Test 2 Questions

Question 1

Allergic Rhinitis…tell me about allergens and how they trigger histamine release

Answer 1

histamine in mast cells

Question 2

what triggers histamine release?

Answer 2

forein substance activate WBC produce IGE , repeat exposure triger activation must cells and release histamin

Question 3

can you have allergic reaction with first exposure to allergen?

Answer 3

no, Requires repeat exposure to allergen

Question 4

What is first line for allergic rhinitis?

Answer 4

intranasal glucocorticoids

Question 5

are intranasal glucocorticoids prn or daily?

Answer 5

daily

Question 6

1st gen/2nd gen antihistamines

Answer 6

1st-sedation

1st- potential for anticholinergic effects

Question 7

what are anticholinergic effects?

Answer 7

cant pee, cant see, cant shit

Question 8

oral and intranasal decongestants…how do they work? Mechanism of action?

Answer 8

Use alpha1 adrenergic receptors (nervous system) to cause vasoconstriction:
Drugs like Phenylephrine, pseudoephedrine

Question 9

systemic oral decongestants…what population should we be cautious in prescribing?

Answer 9

HTN

CVD

Question 10

Intranasal decongestnts like Afrin…provide me with some education points for your patient?

Answer 10

rebound reaction, cannot use more than 5 day

Question 11

Drugs for cough…talk to me about benzonatate (Tessalon Perles)…how do they work?

Answer 11

They are derivative of local aneshetic…numbs (decreases sensitivity) to stretch receptors that promote cough

Question 12

benzonatate patient education

Answer 12

cant give to kids

must take whole, no sucking chewing, or dissolving med in mouth

Question 13

what do we treat the inflammation with?

Answer 13

inhaled glucocorticoid

Question 14

how do we treat bronchoconstriction?

Answer 14

bronchodilators

Question 15

ICS therapy is critical part of asthma treatment. Tell me about these drugs…how do they work?

Answer 15

Suppress inflammation

Question 16

ICS AE

Answer 16

1. Adrenal suppression
Oropharyngeal candidiasis/Dysphonia
2↓bone
3.↑ hyperglycemia
4.↑ cataract/glaucoma
5. ↑peptic ulcer
6. young-growth suppression

Question 17

pt education regarding med aministration to prevent thrush?:

Answer 17

rinse mouth out after each use

Question 18

From a side effect standpoint, why is it beneficial take inhaled glucocorticoid versus systemic?

Answer 18

very effective, much safer, less AE

Question 19

ICS daily or PRN

Answer 19

daily

Question 20

If someone takes daily steroids and comes in with significant problem like infection or surgery, what would you need to do?

Answer 20

stress dose of steroids because their adrenals probably arent producing their own.

Question 21

What education should provide parents whose kids are on ICS about growth?

Answer 21

Growth will be slower but they will reach their adult height

Question 22

Black box warning for Omalizumab (Xolair)

Answer 22

anaphylatic reaction at anytime and cancer causing

Question 23

Tell me about B2 agonist…how do they work?

Answer 23

use Beta 2 adrenergic receptors!

Question 24

What is most useful in acute asthma attack?

Answer 24

SABA

Question 25

How about using LABA as monotherapy for asthma? Can you do?

Answer 25

No
increases the risk for death, black box warning
must always combined with a glucocorticoid