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Questions and Answers
Which of the following is an adverse reaction associated with mast cell stabilizers?
Which of the following is an adverse reaction associated with mast cell stabilizers?
What is the primary mechanism of Montelukast as a leukotriene receptor antagonist?
What is the primary mechanism of Montelukast as a leukotriene receptor antagonist?
Which of the following is NOT a recommended treatment for angioedema related to anaphylaxis?
Which of the following is NOT a recommended treatment for angioedema related to anaphylaxis?
What consequences does bradykinin-mediated angioedema primarily affect?
What consequences does bradykinin-mediated angioedema primarily affect?
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Among the following, which symptom is associated with leukotriene receptor antagonists?
Among the following, which symptom is associated with leukotriene receptor antagonists?
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What triggers an allergic response in the immune system?
What triggers an allergic response in the immune system?
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Which cell type is primarily responsible for producing antibodies in response to allergens?
Which cell type is primarily responsible for producing antibodies in response to allergens?
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Which of the following symptoms is NOT associated with the release of histamine during an allergic reaction?
Which of the following symptoms is NOT associated with the release of histamine during an allergic reaction?
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What is an example of a condition characterized by dark circles under the eyes due to allergies?
What is an example of a condition characterized by dark circles under the eyes due to allergies?
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In seasonal allergic rhinitis, what is the primary trigger for allergy symptoms?
In seasonal allergic rhinitis, what is the primary trigger for allergy symptoms?
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What classification does a hypersensitivity reaction fall under?
What classification does a hypersensitivity reaction fall under?
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Which medication class is commonly used in the treatment of allergies by blocking histamine action?
Which medication class is commonly used in the treatment of allergies by blocking histamine action?
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What is the primary mechanism of action of glucocorticosteroids in inflammatory response?
What is the primary mechanism of action of glucocorticosteroids in inflammatory response?
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Which of the following options is NOT a listed adverse reaction of glucocorticosteroids?
Which of the following options is NOT a listed adverse reaction of glucocorticosteroids?
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Which class of medication is effective in reducing reactivity to allergens?
Which class of medication is effective in reducing reactivity to allergens?
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What must be avoided while taking fexofenadine?
What must be avoided while taking fexofenadine?
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Which of the following inhaled medications is a glucocorticosteroid?
Which of the following inhaled medications is a glucocorticosteroid?
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Which of the following combinations are examples of look-alike/sound-alike drug pairs?
Which of the following combinations are examples of look-alike/sound-alike drug pairs?
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What should be done before using an inhaler?
What should be done before using an inhaler?
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Which of the following statements about mast cell stabilizers is correct?
Which of the following statements about mast cell stabilizers is correct?
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Which of the following is a potential side effect of nasal corticosteroids?
Which of the following is a potential side effect of nasal corticosteroids?
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Which of the following drugs is used as a mast cell stabilizer for intranasal use?
Which of the following drugs is used as a mast cell stabilizer for intranasal use?
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What is a common symptom of urticaria?
What is a common symptom of urticaria?
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Which cause is NOT associated with urticaria?
Which cause is NOT associated with urticaria?
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What treatment is primarily used for severe urticaria?
What treatment is primarily used for severe urticaria?
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Allergic rhinitis symptoms may include which of the following?
Allergic rhinitis symptoms may include which of the following?
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What is a symptom of allergic conjunctivitis?
What is a symptom of allergic conjunctivitis?
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What type of allergens could be found in disposable gloves?
What type of allergens could be found in disposable gloves?
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Allergic rhinitis may recur seasonally due to the presence of which immune cells?
Allergic rhinitis may recur seasonally due to the presence of which immune cells?
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In allergic reactions, which symptom is indicative of respiratory issues?
In allergic reactions, which symptom is indicative of respiratory issues?
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What is a potential consequence of using decongestants for allergic conjunctivitis?
What is a potential consequence of using decongestants for allergic conjunctivitis?
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Which class of antihistamines is known for causing the most sedation?
Which class of antihistamines is known for causing the most sedation?
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What is the mechanism of action of H1 receptor antagonists?
What is the mechanism of action of H1 receptor antagonists?
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Which of the following is not a first-generation antihistamine?
Which of the following is not a first-generation antihistamine?
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What adverse effect is most commonly associated with the use of antihistamines?
What adverse effect is most commonly associated with the use of antihistamines?
