Deck 20: Drugs for the Treatment of Allergic Rhinitis

Question 1

Why should intranasal decongestants only be used for 3 to 5 days?

A) They produce systemic toxicity.
B) They can cause rebound congestion.
C) They will start to cause systemic autocoid effects.
D) They will produce xerostomia.

Answer 1

They can cause rebound congestion.

Question 2

Which of the following are sources of seasonal allergic rhinitis rather than perennial allergic rhinitis? (Select all that apply.)

A) Pollen from flowers
B) Pollen from trees
C) House dust
D) Animal dander

Answer 2

Pollen from flowers
Pollen from trees

Question 3

Antihistamines that are H₁-antagonists are least effective at competitively blocking the effect of histamine at which of the following sites?

A) Nonvascular smooth muscle (bronchial)
B) Vascular smooth muscle (vessels)
C) Capillary permeability
D) Nerve endings

Answer 3

Nonvascular smooth muscle (bronchial)

Question 4

Which of the following types of medication are considered first-line therapy for the treatment of moderate to severe allergic rhinitis?

A) Leukotriene modifiers
B) Intranasal corticosteroids
C) Mast cell stabilizers
D) Intranasal decongestants

Question 5

Ipratropium bromide (Atrovent)is an intranasal _____ drug.

A) adrenergic
B) cholinergic
C) antiadrenergic
D) anticholinergic

Question 6

The term _______ refers to agents that are H₁-blockers.

A) histamine
B) antihistamine
C) adrenergic
D) cholinergic

Question 7

Which of the following is the mechanism of action of cromolyn sodium (Nasalcrom)?

A) Inhibits mast cell degranulation
B) Blocks acetylcholine receptors
C) Stimulates alpha1 adrenergic receptors
D) Stimulates cholinergic receptors

Question 8

Montelukast (Singulair)is a(n):

A) intranasal corticosteroid.
B) leukotriene modifier.
C) intranasal anticholinergic drug.
D) mast cell stabilizer.
E) oral decongestant.

Question 9

Allergic rhinitis is primarily associated with immunoglobulin A.

Question 10

Which of the following common antihistamines produces the most sedation?

A) Brompheniramine (Dimetane)
B) Chlorpheniramine (Chlor-Trimeton)
C) Diphenhydramine (Benadryl)
D) Fexofenadine (Allegra)
E) Loratadine (Claritin)

Question 11

Oral decongestants are alpha-adrenergic antagonists that cause a vasoconstriction of the nasal mucosa. Intranasal decongestants are an alternative to oral decongestants that are less likely to cause systemic adverse effects.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second statement is false.
D) The first statement is false; the second statement is true.

Question 12

Montelukast is generally well tolerated. It is more effective than H₁-antihistamines and intranasal corticosteroids.

A) Both parts of the statement are true.
B) Both parts of the statement are false.
C) The first part of the statement is true; the second part is false.
D) The first part of the statement is false; the second part is true.

Question 13

Histamine is released by which of the following types of white blood cells? (Select all that apply.)

A) Polymorphonuclear leukocytes (PMNs)
B) Mast cells
C) Basophils
D) Macrophages

Question 14

Which of the following classes of antibodies is triggered when an allergen is inhaled in an individual with a sensitized immune system?

A) IgA
B) IgD
C) IgE
D) IgG
E) IgM

Question 15

The primary advantage of second generation H₁ agents is that they are less likely to have which of the following pharmacologic effects of first generation H₁ antihistamines?

A) Antihistaminic
B) Antiserotonergic
C) Anticholinergic
D) Sedative

Question 16

Which of the following types of drugs is known to increase intraocular pressure if inadvertently placed in the eye?

A) Mast cell stabilizer
B) Antihistamine
C) Intranasal anticholinergic
D) Leukotriene modifier

Question 17

Which of the following symptoms is the most common side effect associated with the older antihistamines? (Please note: all are associated, but one is most common)

A) Nausea
B) Xerostomia
C) Sedation
D) Constipation

Question 18

Which of the following drugs is a mast cell stabilizer?

A) Ipratropium bromide (Atrovent)
B) Montelukast (Singulair)
C) Cromolyn sodium (Nasalcrom)
D) Azelastine (Astelin)

Question 19

Oral decongestants should be used with caution in patients with: (Select all that apply.)

A) cardiovascular disease.
B) hypertension.
C) diabetes.
D) hyperthyroidism.
E) closed-angle glaucoma.

Question 20

Antihistamines such as loratadine (Claritin)are nonsedating because they:

A) stimulate the CNS.
B) bind only to H₂-receptors.
C) are combined with decongestants that have CNS stimulant activity.
D) do not cross the blood-brain barrier.

Question 21

Sedation with antihistamines is additive with that caused by other CNS depressant drugs.

Question 22

Second generation antihistamines are more likely to cause sedation than first generation antihistamines.

Question 23

Cromolyn sodium works by blocking acetylcholine receptors.

Question 24

Antihistamines may be used to treat a mild allergic reaction.

Question 25

Ipratropium bromide should be used with caution in patients with glaucoma.

Question 26

Montelukast (Singulair)has been associated with postmarketing reports of psychiatric symptoms.

Question 27

The H₁-receptor antagonists have varying cholinergic effects.

Question 28

Intranasal corticosteroids are considered first-line therapy for treating moderate to severe allergic rhinitis.