29- drugs used to treat upper respiratory disease Flashcards
Nasal structures innervated by which system
Autonomic nervous system
Cholinergic stimulations cause what to blood vessels lining nasal mucosa
 Vasodilation
Sympathetic, primarily, alpha- adrenergic, stimulation causes what
 Vasoconstriction
Cholinergic fibers also innervate secretory glands, when stimulated they produce what in nostrils
 Serous and mucus secretions
Inflammation of nasal mucosa, as a result of allergic reaction is called what
Allergic rhinitis
What happens when large amounts of histamine is released?
Extensive arterial dilation, hypotension, skin flushes becomes edematous, itching, construction and spasm of bronchial tubes. Make breathing difficult, pulmonary and gastric secretions released.
What is rhinitis medicamentosa
Overuse of topical decongestants, leading to rebound effect. Secondary congestion, caused by excessive vasodilation of blood vessels and direct irritation of nasal membranes by solution.
Anti-inflammatory agents used in AR
Corticosteroids and cromolyn sodium
When are anti-inflammatory agents, corticosteroids and cromolyn sodium, used?
When antihistamines and sympathomimetic agents do not work
Nasal decongestants, provide temporary relief of symptoms, what should be included in patient education
Read label carefully, initially symptoms will be relieved. Do not miss use or use excessively as it may cause rebound swelling.
Why should patients with hypertension, hyperthyroidism, diabetes, cardiac disease, increased, intraocular pressure, or prostatic hyperplasia use caution when, taking an oral alpha-adrenergic agent nasal decongestant
Alpha-adrenergic agents can stimulate the alpha receptors at other sites of the body
What should a patient do if they experience rebound swelling
Stop topical nasal decongestant at once
Common adverse effect in the respiratory system for sympathomimetic decongestant- what can be used to help
Mild nasal irritation, burning or stinging, may be avoided by using a weaker solution- use nasal saline spray for nasal irritation
What effect does sympathomimetic decongestant have on the cardiovascular system? Pts on what medication should avoid these decongestants
May result in significant hypertension, patients on anti-hypertensive medication should avoid using decongests
Are oral antihistamines recommended as first line or second line agents in patients with mild symptoms of AR or those with sneezing and itching as a primary complaint
First line
This first line agent reduces rhinorrhea, lacrimation, nasal and conjunctival pruritus, and sneezing, but does not stop nasal congestion
Oral antihistamines
Do antihistamines work best if taken on a scheduled basis or as needed during the allergy season?
Scheduled basis - they are most effective taken 45 to 60 minutes before exposure to the allergen
Which is least sedating antihistamine -first or second generation
Second generation
Azelastine, fexofenadine, loratadine, cetirizine, levocetirizine, and desloratadine: what is the dug class? Are they first or second generation? Are they the most or the least sedating?
Second generation, antihistamines, least sedating
Antihistamines have what kind of effect on the respiratory system- what should be done about the effect
Drying affect. Cough and sputum must be monitored. Give adequate fluids and increase diet fiber concurrently with anti-histamines.
What visual effect does antihistamines have on anti-cholinergic receptors
Blurred vision may occur. Caution patients on their personal safety.
Can antihistamines be taken with prescribed medication’s?
Not without doctors approval
Intranasal corticosteroids are the most effective pharmacologic therapy for AR, Why should systemic corticosteroids be avoided?
Because of their adverse systemic effects
Beclomethasone (Beconase Q), budesonide, fluticasone (Flonase), flunisolide are highly effective (t)_______ (a)_______ (a)_______ (s)_______ with few adverse effects
Topically active aerosol steroids