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Which antihistamine has a longer half-life, lasting up to 24 hours?
Which antihistamine has a longer half-life, lasting up to 24 hours?
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In which situation should antihistamines be used with caution?
In which situation should antihistamines be used with caution?
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Which of the following antihistamines can metabolize to another drug?
Which of the following antihistamines can metabolize to another drug?
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What should patients be advised regarding the consumption of alcohol while taking certain antihistamines?
What should patients be advised regarding the consumption of alcohol while taking certain antihistamines?
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What is a major concern regarding the use of antihistamines in young children?
What is a major concern regarding the use of antihistamines in young children?
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Which of the following is an example of a second-generation antihistamine?
Which of the following is an example of a second-generation antihistamine?
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Study Notes
Allergy Treatment
- Allergies are hypersensitivity reactions by the immune system, affecting approximately 40-50 million people in the United States
- Seasonal allergic rhinitis, an allergy to seasonal pollens, affects up to 20% of the US population
- Allergic reactions occur when the immune system treats an allergen as an invader, producing antibodies (IgE)
- These antibodies attach to mast cells, which contain histamine
- Histamine release triggers symptoms like wheezing, rash, runny nose, and itching
- Symptoms of allergies can be localized or generalized
- Allergic shiners are dark circles under the eyes caused by increased blood flow near the sinuses
- Allergic salute is a crease across the bridge of the nose due to persistent upward rubbing of the nose
Allergy Symptoms
-
Dermal Symptoms:
- Wheal (hives)
- Rash
- Redness
- Urticaria (hives)
-
Respiratory Symptoms:
- Itchy eyes, nose, and throat
- Runny nose
- Stuffy nose
- Sneezing
- Coughing
- Watery eyes
- Conjunctivitis
Urticaria (Hives)
- Urticaria symptoms include itching, angioedema, redness, swelling, and wheals (blister-like vesicles)
- Urticaria can be triggered by insect bites, drugs, food allergies, or injections of allergen extracts (e.g., allergy shots)
- Urticaria is usually self-limiting
Urticaria Treatment
- Most urticaria cases are self-limiting
- Severe urticaria is treated with antihistamines and glucocorticosteroids
Allergic Rhinitis
- Allergic rhinitis symptoms include nasal itching, runny nose, nasal congestion, and sneezing
- Allergic Rhinitis is caused by inflammation and swelling in nasal passages
- Allergic rhinitis can be perennial or seasonal
- Symptoms often appear after a period of absence from allergen exposure
- Allergic rhinitis recurs seasonally due to the presence of memory CD4+ T cells, resulting in the production of allergen-specific antibodies (e.g., to tree, grass, or pollen)
- Allergic rhinitis is usually self-limiting
Allergic Conjunctivitis
- Allergic conjunctivitis symptoms include red, watery, itchy, or burning eyes, ocular puffiness, and stringy discharge
- It typically worsens during allergy and hay fever season
- Allergic conjunctivitis is typically self-limiting, however, decongestants, may cause, medicmentosa- rebound redness and nasal congestion
Occupational Allergies
- Latex proteins from disposable gloves, IV tubing and similar medical supplies may trigger occupational allergies
- Occupational allergens can become airborne and be inhaled, leading to dermal or respiratory symptoms
Drugs Used in Allergy Treatment
-
Antihistamines (H1 Receptor Antagonists)
- First generation: Diphenhydramine, chlorpheniramine, hydroxyzine, brompheniramine
- Second generation: Cetirizine, levocetirizine, loratadine, desloratadine, fexofenadine
- Inhaled corticosteroids
- Mast cell stabilizers
- Leukotriene receptor agonists
- Vasoconstrictors
H1 Receptor Antagonist MOA
- Prevents histamine binding to H1 receptor sites, as drugs compete with free histamine for binding
- Half-life can vary, ranging from short (4-6 hours) to long (24 hours)
- Hydroxyzine metabolizes into Cetirizine
H1 Receptor Antagonist Adverse Effects
- Decreased alertness
- Sedation (most commonly with diphenhydramine and promethazine)
- Dizziness
- Dry mouth
- Blurred vision
- Urinary retention
Precautions for Antihistamines
- Use with caution in men with prostate disease and breastfeeding women
- Not recommended for children under 2 years
H1 Receptor Antagonist Warning Labels
- May cause drowsiness; alcohol may increase this effect (particularly in Ethylenediamines, alkylamines and piperazines)
- Swallow whole; do not crush or chew (extended-release products)
- May cause dizziness or drowsiness
Additional H1 Receptor Antagonist Warning Labels
- Protect from moisture; leave in foil packet until ready to use (disintegrating tablets).
