-Your patient calls and is worried because his antihistaminehas not taken away the hives he broke

-Your patient calls and is worried because his antihistaminehas not taken away the hives he broke out with today. What do you tell him? Histamine levels are especially high in the skin, lungs, and gastrointestinal (GI) tract and are responsible for the allergic reaction on the second-time allergen exposure. Histamine acts primarily through two types of receptors, histamine-1 and histamine-2 and the response produced depend on which of these receptors are involved (Rosenthal & Burchum, 2021). The symptoms of mild allergy (e.g., itching, localized edema) are mainly caused by histamine acting at H1 receptors. Antihistamine is drugs that help treat allergic reaction and, in this case, it is the H1 antagonist which blocks the action of histamine at H1 receptors. By blocking histamine at sensory nerves, H1 antagonists reduce itching and pain. Depending on what antihistamine the patient took, antihistamine usually takes effect within few hours while others may take a couple of days and as long as it is not getting worse and that no additional symptoms are appearing such as shortness of breath, he just need to wait for the medication to work. Advice the patient to call the office or call 911 if new symptoms appear and the hives are getting worse. And it can be beneficial to prescribe anti-inflammatory drugs, such as oral corticosteroid drugs (e.g., prednisone) to reduce the swelling, redness, and itching (Mayo Foundation for Medical Education and Research, 2019)  -Your patient works at a garden nursery and has seasonal allergies. Which antihistamine do you recommend while working, Benadryl or Claritin? For a patient with seasonal allergy, the best option is to prescribe a Second-Generation (Nonsedating) Histamine-1 Antagonist such as Claritin. Benadryl is one of the First-Generation Histamine-1 Antagonists. One of the downsides of using a First-Generation Histamine-1 Antagonist is its sedating effect because of CNS depression (Rosenthal & Burchum, 2021). This can cause a significant problem especially for a patient who works at a garden nursery. On the other hand, Second-Generation (Nonsedating) Histamine-1 Antagonist produces much less sedation than the First-Generation because Second-Generation agents cross the blood-brain barrier poorly and they have a low affinity for H1 receptors of the CNS (Rosenthal & Burchum, 2021).  -A patient presents at the clinic with s/s of Guillain-Barre Syndrome, which vaccine may be associated with this condition? Meningococcal Conjugate Vaccine (MCV) (e.g., Menactra, Menveo, Bexsero, Trumenda) may be associated with Guillain-Barre Syndrome (Rosenthal & Burchum, 2021). This vaccine is use to prevent infection by Neisseria meningitis (Center for Disease Control and Prevention (CDC), 2019).  -A patient is diagnosed with Scabies, she asks if an OTC medication like RID will work. What is your response? The simple answer to this question is NO. Scabies is a contagious skin disease caused by Sarcoptes scabiei and is transmitted by close personal contact. Symptoms include burrows, papules, and vesicular lesions with severe itching that worsens at night and usually appears 3 to 5 weeks after infestation (McCance & Huether, 2019). Products used to treat scabies are called scabicides and are available only with a doctor’s prescription because there are no over-the-counter products have been tested and approved to treat scabies. Permethrin is the drug of choice for the treatment of scabies (Center for Disease Control and Prevention (CDC), 2018).  -The patient is allergic to Sulfa drugs, how will this affect the medication choice for Herpes? Acyclovir is the drug of choice for most infections caused by the Herpes simplex virus (HSV) and varicella zoster virus (VZV) which are members of the herpesvirus group. Acyclovir inhibits viral replication by suppressing the viral synthesis of the virus (Rosenthal & Burchum, 2021). Allergic and other adverse reactions to oral acyclovir are rare and after reviewing all possible research articles, the author did not find any relationship between sulfa and antiviral medication such as acyclovir. So, patients who are allergic to sulfa can take antiviral medications such as acyclovir.  -You are considering prescribing Penicillin for your patient, what is extremely important to assess first and why? Before prescribing Penicillin to a patient, the most important question to ask is if the patient is allergic to penicillin because penicillins are the most common cause of drug allergy and the severity of the reaction can range from a minor rash to life-threatening anaphylaxis (Rosenthal & Burchum, 2021). Because of cross-sensitivity, allergy to one penicillin should be considered allergic to other penicillins. The use of cephalosporins should also be guarded because approximately 1% of patients who are allergic to penicillin have cross-sensitivity to cephalosporins (Rosenthal & Burchum, 2021).Needs a peer response from a student nurse practitioner’s point of view with references Health Science Science Nursing NURSING MSN 571 Share QuestionEmailCopy link Comments (0)