Describe the mechanism of action for each of the medication classes identified above:

 

Intranasal steroids, such as Flonase, work by inhibiting mast cells, macrophages, and other biological mediators to produce anti-inflammatory and vasoconstricting effects (Wolters Kluwer, 2019). INS are very effective and directly modulate the pathophysiology of allergic rhinitis by decreasing the release of mediators from mast cells and inhibiting the recruitment of white blood cells to the nasal secretions as well as being able to cause a decrease in antigen-induced hyperresponsiveness of nasal mucosa to subsequent invasions by allergens and histamine release (Seidman et al., 2015).

Second-generation oral antihistamines are a class of drugs known as H1 receptor antagonists that compete with histamine by binding to the cellular receptor and blocking histamine’s ability to attach to the cell and trigger the inflammatory response (Wolters Kluwer, 2019). These second-generation oral antihistamines were created to have less sedating and anticholinergic side effects that occurred with the older oral antihistamines such as Benadryl (Seidman et al., 2015).

NR 507 Week 1 – Open Forum Discussion

Identify two treatment options that are NOT recommended (I.e., recommended against):

Two treatment options that are not recommended for treating allergic rhinitis include imaging studies and oral leukotriene receptor antagonists (LTRAs). Imaging studies are not recommended as there are no radiologic findings specific to allergic rhinitis, the risk of radiation exposure outweighs the benefits of radiologic results, and imaging studies are costly for the patient (Seidman et al., 2015). LTRAs are not recommended as they are more expensive than oral antihistamines and less effective for nasal-related symptoms. However, there has been a benefit shown for those patients who suffer from allergic rhinitis and asthma (Seidman et al., 2015).

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References

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th ed.). Elsevier.

Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., Dawson, D. E., Dykewicz, M. S., Haskell, J. M., Han, J. K., Ishman, S. L., Krouse, H. J., Malekzadeh, S., Mims, J. W. W., Omole, F. S., Reddy, W. D., Wallace, D. V., Walsh, S. A., Warren, B. E., . . . Nnacheta, L. C. (2015). Clinical Practice Guideline. Otolaryngology–Head and Neck Surgery, 152(1_suppl), S1–S43. https://doi.org/10.1177/0194599814561600

Wolters Kluwer. (2019). Nursing 2019 Drug Handbook (39th ed.). Wolters Kluwer.