Question

Mr. Hagrid works as an animal caretaker for Hogwarts, the local boarding school. He enjoys his job and loves tending to the school's animals. However, he is visiting you at the clinic today to discuss his allergies and wants your professional opinion. Mr. Hagrid has a history of allergic rhinitis with rhinorrhea, itching throat, watery eyes, and sneezing when in the presence of cats. His co-worker Mr. Filch, who lives and works at the boarding school, owns a cat named "Mrs. Norris", who seems to follow him everywhere. Because Mr. Hagrid and Mr. Filch work together every day, Mr. Hagrid has been taking antihistamines for several months, but this regimen does not seem to be working as well as it once did.

1. What do you tell Mr. Hagrid about drug tolerance with antihistamines?

2. Would you as a health care professional suggest that Mr. Hagrid use an oral antihistamine or use an oral decongestant to treat his symptoms? Explain why you would chose one instead of the other.

Because "Mrs. Norris" the cat is aggravating his allergies and the oral antihistamines haven't been working as well, Mr. Hagrid has also been using a nasal decongestant spray several times daily for the past few weeks. He tells you the nasal spray does not seem to be helping anymore, even though he has increased the amount of sprays he is using. Mr. Hagrid is desperately looking to you for a solution to his allergy problem or he says that "as for that cat, 'Mrs. Norris', I'd like to introduce her to my dog Fang sometime".

3. How do you explain the reaction Mr. Hagrid is having to the nasal spray?

4. Would you expect Mr. Hagrid to be able to continue to use the nasal spray without interruption? Why or why not?

Answer 1

1).

The term “antihistamines” refers to the drugs that prevent the release of histamine, which is one of the inflammatory mediators. Antihistamines help in relieving sneezing, runny nose, itchiness, and rashes.

Tolerance is the decreased response of the body towards the drug with repeated administration. Means, the patient needs more quantity of the drug to produce the same therapeutic response as before.

With repeated administration, antihistamines cause drug tolerance (due to the receptor downregulation). So, the drug tolerance might be the cause of reduced drug response in Mr. Hagrid