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Self Care Exam 2
Flashcards covering all the material for the second Self Care exam
100
Pharmacology
Graduate
03/28/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
After quitting smoking for 2 weeks to 3 months, what kind of benefits already occur?
Definition
Improved circulation, walking becomes easier, increase in lung function up to 30%
Term
When can you expect your lung cilia to regain normal function, increased ability to clear mucus, and decrease in coughing, fatigue, and shortness of breath after quitting smoking?
Definition
1-9 months after quitting
Term
When does your risk for CHD decrease by half after quitting smoking?
Definition
1 year
Term
After 5 years of quitting smoking, what benefit do you gain?
Definition
Risk of stroke is reduced to that of people who have never smoked
Term
After 10 years of quitting, what benefits do you gain?
Definition
Lung cancer death rate halves, rick of cancer of mouth, throat, esophagus, bladder, kidney, and pancreas decrease
Term
When can you expect your risk of CHD to become similar to someone who has never smoked after quitting?
Definition
After 15 years
Term
Is tobacco use an acute condition?
Definition
No, it is a chronic disease
Term
What are the three targets of tobacco use behavior?
Definition
Physical addiction - nicotine craving
Habit - behavior
Psychological dependence - perceived benefits
Term
Main difference between the 2000 and 2008 Clinical practice guidelines?
Definition
In 2000, there were 5 FDA approved medications
In 2008, there are now 7 FDA approved medications and added a great emphasis on counseling, especially in regards to special populations
Term
What are the special populations of the 2008 Clinical Practice Guidelines?
Definition
Pregnant patients
Light smokers
Adolescents (<18 yo)
Smokeless tobacco users

These populations should be encouraged to use counseling cessation rather than medications.
Term
Name the 5 A's.
Definition
Ask
Advise
Assess
Assist
Arrange
Term
Why is assess important?
Definition
This is when you decide if the patient is ready to quit.
If they are not, you would use the 5 R's, else move on with the remaining A's
Term
Name the 5 R's.
Definition
Relevance
Risks
Rewards
Roadblocks
Repetition
Term
Name all the pharmacological tobacco cessation treatments.
Definition
NRT (nicotine replacement therapies)gum, patch, lozenge, nasal spray, inhaler

Bupropion SR (Zyban)

Varenicline (Chantix)
Term
What are precautions and DIs in regards to NRTs?
Definition
Precautions - patients with underlying cardiovascular conditions such as recent MIs

There are no significant DIs
Term
Nicotine gum - OTC dosages and administration/frequency?
Definition
2mg or 4mg
2mg if less than one pack a day
4mg if greater than one pack a day

Gum must be used on a scheduled basis and not just chewed

Chew and park between cheek and gum for buccal absorption ELSE GI IRRITATION FROM SWALLOWING NICOTINE

Weeks 1-6 = 1 piece every 1-2 hours
Weeks 7-9 = 1 piece every 2-4 hours
Weeks 10-12 = 1 piece every 4-8 hours
Max 24/day

DO NOT EAT OR DRINK 15 MIN ESPECIALLY ACIDIC FOODS AND DRINKS
Term
Nicotine Lozenge - OTC dosages and administration/frequency?
Definition
2mg - if patient can avoid smoking for 1 hour after waking up
4mg - if within 30 minutes

Don't chew!

Weeks 1-6 = 1 every 1-2 hours
Weeks 7-9 = 1 every 2-4 hours
Weeks 10-12 = 1 every 4-8 hours
Max = 20 per day

DO NOT EAT/DRINK 15 MIN BEFORE
Term
Nicotine CQ OTC - strengths and administration/frequency?
Definition
21mg - Start here is 10+ cigarettes/day; 6 weeks (4 if generic brand)
14mg - 2 weeks (start here if <10 cigarettes /day)
7mg - 2 weeks

1 patch over a 24 hour duration on a new area each time that is CLEAN, DRY, NATURALLY HAIRLESS, and on the upper body/arm (do not use the same area for at least 1 week)
Term
Which 3 NRTs are OTC?
Definition
Gum, lozenge, and patch
Term
What is one odd side effect of the NRT patch?
Definition
Vivid dreams; can tell patients to remove before sleeping
Term
Nicotrol NS (NRT nasal spray) - dosages and administration/frequency?
Definition
0.5 mg per spray
ONE DOSE = 1 mg nicotine; thus 1 spray in each nostril for a total of 2 sprays

