Antihistamines; decongestants; antitussives; expectorants Flashcards
Treatment of common cold:
symptomatic only; not curative
Treatment of common cold is considered
empiric therapy: treating the most likely cause
Antihistamine effects:
Anticholingeric; drying effect; sedative
Why give nasal decongestants?
Acute/chronic rhinitis Common cold Sinusitis Hay Fever Other allergies
Which nasal decongestants raise BP?
Monoamine oxidase inhibitors (MOIs) & Sympathomimetic
Nasal steroids have:
anti-inflammatory effect
Andrenergics do what?
constrict small blood vessels; better draining
Drug interactions with loratadine
Ketoconazole
Cimetidine
Erythromycin
Drug Interactions with Diphehydramine
Alcohol
MAOIs
CNS depressants
Mechanism of the drug interactions of loratadine
inhibits metabolism & increases loratadine levels
Mechanism of drug interactions of diphenhydramine?
Additive effects & increased CNS depression
When do you take diphenhydramine
25-50 mg @ bedtime as needed for short term use
Indications for loratadine (claritin)
Allergic rhinitis & chronic urticaria
Non-sedating antihistamines does not what?
crossss blood brain barrier like other antihistamines
What are non sedating antihistamines called also?
peripherally acting antihistamines
rebound decongestion occurs with
inhaled decongestants
Intranasal steroids are not associated with
rebound congestion
Adrenergic are considered what because of what?
sympathomimetics; sympathetic nervous system; constriction of BV
Oral decongestants have what effect?
Prolonged effect but delayed onset
Oral decongestants last what?
longer than inhalants & NO REBOUND CONGESTION
Topical adrenergic are what?
prompt onset & potent
Topic adrenergic (phenylephrine) can be sustained use over
several days but CAUSES REBOUND CONGESTION
Inhaled decongestant is not associated with
rebound congestion
Inhaled decongestants are mostly used for
prevention of nasal congestion
Systemic sympathomimetic drugs & sympathomimetic nasal decongestants are likely to cause
Drug toxicity when given together
Antitussives are used only for
nonproductive coughs aka dry cough
Antitussives may be used when:
coughing is harmful or used to stop cough reflex when cough is nonproductive or harmful
Codeine is used in
combo with other respiratory meds to control coughs
Codeine alone without a combo drug is considered a
schedule II drug
Codeine-containing cough suppressants are what schedule of drug?
V
Contraindications for Codeine
Respiratory depression
Increased intracranial pressure
Seizure disorders
Dextromethorphan is
safe, non addicting & does not contain CNS depression
Dextromethorphan contraindicated
Asthma/emphysema
Persistent headache
stop antihistamines how many days prior before an allergy test?
4 days
dextro
benzo
non opioid antitussive drugs
Contraindications of antitussive drugs
drug allergy
hypothyroidism
respiratory depression
opioid dependency
report to doc if what happens with antitussives?
cough more than 1 week
fever
rash
persistent headache
Adrenergic adverse effects
nervousness
insomnia
palpatations
tremors
contraindications of nasal decongestants
Drug allergy narrow eye glaucoma CVD, HTN Diabetes hyperthyrodisim long standing asthma
Topical nasal adregenic
phenylephrine
Oral adrenergic
Pseudoephedrine (Sudafed)
