Hay Fever

Front 1

hay fever symptoms

Back 1

1. runny nose
2. nasal congestion
3. sneezing
4. itching: nose, eyes, ears, throat
5. watery, red, irritated eyes

Front 2

refer when

Back 2

1. unresponsive to OTC treatment
2. quality of life is seriously affected
3. unilateral nasal obstruction without rhinorrhea
4. impaired sense of smell (anosmia)
5. infection symptoms:
a. persistent purulent nasal discharge
b. facial pain and tenderness
c. severe headache and fever (sinusitis)
d. hearing loss, earache and fever (otitis media)

Hint 2

6. asthma (wheezing, shortness of breath)
7. child <12, first episode
8. medication caused: aspirin, NSAIDs, vasodilator, oral contraceptive, extended use of nasal decongestants

Front 3

use of antihistamine in hay fever

Back 3

1. rapid relief for sneezing and rhinorrhoea
2. fail for nasal congestion

Front 4

sedating antihistamine's contraindication

Back 4

1. closed-angle glaucoma, increase intra-ocular pressure
2. pyloroduodenal obstruction
3. bladder neck obstruction
4. hyperthyroidism

Front 5

sedating antihistamines and ADR

Back 5

1. cyclizine
2. cyproheptadine
3. chlorpheniramine
4. dexchlorpheniramine (Polaramine)
5. diphenhydramine
6. doxylamine
7. pheniramine
8. promethazine
9. trimeprazine

Hint 5

1. sedation
2. anti-cholinergic effects (blurred vision, dry mouth, tachycardia)

Front 6

less (new) sedating antihistamines

Back 6

1. fexofenadine (Telfast)
2. cetirizine (Zyrtec)
3. loratadine (Claritin)
4. desloratadine (Aerius)
5. levocetirizine

Hint 6

cetirizine (Zyrtec) is more likely to cause sedation

Front 7

use of intranasal corticosteroid

Back 7

1. treatment of choice for moderate to severe symptoms
2. relieve and prevent
a. allergic rhinitis
b. congestive symptoms
c. alleviate ocular symptoms

Hint 7

1. symptomatic relief in 3-4 days
2. complete relief may take 2-4 WEEKS
3. use concomitantly oral/topical decongestant for the first 24-48 hours (not longer than 5 days)

Front 8

nasal decongestants

Back 8

1. oral decongestants: rapid relief (contraindication: cardiovascular disease)
2. topical decongestants: should not be used more than 5 days to avoid rebound congestion
3. symptom relief in 24-48 hours

Front 9

intranasal decongestants

Back 9

1. ephedrine
2. oxymetazoline
3. phenylephrine
4. tramazoline
5. xylometazoline

Front 10

oral decongestants

Back 10

1. phenylephrine
2. pseudophedrine

Front 11

intranasal corticosteroid's ADR

Back 11

1. nasal stinging, dryness and irritation
2. nose bleeding
3. sore throat, dry mouth and cough

Front 12

intranasal saline

Back 12

1. relieve mucosal irritation and dryness
2. decreasing nasal stuffiness, rhinorrhoea and sneezing
3. counteract drying from INCS use

Front 13

antihistamine eye drops

Back 13

persist allergic conjunctivitis (despite INCS and oral antihistamine)

Hint 13

aritificial tears can alleviate mild symptoms

Front 14

ipratropium bromide

Back 14

may be added in intractable rhinorrhoea

Front 15

leukotriene receptor antagonist

Back 15

refer used in children with asthma/allergic rhinitis