Allergic rhinitis, cough & cold
45 important questions on Allergic rhinitis, cough & cold
Nasal irrigations and wetting agents provide relief of what symptoms?
A nasal irrigation with premixed saline must be combined with what type of water? What type of water cannot be used and why?
Do not use tap water ("drinking or potable") because can cause infections.
1st line for chronic, moderate-severe symptoms
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1st line for mild-moderate symptoms and have little effect on nasal congestion
1st line if congestion is present
How do the intranasal steroids work?
Great for reducing nasal symptoms
Main side effect of intranasal steroids
Which intranasal steroids are preferred in pregnancy?
Beclomethasone
Which PO antihistamines are preferred and why?
Which 2nd gen antihistamines are preferred in pregnancy?
Cetirizine (Zyrtec; + pseudoephedrine= Zyrtec-D)
Which 2nd gen antihistamines are MORE sedating?
Levocetirizine (Xyzal)
Which 2nd gen antihistamines are less sedating?
Loratadine (Claritin; Claritin-D)
Which 2nd gen antihistamine should NOT be taken with fruit juice?
What are the main side effects of 1st gen antihistamines?
1st gen antihistamines should be AVOIDED in what populations?
Elderly
Prostate enlargement
Glaucoma
Which 1st gen antihistamine has a brand name approved for helping with sleep?
Can diphenhydramine be used OTC in children <6 yrs old?
What can also help with symptoms of allergic conjunctivitis (itchy, red eyes)
What does it mean that decongestants are "sympathomimetics"?
Systemic (PO) decongestants should be AVOIDED in what populations?
cautiously use in CVD
Main side effects of the systemic (PO) decongestants
ALL decongestants are contraindicated if used within 14 days of?
Are PO decongestants safe in the 1st trimester of pregnancy?
Which systemic (PO) decongestant has poor oral absorption, which is why it also comes as a shorter acting nasal spray?
Which systemic (PO) decongestant has restricted distribution because it is a precursor to methamphetamine?
Since pseudoephedrine, phenylpropanolamine & ephedrine can all be converted to methamphetamine, they must be kept behind the counter, with a max of _______ allowed for purchase per day, and ______ total in a 30 day period.
9 grams per 30 days
Why can Oxymetazoline only be used for 3 days?
Which drug is started at onset of allergy symptoms and used regularly in order to be effective for prophylaxis & treatment of allergic rhinitis?
Even though intranasal Cromolyn is not as effective as other agents, what is it safe to use in?
Pregnancy
Which drug is for treatment of allergic rhinitis and asthma, and commonly used in children?
[Leukotriene modifying agent]
What is a preventative treatment for allergies, either as SC or SL, that work by slowly increasing exposure to allergen?
How should the 1st dose of SL immunotherapy be given?
Do ALL doses of SL immunotherapy have to be given in a medical office?
What are the 3 natural products for colds?
Vitamin C (ascorbic acid)
Echinacea
1st line if a productive cough is present in a cold
What is used for dry, non-productive cough or to suppress a productive cough as night?
How do opioids and dextromethorphan work to suppress cough?
How does dextromethorphan work if used at low, usual antitussive doses?
Why does dextromethorphan have abuse potential if used at high doses?
Dextromethorphan is contraindicated if used within 14 days of what?
Codeine is contraindicated in what populations?
Children less than 18 yrs after tonsillectomy &/or adenoidectomy
How does benzonatate work as a cough suppressant?
For children <4 yrs with cough and cold
For children <2 yrs with cough and cold
Avoid promethazine (FDA)
Avoid topical menthol & camphor (package label)
Why can any form of promethazine NOT be used in children <2 yrs?
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