NSGl 533/l NSG533l Examl 3l –l (NEWl
2026/l 2027l Update)l Advancedl
Pharmacologyl Guide|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Leukotrienel Receptorl Antagonistsl AR
Answer:
Example
Montelukast
Mechanism
Blockl leukotrienel receptors
Reducel inflammationl andl mucusl production
Adversel Effects
Headache
Rarel neuropsychiatricl effects
Cautionl inl Patientsl withl historyl ofl psychiatricl disorders
Placel inl Therapy
Helpfull inl patientsl withl allergicl rhinitisl +l asthma
QUESTION
Stepwisel Approachl tol Treatingl Allergicl Rhinitis
Answer:
Stepl 1:l Allergenl Avoidance
First-linel managementl includesl environmentall controll measures,l suchl as:
Avoidl exposurel tol knownl allergensl (pollen,l dustl mites,l mold,l petl dander)
Usel HEPAl airl filters
Washl beddingl inl hotl waterl weekly
Usel dustl mitel coversl onl pillowsl andl mattresses
Keepl windowsl closedl duringl highl pollenl seasons
,Stepl 2:l Pharmacologicl Therapy
Medicationl choicel dependsl onl thel severityl andl predominantl symptoms.
Mildl orl Intermittentl Symptoms
Optionsl include:
Second-generationl orall antihistamines
loratadine
cetirizine
fexofenadine
Intranasall antihistamines
Cromolynl nasall spray
Thesel medicationsl primarilyl relieve:
Sneezing
Rhinorrhea
Nasall itching
Moderatel tol Severel Symptoms
Intranasall corticosteroidsl (first-linel therapy)
Examples:
fluticasone
budesonide
mometasone
Benefits:
Mostl effectivel therapyl forl AR
Reducel nasall congestion,l inflammation,l sneezing,l andl rhinorrhea
Persistentl orl Uncontrolledl Symptoms
Combinationl therapyl mayl bel used:
Intranasall corticosteroidl +l antihistamine
Addl decongestantl forl severel congestion
Leukotrienel receptorl antagonistl (montelukast)l inl somel patients
Stepl 3:l Immunotherapyl (Severel orl Refractoryl AR)
Forl patientsl withl persistentl symptomsl despitel medication:
Allergenl immunotherapyl (allergyl shotsl orl sublinguall therapy)
Benefits:
Modifiesl immunel responsel tol allergens
Mayl providel long-terml symptoml control
QUESTION
Keyl Examl Pointsl AR
Answer:
,Intranasall corticosteroidsl =l mostl effectivel treatmentl forl allergicl rhinitis
Cromolynl =l safestl option
Decongestantsl primarilyl treatl congestion
Antihistaminesl treatl sneezing,l itching,l andl rhinorrhea
QUESTION
Rapidl vsl Delayedl onsetl AR
Answer:
Rapid-onsetl medicationsl providel quickl symptoml reliefl butl oftenl dol notl treatl thel
underlyingl inflammation.l (intranasall decongestants,l intranasall antihistamines)
Delayed-onsetl medicationsl (likel cromolyn)l arel saferl forl long-terml usel butl requirel
consistentl usel beforel fulll benefitl isl seen.
QUESTION
Pregnancyl considerationsl ARl meds
Answer:
Saferl optionsl oftenl include:
Intranasall corticosteroidsl (e.g.,l budesonide)
Cromolynl sodium
Medicationsl typicallyl avoidedl orl usedl cautiously:
Orall decongestants,l especiallyl inl earlyl pregnancy.
QUESTION
1stl andl 2ndl generationl antihistaminesl differ
Answer:
1stl generationl antihistaminesl =l sedatingl +l anticholinergicl effects
Clinicall Considerations
Shorterl durationl ofl action
Usuallyl requirel multiplel dailyl doses
Notl preferredl forl allergicl rhinitisl duel tol sidel effects.
2ndl generationl antihistaminesl =l lessl sedatingl andl preferredl forl allergicl rhinitis
Clinicall Advantages
Longerl durationl ofl action
Usuallyl once-dailyl dosing
, Fewerl anticholinergicl sidel effects
QUESTION
Corticosteroidl potency
Answer:
Relativel anti-inflammatoryl strengthl comparedl withl hydrocortisonel (referencel drug).
QUESTION
Relativel potencyl ofl orall corticosteroids
Answer:
Hydrocortisonel =l 1;l Prednisone/Prednisolonel ≈l 4;l Methylprednisolonel ≈l 5;l
Dexamethasone/Betamethasonel ≈l 25-30.
QUESTION
Equivalentl corticosteroidl doses
Answer:
20l mgl hydrocortisonel ≈l 5l mgl prednisonel ≈l 4l mgl methylprednisolonel ≈l 0.75l mgl
dexamethasone.
QUESTION
Short-actingl corticosteroid
Answer:
Hydrocortisonel (8-12l hrl duration).
QUESTION
Intermediate-actingl corticosteroids
Answer:
Prednisone,l prednisolone,l methylprednisolonel (12-36l hrl duration).