1-2 doses every hour; max = 5 per hour

Use for 12 weeks; start with 8 doses daily for first 6-8 weeks and gradually taper off for an additional 2-4 weeks after the 3 months
Term
Nicotine inhaler prescription - dosing and administration/frequency?
Definition
10mg cartridge that delivers 4mg of nicotine

Start with at least 6 cartridges (first 3-6 weeks) to a max of 16 per day while gradually reducing over the following 6-12 weeks

20 minutes of actual puffing that can be paused and restarted later (cartridge is good for 24 hours)

NO EATING/DRINKING 15 MIN BEFORE; inhale into back of throat or puff in SHORT breaths
Term
Bupropion SR - MOA, dosages, administration, warnings?
Definition
MOA - affects levels of brain neurotransmitters such as dopamine and norepinephrine to decrease craving and withdrawal symptoms

START TREATMENT 1-2 WEEKS BEFORE QUIT DATE TO ENSURE THERAPEUTIC LEVELS ARE REACHED
150 mg orally in the morning for 3 days THEN 150 mg orally twice a day for 7-12 weeks

Common side effect - insomnia
Rare - seizure risk
Precaution/Contraindications - history of seizures, anorexia/bulimia; medications that lower seizure threshold
Term
Varenicline - MOA, dosages, administration, warnings?
Definition
MOA - binds to alpha4beta2 neuronal nicotinic acetylcholine receptors to stimulate low activity while competing with nicotine to reduce craving and withdrawal symptoms

START TREATMENT 1 WEEK BEFORE QUIT DATE FOR NAUSEA AND INSOMNIA ADJUSTMENT
0.5 mg daily for first 3 days
0.5 bid for days 4-7
1 mg bid for 12 weeks

Potential neuropsychiatric symptoms
Term
Explain combination theory for tobacco cessation.
Definition
Combination NRT
Using a long acting formulation (patch) with a short acting formulation (gum, lozenge, inhaler, spray) for sudden increase in withdrawal symptoms at peak times in the day

OR

Bupropion SR + nicotine patch
Term
Are there any exclusions for self care in regards to tobacco cessation?
Definition
NO; ALL patients should be provided with smoking cessation medications unless a contraindication or special population, which would be given counseling instead
Term
Pregnancy etiology
Definition
5 days before ovulation and during day of ovulation = highest chance of pregnancy (5-45% chance)
Term
Name all the natural methods of contraception.
Definition
AKA Natural family planning; typically used to TRY TO GET PREGNANT

All have 25% typical failure rate

Calendar method
Basal body temperature - drop in temperature 12-24 hours before ovulation; 0.4 degrees F rise at ovulation
Cervical mucus method - increase in amount and elasticity
Symptotermal method - use BBT and cervical methods together

Lactational Amenorrhea method - patient is postpartum and meets 3 requirements (not having menses yet, breastfeeding exclusively without pumps, within 6 months after birthing)
Term
Name the barrier methods.
Definition
Male condom
Female condom
Sponge
Spermicides
Diaphragm and cervical caps
Term
Male condoms?
Definition
15% typical failure rate
Latex, polyurethane, spermicide-treated

Can break due to incorrect placement, reuse, OIL BASED OINTMENT, increase duration/frequency of intercourse, exposure to heat

3-5 years of shelf life
Term
Female Condom?
Definition
FC1 - polyurethrane (no longer in use)
FC2 - nitrile

21% typical failure rate

Pre-lubricated
Can be put in 8 hours before intercourse
Smaller ring inserted first to cover cervical opening; larger ring covers external vaginal mucosal area
Term
Sponge?
Definition
Discontinued
Barrier, spermicide, and absorbs semen

16%(nulliparous)-32%(parous) typical failure rate

6 hours prior to intercourse; at least 6 hours after up to 24 hours

Toxic shock syndrome
Term
Spermicides?
Definition
Foams, gels, suppositories, and film

29% typical failure rate

Active ingredients = nonoxynol-9 (most common), octoxynol-9, and menfegol

use higher concentrations with diphragms and caps
Term
Diaphragm? Cervical cap?
Definition
Both require professional fitting