- Dissolve reditab under the tongue (disintegrating tablets)
- Avoid orange, grapefruit, and apple juice (fexofenadine)
- Prime inhalers before use
Look-Alike/Sound-Alike Drugs
- Diphenhydramine and dimenhydrinate
- Allegra and Viagra
- Zyrtec, Zantac, Xanax, and Serax
- Claritin and Clarinex
Glucocorticosteroids (Intranasal):
- Beclomethasone
- Budesonide
- Flunisolide
- Fluticasone propionate and fluticasone furoate
- Triamcinolone
- Mometasone
Glucocorticosteroids MOA
- Inhibit inflammatory responses by reducing permeability of nasal mucosa to T lymphocytes and eosinophils, as well as decreasing mediator release
- Reduce inflammatory cells to decrease mucus and swelling
Glucocorticosteroids Adverse Reactions
- Nasal burning or stinging
- Throat irritation
- Nosebleeds
- Nasal candidiasis (fungal infection)
###Mast Cell Stabilizers
- Cromolyn sodium (Opticrom and Rhinaris)
- Nedocromil sodium (Alocril)
- Intranasal and ophthalmic use
- Reduces reactivity to allergens decreasing mast cell degranulation and inflammatory substance release
- Not effective for acute symptoms
Mast Cell Stabilizers Adverse Reactions
- Unpleasant taste
- Dry throat and cough
- Difficulty breathing
- Headache
- Nose bleeds
- Runny nose and sneezing
- Stinging, burning or irritation inside the nose
Leukotriene Receptor Antagonists
- Montelukast
- Controls allergic rhinitis symptoms
- Selective antagonist of the cysteinyl leukotriene D4 receptor
Leukotriene Receptor Antagonists Adverse Reactions
- Cough, hoarseness, or sore throat
- Headache
- Indigestion, heartburn, or stomach upset
- Runny nose
- Difficulty sleeping
- Dizziness
- Drowsiness
- Muscle aches or cramps
- Unusual dreams
Immunotherapy (Allergy Shots)
- Administered subcutaneously
- For perennial or seasonal allergies
- Lowers IgE levels and stimulates IgG production
- Administered as a series with increasing allergen concentration to reduce sensitivity
Angioedema
- Self-limiting, localized subcutaneous swelling from fluid extravasation into interstitial tissues
- Primarily affects loose connective tissue, including face, lips, mouth, throat, larynx, uvula, extremities, and genitalia
- Two types: mast cell-mediated/histaminergic and bradykinin-mediated
Angioedema Treatment
- If affecting the airways: intubation, epinephrine, O2, and IV fluids are necessary
- Acute allergic reactions: antihistamines or glucocorticoids
- ACE inhibitor induced: discontinue the ACE-inhibitor and substitute by an angiotensin receptor blocker if appropriate
Anaphylaxis
- Acute, potentially life-threatening, systemic hypersensitivity reaction from sudden release of mast cell mediators due to IgE mediated reactions (foods, drugs, insect stings)
- Severity ranges from self-limiting mild to fatal
Anaphylaxis Signs & Symptoms
- Skin and mucosal: Hives, itching, flushing, swollen lips, tongue, uvula, periorbital edema, conjunctival swelling
- Respiratory: Nasal discharge, nasal congestion, sneezing, itching of throat and ear canals, voice quality change, throat closure sensation, stridor, shortness of breath, wheezing, cough
- Gastrointestinal: Nausea, vomiting, diarrhea, crampy abdominal pain
- Cardiovascular: Hypotension (collapse), syncope, incontinence, dizziness, tachycardia, hypotension
Anaphylaxis Emergency Management
- Remove inciting cause (medication or allergen)
- Call for help
- Intramuscular (IM) injection of epinephrine
- Supplemental oxygen
- Volume resuscitation with IV fluids
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Description
Test your knowledge on allergy mechanisms, treatments, and symptoms with this quiz. Questions cover mast cell stabilizers, leukotriene receptor antagonists, and more. Perfect for students studying immunology or related fields.
