Drugs Dfornallergic Rhinitis And The Common Cold Flashcards
Diphenhydramine
Therapeutic:
drug to treat allergies
Class:
H1- receptor antagonist: antihistamine
Mechanism of action:
histamine (H1) receptor blocker (1st gen); fexofenadine (Allegra) (2nd gen)
Actions and uses:
first gen H1 receptor antagonist whose primary use is to treat minor symptoms of allergy and the common cold such as sneezing, runny nose, and teary eyes. It is often combined with an analgesic, decongestant or expectorant in OTC cold and fly products. It is also administers termed to treat rashes and IM and IV for severe allergic reaction. Other reasons are for Parkinson’s disease, motion sickness, and insomnia
Risks:
anaphylactic schlock if the drug is administered parenterally; IV is only 25mg to reduce the risk of shock; IM inject to a large muscle to minimize tissue irritation; pregnancy category C
Pharmacokinetics:
one set (15-30min) ; peak (1-4hr); duration (4-7hr)
Adverse effects:
first gen H1 antagonists such as diphenhydramine cause significant drowsiness. Excitation is more frequent in children than adults. Anticholinergic effects such as dry mouth, tachycardia, and mild hypotension occur in some patients. Diphenhydramine may cause photosensitivity
Contraindications:
hypersensitivity to the drug, BPH, narrow angle glucose, GI obstruction of use. Should be used cautiously in patients with asthma or hyperthyroidism
INTERACTIONS —-
drug to drug:
use with CNS depressants, such as alcohol or opioids, will increase sedation. Other OTC Cold preparations may increase anticholinergic side effects. Monoamine oxidase inhibitors (MAOIs) may chase hypertensive crisis
Lab test:
drug should be discontinues at least4 days prior to skin allergy test bc false negative tests may result
Herbal/foods:
henbane may cause increased anticholinergic effects
Treatment for overdose :
overdosed may cause their cns depression or excitation there is no specific treatment for overdose
Fluticasone
Therapeutic class :
drug for allergic rhinitis, asthma, and skin inflammation
Pharmacological class:
corticosteroid
Mechanism of action :
decreases local inflammation in nasal, passages reducing nasal stuffiness
Actions and uses :
intranasal corticosteroid used to treat seasonal allergic rhinitis. Begins with two sprays in each nostril (twice daily) and decrease to one dose per day. Fluticasone is available in oral inhalation and topical. Flovent is administered by oral inhalation or reduce
risks:
pregnancy category C (fetus can have adverse effects and there are no well studies)
Pharmacokinetics:
onset - 12 h to several days
peak- unknown
duration- several days
adverse effect:
are rare. Swallowing large amounts increases the potential for systemic corticosteroid adverse effects. Nasal irritation and epistaxis occur in a small number of patients. When inhaled to treat asthma or COPD, the most frequent side effects are headache and nasopharyngitis.
Contraindications:
prior hypersensitivity to the drug. Because corticosteroids can mask signs of infection, patients with known bacterial, viral, fungal, or parasitic infections (especially of the respiratory tract)
should not receive intranasal corticosteroids.
Interactions—>
drug to drug:
associated with the use of an intranasal
decongestant increases the risk of nasal irritation or
bleeding. Use with ritonavir should be avoided because this drug significantly increases plasma fluticasone levels.
Lab test: unknown
herbal/food:
Use with caution with licorice, which may
potentiate the effects of corticosteroids.
Treatment of overdose:
no specific treatment
oxymetazoline
Therapeutic Class:
Nasal decongestant
Pharmacologic Class:
Sympathomimetic
Mechanism of Action and Uses:
Treat nasal congestion by activating alpha-adrenergic receptors in the sympathetic nervous system causing arterioles in the nasal passages to constrict drying the mucous membranes. Relief from nasal congestion occurs within minutes and lasts for 10 or
more hours. Oxymetazoline is administered with a metered spray device or by nasal drops.
Oxymetazoline (Visine L R) is also available as eyedrops. It causes vasoconstriction of vessels in the eye and is used to relieve redness and provide relief from dryness and minor eye irritations.
risks:
hand hygiene to prevent anisocoria (blurred vision and unequal pupil size)
Pharmacokinetics:
onset- 5-10min
peak- unknown
duration- 6-10 hrs
Adverse effects:
Rebound congestion is common when oxymetazoline is used for longer than 3 to 5 days. Minor stinging and dryness in the nasal mucosa may be experienced. Systemic adverse effects are unlikely, unless a large amount of the medicine is swallowed.
contraindication:
Patients with thyroid disorders,
hypertension, diabetes, or heart disease should use
sympathomimetics only on the direction of their healthcare provider.
interactions—>
drug to drug:
No clinically important interactions occur because absorption of oxymetazoline is limited.
lab test: unknown
herbal/food:
use with caution herbal supplements
treatment of overdose:
no treatment
dextromethorphan
Therapeutic Class:
Cough suppressant
Pharmacologic Class:
Centrally-acting antitussive
Mechanism of action and uses:
It acts in the medulla to inhibit the cough reflex.
Actions and Uses:
Dextromethorphan is a nonopioid drug that is
a component in many OTC severe cold and flu preparations. It is available in a large variety of formulations. It has a rapid onset of
action, usually within 15 to 30 minutes. Like codeine, it acts in the medulla, although it lacks the analgesic and euphoric effects of the opioids and does not produce dependence. Patients whose
cough is not relieved by dextromethorphan after several days of therapy should notify their healthcare provider.
Risk:
-avoid pulmonary irritant (smoking and fumes) = decrease drug effectiveness
-pregnancy category C
Pharmacokinetics
onset- 15-30min
peak- unknown
duration: 3-8hrs
adverse effects:
Are rare. Dizziness, drowsiness, and GI upset occur in some patients. In abuse situations, the drug can cause CNS toxicity with a wide variety of symptoms, including slurred speech, ataxia, hyperexcitability,
stupor, respiratory depression, seizures, coma, and toxic psychosis.
Contraindications:
Dextromethorphan is contraindicated in the treatment of chronic cough due to excessive bronchial secretions
(asthma, smoking, and emphysema. Suppressing the
cough reflex is not desirable in these patients. The FDA has issued advisories that nonprescription cough and cold products (including those containing dextromethorphan) not be used in children under 6
years of age and that they be used with extreme caution in all children.
Interactions—>
drug to drug:
excitation, hypotension, and hyperpyrexia when used concurrently with MAO Is. Use with alcohol, opioids, or other C N S depressants may result in sedation.
lab tests: unknown
herbal/food:
grapefruit juice can raise serum levels of dextromethorphan and cause toxicity
Treatment of overdose:
no