Diaphragm
Silicone device filled with spermicide
16% typical failure rate

Cervical cap
Thimble-shaped silicone device
16-32% failure rate depening on parous status
Term
Which contraceptives offer STD protection?
Definition
Only male and female condoms
Term
A female and male condom used together will decrease chances of pregnancy?
Definition
FALSE; using both will most likely cause breakage and increase chances of pregnancy
Term
What is the mechanism of emergency contraceptives that is the cause of much debate?
Definition
Interference with implantation because this depends on personal opinions of whether pregnancy begins at fertilization or at implantation
Term
What are the four options for EC?
Definition
Plan B One-step (Levonorgestrel)
Ella (Ulipristal Acetate)
Yuzpe (Combination estrogen and progestin)
Copper IUD insertion
Term
Plan B One-step?
Definition
90% within 72 hours
Take one tablet (1.5mg of levonorgestrel) asap
CYP3A4 inducers (phenobarbital etc.) make reduce efficacy
Nausea and vomiting are common side effects
Term
Ella (Ulipristal Acetate)?
Definition
90% within 120 hours
Delays ovulation by tricking body into thinking it already has
Take one 30 mg tablet asap
CYP3A4 inducers (phenobarbital and etc.) may reduce efficacy
Headache and nausea
Term
Yuzpe?
Definition
75% within 72 hours
Dosing depends on brand name, but more than 1 pill
50% of patients get nausea (higher than other options) 25% vomiting
Term
Copper IUD?
Definition
Less than 0.1% failure rate within 7 days
Term
Points on counseling for EC?
Definition
How to take
Expected side effects
98% of patients should have menses within 21 days of EC, else need to see doctor to rule out pregnancy
Patient education on contraceptive use and STDs
Term
Plan B OTC issues
Definition
Only for 17+ year olds regardless of gender without prescription

Pharmacy Access Programs - in 9 states, anyone despite age can obtain without prescription

Pharmacist's right to refusal
Term
OTC Plan B requirements?
Definition
Proof of age
Term
Majority of the flora in the vagina is?
Normal pH?
Definition
Lactobacillus
4 to 4.5
Term
What can cause vaginal infections?
Definition
Changes in flora, hormones, pH, sexual partners
Term
What are the three symptoms for differentiating vaginal infections? What is a good OTC device for self-testing?
Definition
Color
Consistency
Odor

A vaginal pH self-testing device is good for testing
Term
Bacterial Vaginosis (BV)? Risk factors? Complications?
Definition
33% of vaginal symptoms
Due to imbalance in normal flora
Polymicrobial

Risk factors
higher occurence in African americans
IUD use
Douching
Antibiotic use
Pregnancy
Tobacco use

30-50% of women are asymptomatic
Increase discharge that is watery, thin, and off-white
Fishy odor
Increased vaginal pH

Can itch, have inflammation, irritation

Complications include pelvic inflammatory disease, increased risk of HIV, UTIs, cervicitis, endometriosis, pregnancy issues
Term
Trichomoniasis? Risk factors? Complications?
Definition
Considered STD
Caused by Trichomonas vaginalis

Risk factors include multiple sex partners or new partner, lack of barrier contraceptives, other STDS

50% are asymptomatic
Yellow-gray or green discharge that is foamy; may have fishy odor
A great amount of discharge (copious)
Increased pH
Dysuria
Irritation
Pruritis (itchiness)

Complications - 40% increased risk for low-birth weight babies if untreated; increased risk for tubal infertility; increased risk for HIV (secondary to infection)
Term
Vulvovaginal candidiasis (VVC; yeast infection)? Risk factors? Complications?
Definition
Candida albicans is most common cause

Risk factors
African American women
Pregnancy
Oral contraceptives
Diabetes
Diet
Antibiotic use
IUD use
Use of barrier contraceptives
HIV
Sexual intercourse
GI colonization

Cottage-cheese discharge
Vaginal redness
Dysuria
Pruritis
LACK OF ODOR
Normal pH

Complications = increased risk of other infections
Term
VVC treatment pharmacologic options? Precautions?
Definition
Imidazole antifungals (miconazole, butoconazole, clotrimazole, tloconazole) as vaginal creams, suppositories, and tablets

1, 3, or 7 day treatments
Well-tolerated, some burning, irritation, and itching
WARFARIN INTERACTION (can increase warfarin efficacy)

Cream can degrade condom so use a backup contraceptive
Term
VVC non-pharmacologic treatments?
Definition
Dietary changes
Avoidance of non-absorbent clothing
Sitz (sodium bicarbonate) bath - 1 TSP in bath for at least 10 minutes
Modifications to drug therapy
Tea tree oil (200 mg vaginal suppository)
Gentian Violet (soak tampon and insert each night for 5 days)
Boric acid (FOR NON CANDIDA INFECTION; 600 mg vaginal capsule for 14 nights)

