The client asks the nurse which antihistamines are available as intranasal sprays. Which response by the nurse is most appropriate? (Select all that apply.)
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
1. Loratadine (Claritin)
2. Diphenhydramine (Benadryl)
3. Olopatadine (Patanase)
4. Azelastine (Astelin)
5. Neo-synephrine (Afrin)
Correct Answer: 3, 4
Rationale 1: Loratadine (Claritin) is incorrect because it is not available as a nasal spray.
Rationale 2: Diphenhydramine (Benadryl) is incorrect because it is not available as a nasal spray.
Rationale 3: Azelastine (Astelin) is approved for non-allergic rhinitis. Although it is a first-generation agent, azelastine causes less drowsiness than do others in its class because it is applied locally to the nasal mucosa, and limited systemic absorption occurs. Olopatadine (Patanase) is a second-generation antihistamine approved in 2008 for allergic rhinitis.
Rationale 4: Azelastine (Astelin) is approved for non-allergic rhinitis. Although it is a first-generation agent, azelastine causes less drowsiness than do others in its class because it is applied locally to the nasal mucosa, and limited systemic absorption occurs. Olopatadine (Patanase) is a second-generation antihistamine approved in 2008 for allergic rhinitis.
Rationale 5: Neo-synephrine (Afrin) is incorrect because this medication is a decongestant.
Global Rationale: Azelastine (Astelin) is approved for non-allergic rhinitis. Although it is a first-generation agent, azelastine causes less drowsiness than do others in its class because it is applied locally to the nasal mucosa, and limited systemic absorption occurs. Olopatadine (Patanase) is a second-generation antihistamine approved in 2008 for allergic rhinitis. Loratadine (Claritin) is incorrect because it is not available as a nasal spray. Diphenhydramine (Benadryl) is incorrect because it is not available as a nasal spray. Neo-synephrine (Afrin) is incorrect because this medication is a decongenstant.
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