Antihistamines, etc. Flashcards
What causes most common colds
A viral infection (influenza or rhinovirus)
What happens when you get the common cold (physiology)
Virus invades mucosa of URT causing infection
Inflammatory response causes excessive mucus production
Mucus drips down pharynx into the LRT and esophagus causing sore throat, coughing and an upset stomach
Irritation also dilates small blood vessels in nasal sinuses causing congestion and sneezing
How is the common cold treated
Treatment is symptomatic only and not curative (Empirical)
Combo of antihistamines, decongestants, antitussives and expectorants
T/F: Cough and cold products should be given to children 6 years or younger
False: They should not be given to them
Name 2 antihistamines
Loratadine (claritin) and Diphenhydramine (benadryl)
What is the MOA of antihistamines
Histamine antagonist or H1 blocker
Compete with histamine for H1 receptor sites
Binds and prevents further release of histamine
What are the indications of antihistamines
Rhinitis
Anaphylaxis
Symptoms of common colds
Urticaria (hives)
Vertigo
Insomnia
When are antihistamines most effective
When they are given early in histamine mediated reactions
What are the contraindications of antihistamines
Narrow angle glaucoma
Heart disease
HTN
COPD
Peptic ulcer disease
Seizure disorders
BPH
Pregnancy
T/F: Antihistamines should not be used as sole therapy in acute asthma attacks
True
Loratadine (Claritin) is not recommended in children under _________
2 years
What are the adverse effects of antihistamines
Drowsiness
Dry mouth
DIfficulty urinating
Constipation
Vision changes
What are possible drug interactions with antihistamines
Ketoconazole, Cimetidine, Erythromycin can increase concentrations of loratadine
Alcohol, CNS depressants, MAOIs increase depressant effects of diphenhydramine
What is nasal congestion and what are the 2 primary causes
Excessive nasal secretions and inflamed nasal mucosa
Allergies and Upper respiratory infection
What are the 3 classes of decongestants
Adrenergics (sympathomimetics)
Anticholinergics (parasympatholytics)
Corticosteroids
What are 2 adrenergic decongestants
Pseudoephedrine oral
Oxymetazoline HCL nasal spray
Name an anticholinergic decongestant
Ipratropium
What are 3 corticosteroid decongestants
Fluticasone propionate nasal spray
Beclomethasone dipropionate nasal spray
Budenoside
What is the MOA of adrenergic decongestants
Constrict small arterioles to reduce swelling and allow secretions to drain
How do anticholinergic decongestants work
Inhibit secretion of serous and mucous membranes in the nasal passage
How do corticosteroid decongestants work
Target inflammatory response to turn off cell response
What are the contraindications of decongestants
Narrow angle glaucoma
Uncontrolled cardiovascular disease
HTN, Diabetes, BPH
Hyperthyroidism
Inability to close eyes
Asthma
What are the adverse effects of adrenergic decongestants (PINT)
Palpitations
Insomnia
Nervousness
Trauma
What is the MOA for antitussives
Suppress the cough reflex and dries mucosa (increases mucous viscosity)
What are the 2 types of antitussives and name an example of each
Opioid: Codeine
Nonopioid: Dextromethorphan hydrobromide
What is the main difference between opioid and non opioid antitussives
Opioids provide analgesia
What are the contraindications of antitussives
Opioid dependency
Respiratory depression
Alcohol
CNS depression
Anoxia
Hypercapnia
COPD
Impaired kidney & liver function
Increased intracranial pressure
Hyperthyroidism
HTN
Glaucoma
What are adverse effects of antitussives
Sedation
Dizziness
Constipation
What are possible drug interactions with antitussives
Other opioids
Anesthetics
Tranquilizers
Sedatives
Hypnotics
MAOIs
Alcohol
What is the MOA of expectorants
Aid in expectoration (coughing up) of excessive mucous by loosening and thinning the secretions to unstick them from airways
Name 1 expectorant
Guaifenesin
What are the indications of expectorants
Relief of productive cough
What are the contraindications of expectorants
Hyperkalemia
What are the adverse effects of expectorants
Very minor:
Nausea
Vomiting
Gastric irritation
What should patients take with expectorants to aid the drug
More fluids to loosen and liquify secretions