Yogurt
Term
Exclusions to self care for VVC self-care?
Definition
<12 years
Pregnant
First time yeast infection
More than 3 infections in one year
Recent previous infection within 2 months

Breastfeeding and geriatric patients do no require special considerations

Treatments should have some effect by 3 days
Term
Is one imidazole superior to another in terms of treating VVC?
Definition
No, all are equally efficient
Term
Common cold is usually caused by?
Symptoms?
Self-limiting?
Definition
Rhinovirus

1-3 days after inoculation = water nasal secretions, sore throat, fever
2-5 days later = greater nasal symptoms and thicker secretions
4-5 days after = weaker nasal symptoms; 20% develop coughing

It is self-limiting within 7-14 days
Term
Differentiating the cold from other illnesses?
Definition
Allergic rhinitis - itchy eyes, nose, and throat; more seasonal; possible sneezing

Ifluenza - severe muscle aches

Asthma/pneumonia/bronchitis - shortness of breath (REFER!)

Sinusitis - facial pain; tender sinuses
Term
Treatment goals of the common cold?
Definition
NO CURE
Prevent transmission
Alleviate symptoms
Term
Exclusions for common cold self-care?
Definition
Chronic conditions suspected or symptoms lasting longer than 14 days
Fever >101.5 degrees F
Chest pain
Shortness of breath
Worsening of symptoms with treatment
Underlying cardiopulmonary conditions such as COPD or asthma
Immunosuppresive conditions or medications
Frail, elderly patients
Infants younger than 9 months (children less than 4 years can be recommended NON-pharmacological treatments)
Term
Non-pharmacologic treatments for common cold?
Definition
These should be main options

Fluid intake (tea with lemon or honey; chicken soup; broths)
Rest
Healthy diet
Increased humidification (humidifiers or vaporizers; okay for babies)
Topical aromatic products (not for children under 2 years)
Saline gargles for throat
Breathe Right strips
Saline nasal sprays/drops (okay for babies)
Neti-pot WITH STERILE WATER

Upright position (for babies)
Bulb syringe for cleaning nasal passageways (for babies)
Term
Cough/cold products for young children
Definition
Pain/fever relievers such as acetaminophen and ibuprofen
Saline drops
Nasal suctioning
Humidifier/vaporizer
Honey (AT LEAST ONE YEARS OLD ELSE botulism)
Term
Can antibiotics help with the common cold?
Definition
NO; the common cold is a virus!
Term
Are antihistamines good for the common cold?
Definition
No, not really effective
Term
Pharmacologic options for the common cold?
Definition
Decongestants
Antihistamines - not really
Local anesthetics
Systemic analgesics
Antitussives
Protussives
Term
Decongestants? MOA, precautions?
Definition
Alpha-adrenergic receptor stimulation to cause blood vessels to constrict, decreasing mucosal edema

Pseudoephedrine
Phenyleprhine

Similar side effects to adrenaline
Increased CV stimulation (increase BP, tachycardia, palpitations, arrhythmia), CNS stimulation (insomnia, tremor, anxiety, restlessness)

Topical versions can have some of the side effects

Drug interactions - MAOIs, antihypertensives, tricyclic antidepressants

Diseases - hypertension (usually okay if CONTROLLED), hyperthyroidism, diabetes (may increase glucose), heart disease, glaucoma, BPH, Raynaud's syndrome (blue fingers)
Term
Which is better, pseudoephedrine or phenylephrine?
Definition
Pseudoephedrine because of its good and consistent absorption and strong evidence of efficacy; topical forms may not be as affected
Term
Pseudoephdrine sales restrictions?
Definition
Behind the counter
Need valid ID
Sign for purchase
Records maintained for 2 years
3.6 grams max per day
9 grams max per month
Term
Intranasal decongestant sprays/drops?
Definition
Oxymetazoline - not for children under 6 unless doctor supervision, 2-3 sprays every 10-12 hours as needed

Xylometaoline (NOT IN US) - not recommended for children under 12; 2-3 sprays q8-10 hours prn

