Allergic Rhinitis, Cough, and Colds

Question 0

Allergic Rhinitis

Answer 0

Seasonal and perennial; triggered by airborne allergens > allergens bind to immunogloblulin (Ig)E on mast cells
-Inflammatory mediators released: histamine, leukotrienes, and prostaglandins

Question 1

Allergic Rhinitis

Answer 1

Inflammatory disorder of the upper airway, lower airway, and eyes; symptoms: sneezing, rhinorrhea, pruritus, nasal congestion
-for some people: conjunctivitis, sinusitis, and asthma

Question 2

Classes of drugs used for allergic rhinitis

Answer 2

Oral antihistamines, intranasal glucocorticoids, sympathomimetics (oral and intranasal)

Question 3

Oral antihistamines

Answer 3

For allergic rhinitis; do not reduce nasal congestion, most effective if taken prophylactically
-Adverse effects are mild: sedation with first generation (much less with second generation), anticholinergic effects

Question 4

Azelastine nasal spray

Answer 4

Only intranasal antihistamine available, benefits equal to oral antihistamines, metered-spray device, leaves bitter taste

Question 5

Intranasal glucocorticoids

Answer 5

First choice: most effective for treatment and prevention of rhinitis; mild adverse effects: drying of nasal mucosa or sore throat, rarely systemic effects (adrenal suppression and slowing of linear pediatric growth)

Question 6

Intranasal Cromolyn

Answer 6

Trade: NasalCrom; extremely safe but only moderately effective, suppresses release of histamines from mast cells, best used for prophylaxis, not for treatment
-Response may take 1-2 weeks to develop

Question 7

Sympathomimetics (oral/nasal)

Answer 7

Reduce nasal congestion (do not reduce rhinorrhea, sneezing, or itching); activate alpha1 adrenergic receptors on nasal blood vessels
-Adverse effects: rebound congestion, CNS stimulation, cardiovascular effects and stroke, abuse

Question 8

Symphathomimetics (oral/nasal)

Answer 8

Factors in topical administration: should not use longer than 5 consecutive days; drops vs. sprays
-Phenylephrine, ephedrine, pseudoephedrine; antihistamine-sympathetic combinations: ipratropium bromide (Atrovent), montelukast (singulair), omalizumab (xolair)

Question 9

Drugs for Cough

Answer 9

Antitussives: drugs that supress cough

-Opioid antitussives: codeine and hyrocodone; nonopioid antitussives: dextromethorphan, diphenhydramine

Question 10

Common cold

Answer 10

Acute upper respiratory viral infection; rhinorrhea, nasal congestion, cough, sneeze, sore throat, headache, hoarseness, malaise, myalgia
-Fever common in kids, rare in adults; self limited and usually benign, no cure, just treatment of symptoms

Question 11

OTC cold remedies

Answer 11

Combination cold remedies usually contain two or more of the following: nasal decongestant, antitussive, analgesic, antihistamine (for cholinergic actions), caffeine (to offset effect of antihistamine)

Question 12

Pediatric OTC Cold Remedies

Answer 12

Use with caution in young children; no proof of efficacy or safety but proof of harm
-Avoid in children younger than 2 years old, only use products labeled for pediatric use, consult a healthcare professional before giving to a child, read all product safety information before dosing