6020 Exam 1 With Best Solutions -2024

6020 Exam 1 With Best Solutions -2024 A pregnant lady is having bad allegies, whatcha gonna give her? - Rhinocort Aqua (budesonide) - it's preg category B SE's of intranasal glucocorticoids - Irritation of nasal mucosa - drying, burning Bad taste Epistaxis Nasal septal perforation If a patient is on an intranasal glucocorticoid & has a nose bleed, what are you going to tell them? - FRANK epistaxis - stop the med, probably permanently SCANT blood - avoid that nostril for a few days How long after using an intranasal glucocorticoid spray do you need to wait to blow your nose? - 15 minutes This glucocorticoid isn't going to make my kid stop growing, is it? - No, likely not. Systemic effects are small. BUT - if little Johnny is on another steroid already, then we may be concerned so we are going to use the lowest effective dose Antihistamine effect on nasal congestion - VERY LITTLE - if congestion is your patient's biggest symptom, antihistamines aren't your best choice. Antihistamines - MOA - Downregulate H1-receptor activity Antiinflammatory (2nd gen) Reduces itching, sneezing, rhinorrhea Which work longer, 1st or 2nd gen antihistamines? - 2nd generation work longer What is the main SE with 1st gen antihistamines? - Sedation & CNS effects Crosses blood-brain barrier! Adverse effects on intellectual & motor function. Why do 2nd gen anthistamines have fewer CNS effects than 1st gen? - They are LIPOPHOBIC - so they don't pass BBB & therefore have fewer CNS effects Which is the most sedating 2nd gen antihistamine? - Zyrtec (Cetirizine) Which is the least sedating 2nd gen antihistamine? - Allegra (fexofenadine) If your patient's biggest allergy symptoms are sneezing & itching, what is your first choice med? - 2nd gen antihistamine How fast do 2nd gen antihistamines work? - Fast - in 2-3 hours Antihistamine adverse effects - Anticholinergic (no SLUD) CNS effects (sedation, dizzy, confused, falls, cognitive impaired, paradoxical stimulation) Weight gain What CNS effect do you need to look out for in kids on antihistamines? - Paradoxical stimulation - they get more hyper. More common with 1st gen antihistamines Indications for 2nd gen antihistamine? - Rhinorrhea Itching Sneezing Are 2nd gen intranasal antihistamines better or worse than INGC's for nasal congestion? - Worse The steroids are the best. What is Dymista? - Combo antihistamine + steroid spray in one Olopatadine (Patanase) Drug Class - Antihistamine nasal spray Azelastine (Astelin, Astepro) Drug Class - Antihistamine nasal spray How long does it take intranasal antihistamine sprays to work? - Fast - 15 minutes What drug class is Cromolyn sodium (NasalCrom)? - OTC Mast cell stabilizer Indications for Cromolyn sodium (NasalCrom)? - Peds 2 with allergies When should you use Cromolyn sodium (NasalCrom)? - 30 minutes before exposure to allergen For best results, start using it 1-4 weeks prior to exposure MOA of Cromolyn sodium (NasalCrom)? - Inhibits mast cell release of histamine & other inflammatory mediators - decreases allergic