Phenylephrine - Not recommended for children under 6 unless supervised; 1-3 sprays q4-6 hours prn
Term
Intranasal decongestant inhalers?
Definition
Propylhexedrine - 250 mg; 2 puffs q1-2 hours prn

Levmetamfetamine - 50mg; 2 puffs q2 hours prn

Same side effects at systemic versions
Term
Points of counseling for intranasal decongestants?
Definition
Burning, stinging, sneezng, bad taste, drying of the nose, nosebleeds

RHINITIS MEDICAMENTOSA IF DECONGESTANT USED FOR MORE THAN 5 DAYS!!
Term
Are there any benefits from using antihistamines for the common cold?
Definition
The only one may be the sedating effect for first generation antihistamines, but little evidence
Term
Local anesthetics for common cold?
Definition
Numb or alleviate paint through interruption for nerve conduction; ONLY SORE THROAT

lozenges, throat sprays, oral strips

ingredients include benzocaine, dyclonine, and phenol; may include menthol or camphor

take every 2-4 hours prn
Term
Systemic analgesics for common cold?
Definition
Aspirin, acetaminophen, NSAIDs

Good for aches, fever, and sore throat caused by common cold

DO NOT USE ASPIRIN IN CHILDREN due to risk of Reye's syndrome
Term
Name the two combination cough/cold products.
Definition
Dayquil - usually has decongestant

Nyquil - usually has sedating antihistamine
Term
Alternative therapies for common cold
Definition
Zinc (Cold-Eze, Zicam) - antiviral effect; ONLY ONE DAY DECREASE IN DURATION OF SYMPTOMS

Vitamin C (Emergen-C) - NOT EFFECTIVE can cause kidney stones etc.

Echinacea - has immunostimulant effects; can cause allergies and etc.

AIRBORNE - NO EFFECT!
Term
3 Classifications of cough? 2 types of cough?
Definition
Acute - <3 weeks; usually due to viral illness
Subacute - 3-8 weeks; usually bacterial
Chronic - >8 weeks; usually postnasal drip; CAN BE CAUSED BY ACE INHIBITORS (20% OF PATIENTS) OR BETA-BLOCKERS

Productive - mucus, usually bacterial
Nonproductive - no mucus, dry, hacking, usually viral, GERD, cardiac disease, medications, NO PHYSIOLOGIC PURPOSE
Term
Exclusions for cough self-care
Definition
Thick yellow sputum or green phlegm (bacterial cause)
101.5 degrees F
Unintended weight loss (cancer?)
Nighttime sweats (TB)
Hemoptysis
Underlying chronic condition such as asthma, COPD, CHF
Foreign object aspiration
Drug-induced cough
Cough >7 days
Cough that worsens with self-treatment or new symptoms

Children less than 4 years old UNLESS NON-PHARMACOLOGICAL
Term
Non-pharmacologic therapies for cold?
Definition
Lozenges - reduce throat irritation
Humidification - soothe irritated airways
Hydration
Bulb syringe / Saline drops (good if child is less than 2 years)
Honey (not for children less than 1 year; 2-5 years = 1/2 TSP, 6-11 = 1; 12-18 = 2)
Term
Antitussives?
Definition
GOOD FOR DRY COUGHS NOT WET ONES

Codeine
Dextromethorphan
Diphenhydramine
Topical antitussives such as menthol, camphor, lozenges
Term
Codeine? Issues?
Definition
MOA - weak opiate agonist; increase cough threshold, drying effect on respiratory tract mucosa

CONVERTED TO MORPHINE BY CYP2D6
Not much evidence for common cold cough

Schedule 5 thus max is 200mg/100 mL
NOT OTC in VT or NYS
NOT FOR CHILDREN!
Adults - max 60mg/dose, 360mg/day
DIs - CNS depressants; CYP2D6 inducers or inhibitors (can have genetic/ethnic variation)
Term
Dextromethorphan? Issues?
Definition
Non-opioid, but related to codeine
ABUSE potential
Can also antagonize NMDA receptors for pain relief (uncommon usage)

10-20mg q4 hours or 30mg q6-8 hours; max daily dose is 120 mg

Side effects are drowsiness and dizziness

DIs - serotonergic effects (caution with antidepressants or serotonin OD), avoid with MAOIs