2026/l 2027l Update)l Advancedl
Pharmacologyl Guide|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Leukotrienel Receptorl Antagonistsl AR
Answer:
Example
Montelukast
Mechanism
Blockl leukotrienel receptors
Reducel inflammationl andl mucusl production
Adversel Effects
Headache
Rarel neuropsychiatricl effects
Cautionl inl Patientsl withl historyl ofl psychiatricl disorders
Placel inl Therapy
Helpfull inl patientsl withl allergicl rhinitisl +l asthma
QUESTION
Stepwisel Approachl tol Treatingl Allergicl Rhinitis
Answer:
Stepl 1:l Allergenl Avoidance
First-linel managementl includesl environmentall controll measures,l suchl as:
Avoidl exposurel tol knownl allergensl (pollen,l dustl mites,l mold,l petl dander)
Usel HEPAl airl filters
Washl beddingl inl hotl waterl weekly
Usel dustl mitel coversl onl pillowsl andl mattresses
Keepl windowsl closedl duringl highl pollenl seasons
,Stepl 2:l Pharmacologicl Therapy
Medicationl choicel dependsl onl thel severityl andl predominantl symptoms.
Mildl orl Intermittentl Symptoms
Optionsl include:
Second-generationl orall antihistamines
loratadine
cetirizine
fexofenadine
Intranasall antihistamines
Cromolynl nasall spray
Thesel medicationsl primarilyl relieve:
Sneezing
Rhinorrhea
Nasall itching
Moderatel tol Severel Symptoms
Intranasall corticosteroidsl (first-linel therapy)
Examples:
fluticasone
budesonide
mometasone
Benefits:
Mostl effectivel therapyl forl AR
Reducel nasall congestion,l inflammation,l sneezing,l andl rhinorrhea
Persistentl orl Uncontrolledl Symptoms
Combinationl therapyl mayl bel used:
Intranasall corticosteroidl +l antihistamine
Addl decongestantl forl severel congestion
Leukotrienel receptorl antagonistl (montelukast)l inl somel patients
Stepl 3:l Immunotherapyl (Severel orl Refractoryl AR)
Forl patientsl withl persistentl symptomsl despitel medication:
Allergenl immunotherapyl (allergyl shotsl orl sublinguall therapy)
Benefits:
Modifiesl immunel responsel tol allergens
Mayl providel long-terml symptoml control
QUESTION
Keyl Examl Pointsl AR
Answer:
,Intranasall corticosteroidsl =l mostl effectivel treatmentl forl allergicl rhinitis
Cromolynl =l safestl option
Decongestantsl primarilyl treatl congestion
Antihistaminesl treatl sneezing,l itching,l andl rhinorrhea
QUESTION
Rapidl vsl Delayedl onsetl AR
Answer:
Rapid-onsetl medicationsl providel quickl symptoml reliefl butl oftenl dol notl treatl thel
underlyingl inflammation.l (intranasall decongestants,l intranasall antihistamines)
Delayed-onsetl medicationsl (likel cromolyn)l arel saferl forl long-terml usel butl requirel
consistentl usel beforel fulll benefitl isl seen.
QUESTION
Pregnancyl considerationsl ARl meds
Answer:
Saferl optionsl oftenl include:
Intranasall corticosteroidsl (e.g.,l budesonide)
Cromolynl sodium
Medicationsl typicallyl avoidedl orl usedl cautiously:
Orall decongestants,l especiallyl inl earlyl pregnancy.
QUESTION
1stl andl 2ndl generationl antihistaminesl differ
Answer:
1stl generationl antihistaminesl =l sedatingl +l anticholinergicl effects
Clinicall Considerations
Shorterl durationl ofl action
Usuallyl requirel multiplel dailyl doses
Notl preferredl forl allergicl rhinitisl duel tol sidel effects.
2ndl generationl antihistaminesl =l lessl sedatingl andl preferredl forl allergicl rhinitis
Clinicall Advantages
Longerl durationl ofl action
Usuallyl once-dailyl dosing
, Fewerl anticholinergicl sidel effects
QUESTION
Corticosteroidl potency
Answer:
Relativel anti-inflammatoryl strengthl comparedl withl hydrocortisonel (referencel drug).
QUESTION
Relativel potencyl ofl orall corticosteroids
Answer:
Hydrocortisonel =l 1;l Prednisone/Prednisolonel ≈l 4;l Methylprednisolonel ≈l 5;l
Dexamethasone/Betamethasonel ≈l 25-30.
QUESTION
Equivalentl corticosteroidl doses
Answer:
20l mgl hydrocortisonel ≈l 5l mgl prednisonel ≈l 4l mgl methylprednisolonel ≈l 0.75l mgl
dexamethasone.
QUESTION
Short-actingl corticosteroid
Answer:
Hydrocortisonel (8-12l hrl duration).
QUESTION
Intermediate-actingl corticosteroids
Answer:
Prednisone,l prednisolone,l methylprednisolonel (12-36l hrl duration).
