pts seeking medical care for AR sx
    intranasal OTC CCS (Nasacort)
  26. fastest working 2nd-gen AH
    cetirizine
  27. Pregnancy Cat B non-rx AH's (5)
    • 1) cetirizine
    • 2) chlorpheniramine
    • 3) clemastine
    • 4) diphenhydramine
    • 5) loratadine

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