It is a 2D6 and 3A4 substrate
Term
Diphenhydramine? Issues?
Definition
1st generation antihistamine
Not first line for cough, but approved
Increases cough threshold
Term
Topical antitussives?
Definition
Local
menthol, camphor, vick's vapor rub
Term
Guaifenesin?
Definition
Protussive
Helps cough up thick secretions
Side effects include N/V, dizziness, headache, rash, stomach pain, drowsiness
NO DRUG INTERACTIONS
200-400 mg q4 hours (max = 2.4 grams/day
Term
ACCP guidelines for coughs?
Definition
If UACS cough - 1st genreation antihistamine and decongestant combination

If viral UTI - 1st generation / decongestant, naproxen, non-sedating antihistamines DO NOT WORK, codeine and dextromethorphan DO NOT WORK

If bronchitis etc. - short term relief with codeine or dextromethorphan
Term
Pregnant / lactation considerations for self-care cough treatment
Definition
1st generation - Chlorpheniramine (B) if pregnant

Decongestant - avoid pseudoephedrine (C) during 1st trimester; usually okay for breastfeeding

Antitussive - dextromethorphan (C) okay during pregnancy, but consider risks and is okay for breastfeeding

Protussive - avoid gauifenesin (C) during 1st trimester; okay for breastfeeding
Term
Classification of allergic rhinitis?
Definition
Intermittent if <4 days/week OR <4 weeks
Persistent if 4+ days/week or >4 weeks
Term
Exclusions for allegic rhinitis self-treatment?
Definition
<12 years unless doctor confirms it is allergies
Pregnant or lactating (some options are available, but need to be referred)
Symptoms of nonallergic rhinitis, otitis media, sinusitis, bronchitis, or other infections
Symptoms of undiagnosed respiratory disorder
Symptoms worsen
Symptoms do not improve
Term
Non-pharmacologic therapies for allergic rhinitis?
Definition
AVOID ALLERGEN EXPOSURE
Nasal wetting agents such as saline, PEG sprays or gels, propylene
Neti pots
Bulb syrine
Term
Pharmacologic therapy for allergic rhinitis?
Definition
Antihistamines
Decongestants
Mast cell stabilizers
Term
Antihistamines for allergic rhinitis?
Definition
Not really considered effective for congestion, but can treat itchiness or runny nose

Competes with histamine for H1 receptor; 1st generation is more lipophobic than 2nd generation thus sedating effect

Certirizine, although 2nd gen, has some sedation

1st gen = diphenhydramine (25-50mg q4-6 hours), doxylamine (10mg q4-6 hours), chlorpheniramine (4mg q4-6 hours), dimenhydrinate (actually for motion sickness; 50-100 mg q4-6 hours), clemastine (1.34mg BID)

2nd gen = fexofenadine (60mg BID or 180mg QD), loratadine (10mg QD), cetirizine (5-10mg QD)
Term
Do 1st gen antihistamines always have a sedative effect?
Definition
No, some people may become more active, especially children and older patients
Term
Anticholinergic side effects of antihistamines?
Definition
ABCDS - anorexia, blurry vision, constipation, dry mouth, and sedation/stasis of urine

can't see, can't spit, can't pee, can't shit

sunlight sensitivity
Term
Antihistamines and older men?
Definition
BPH issue; harder to pee
Term
Antihistamine interactions?
Definition
CNS depressants - increase sedation
MAOIs - many
Phenytoin - chlorpheniramine decreases phenytoin elmination
Erthyromycin, ketoconaole, cimetidine - increase loratadine concentration
Theophyline at >400mg - increase cetirizine concentrations
Juice - reduced absorption of fexofenadine
Term
Cetirizine versus levocetirizine?
Definition
No difference
Term
What can babies 6 months and older use as an antihistamine for allergic rhinitis?
Definition
Cetirizine

Usually have to be at least 2 years for 2nd generation, 6 years for first generation
Term
Cromolyn sodium?
Definition
OTC if intranasal spray
mast cell stabilizer
1 spray in each nostril 3-6 times a day
can be used in children at least 2yo
NO DRUG INTERACTIONS
Term
Allergic rhinitis treatment options for pregnant women?
Definition
Cromolyn sodium = 1st line, B
Chlorpheniramine = 1st line, B
Pseudoephedrine = avoid during 1st trimester
Nasal decongestant = oxymetazoline C
Term
Allergic rhinitis treatment options for breastfeeding?
Definition
Cromolyn sodium - probably safe
Antihistamines - sedating = usually no; loratadine may be antihistamine of choice
Pseudoephedrine = ok
Nasal decongestant over oral decongestants
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