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318: CH. 76

Drugs for Allergic Rhinitis, cough and cold

QuestionAnswer
What is allergic rhinitis? ALlergic rhinitis is an inflammatory disorder affecting upper/lower airways and eyes. it is IMMUNE MEDIATED.
s/s allergic rhinitis sneezing, rhinorrhea, pruritus, nasal congestion
why does one experience nasal congestion when they have allergic rhinitis? nasal congestion is caused by vasodilation and increased permeability of nasal blood vessels (H1)
What are the 2 forms of allergic rhinitis? seasonal and perennial
what are other names for seasonal allergic rhinitis? hay fever, rose fever
which of the 2 allergic rhinitis' occur in the spring/fall in rxn to OUTDOOR allergens? seasonal
which of the 2 allergic rhinitis' occur in response to INDOOR allergens? perennial
What are 4 drugs used for Allergic rhinitis? (1) intranasal glucocorticoids, (2) oral antihistamines (3) intranasal antihistamines (4) intranasal chromolyn sodium.
what are the most effective drugs for prevention and treatment of seasonal and perennial rhinitis? intranasal glucocorticoids.
Why are intranasal glucocorticoids the most effective drugs at preventing rhinitis? because they can prevent or suppress ALL of the major s/s of allergic rhinitis. (congestion is not suppressed by antihistamines)
what are the side effects of intranasal glucocorticoids? drying of nasal mucosa, burning/itching sensation, sore throat, nosebleed
what is Epistaxis? nosebleed?
what are the first line drugs for allergic rhinitis? oral antihistamines.
what s/s can oral antihistamines relieve? sneezing, rhinorrhea, nasal itching. NOT nasal congestion, NOT helpful for common cold.
When should antihistamines be taken (not time of day)? PRIOR to exposure. they work better prophylactically.
What are the side effects of oral antihistamines? sedation, anticholinergic effects
compare the benefits of oral and intranasal antihistamines. they have equivalent benefits.
what are the side effects of intranasal antihistamines? BITTER TASTE IN MOUTH, NON-SEDATING, nose bleeds, headaches
what is intranasal chromolyn sodium used for? allergic rhinitis (safe but only moderately effective) and the common cold.
what is the mechanism of action for intranasal chromolyn sodium? suppresses release of histamine from mast cells. safe but not as effective as intranasal glucocorticoids.
how are sympathomimetics (decongstants) administered? ORAL (act longer more systemic effects) NASAL (spray or drops)
what is the mechanism of action for decongestants? reduce nasal congestion by activating ALPHA1 adrenergic receptors on nasal blood vessels. NO EFFECTS on sneezing/itching etc.
what are decongestants used for? rhinitis and colds
what are the side effects of decongestants? rebound congestion, CNS stimulation, widespread vasoconstriction, hemorrhagic stroke, abuse
what is rebound congestion? with prolonged use, the effects of each application ware off and congestion becomes progressively worse. to overcome, the pt must take progressively larger and more frequent doses to achieve therapeutic outcomes.
How can the cycle of rebound congsetion be broken? abrupt withdraw (or 1 nostril at a time)
how can you avoid rebound decongestion? use smallest dose as short as possible.
Who (3) would you NOT want to administer an antitussive? you would NOT want to suppress the cough in a pt with COPD, post surgery, pneumonia/bacterial infection in lungs
What are the 2 types of antitussives? opioid and inonopioid
what is the opioid antitussive? codine
how is codine administered when being used as an antitussive? oral
what are the nonopioid antitussive medications? Dextromethorphan and Diphenhydramine
Created by: 1398660434
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