Podcast
Questions and Answers
What is the main mechanism by which intranasal corticosteroids alleviate symptoms of allergic rhinitis?
What is the main mechanism by which intranasal corticosteroids alleviate symptoms of allergic rhinitis?
- Stimulating the nasal mucosa
- Enhancing the histamine response
- Increasing mucus production
- Decreasing the influx of inflammatory cells (correct)
After how long is the peak effect of intranasal corticosteroids usually observed?
After how long is the peak effect of intranasal corticosteroids usually observed?
- One to two hours
- Immediate effect within minutes
- Two to four weeks (correct)
- Several days to weeks
Which of the following statements regarding the effectiveness of nasal corticosteroids is accurate?
Which of the following statements regarding the effectiveness of nasal corticosteroids is accurate?
- They are more effective than both oral and intranasal antihistamines. (correct)
- They are less effective than intranasal antihistamines.
- They have no significant effect on allergic rhinitis symptoms.
- They are equally effective as oral antihistamines.
Which intranasal corticosteroid is noted for having a pregnancy category B safety rating?
Which intranasal corticosteroid is noted for having a pregnancy category B safety rating?
What are the common adverse effects associated with the use of intranasal corticosteroids?
What are the common adverse effects associated with the use of intranasal corticosteroids?
What was the outcome of the RCT regarding mometasone's effect on skeletal growth in children?
What was the outcome of the RCT regarding mometasone's effect on skeletal growth in children?
How do first-generation antihistamines differ from second-generation antihistamines in terms of adverse effects?
How do first-generation antihistamines differ from second-generation antihistamines in terms of adverse effects?
Which of the following antihistamines is noted for potentially causing sedation despite being a second-generation antihistamine?
Which of the following antihistamines is noted for potentially causing sedation despite being a second-generation antihistamine?
What potential long-term effect is associated with the use of intranasal corticosteroids in children?
What potential long-term effect is associated with the use of intranasal corticosteroids in children?
What was observed in the study with beclomethasone compared to placebo in terms of growth?
What was observed in the study with beclomethasone compared to placebo in terms of growth?
Which of the following describes the efficacy of antihistamines for treating nasal congestion compared to intranasal corticosteroids?
Which of the following describes the efficacy of antihistamines for treating nasal congestion compared to intranasal corticosteroids?
What is the expected onset of action for most antihistamines?
What is the expected onset of action for most antihistamines?
What was the general finding regarding the short-term use of first- and second-generation antihistamines in a study of children?
What was the general finding regarding the short-term use of first- and second-generation antihistamines in a study of children?
What impact do second-generation antihistamines have on nasal and ocular symptoms of allergic rhinitis?
What impact do second-generation antihistamines have on nasal and ocular symptoms of allergic rhinitis?
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Study Notes
Intranasal Corticosteroids
- Mainstay treatment for allergic rhinitis
- Reduce inflammation by decreasing inflammatory cell influx and inhibiting cytokine release
- Onset of action is 30 minutes, peak effect in hours to days, maximum effectiveness after 2-4 weeks
- More effective than oral and intranasal antihistamines in treating allergic rhinitis
- Quality of life scores superior in nasal corticosteroid group compared to antihistamines
- Adverse effects: headache, throat irritation, epistaxis, stinging, burning, and nasal dryness
- Long-term use may restrict growth in children
Oral Antihistamines
- First-generation antihistamines cause sedation, fatigue, and impaired mental status due to lipid solubility
- Associated with poor school performance, impaired driving, and increased accidents
- Second-generation antihistamines have better adverse-effect profile, less sedation (except for cetirizine)
- More complex chemical structures decrease movement across blood-brain barrier, reducing central nervous system effects
- Second-generation antihistamines stabilize and control nasal and ocular symptoms but have little effect on nasal congestion
- Both first- and second-generation antihistamines are effective in relieving histamine-mediated symptoms (sneezing, pruritus, rhinorrhea, ocular symptoms) but less effective than intranasal corticosteroids in treating nasal congestion.
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