Drugs for Rhinitis, Cough, and Colds Flashcards
Allergic rhinitis
Release of histamine1, leukotrienes, & prostaglandins cause inflammatory response leading to: Inflammatory disorder of the upper airway, lower airway, and eyes
Allergic rhinitis symptoms
Sneezing; Rhinorrhea; Pruritus; Nasal congestion
Antihistamines
First-line drugs that relieve sneezing, rhinorrhea, nasal itching
Antihistamines do not
reduce nasal congestion
Antihistamines are most effective when
taken prophylactically
Antihistamines 1st generation
diphenhydramine (Benadryl), cyproheptadine (Periactin), chlorpheniramine (Chlor-Trimeton)
Antihistamines 1st generation adverse effects
Sedation, Anticholinergic effects-dry mouth, constipation, urinary retention, increased heart rate
rhinitis means
inflammation of the nasal passages
antihistamines chemical mediators that cause
inflammatory responses; cause vasodilation (blood vessels become dilated so more fluid and volume, so more is stopped up)
antihistamines release first generation to
keep from runny nose
problem with first generation
sedation
second generation antihistamines
azelastine (Astelin) * only intranasal antihistamine available (bitter taste, somnolence), cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra) [all much better than the first generation]
Glucocorticoids end in
“sone”
Glucocorticoids are
steroids
Intranasal Glucocorticoids:
beclomethasone (Beconase), fluticasone (Flonase)
Intranasal Glucocorticoids prevent and treat
seasonal/perennial rhinitis;now part of 1st line therapy
Intranasal Glucocorticoids are
Anti-inflammatory action blocking histamine, prostaglandin, leukotrienes
Intranasal Glucocorticoids adverse effects
Usually mild; drying of nasal mucosa, burning, sore throat, epistaxis, headache
systemic effects of Intranasal Glucocorticoids are
rare at recommended doses
Nasalcrom
Less effective than intranasal glucocorticoids; Blocks histamine release from mast cells; Best suited for prophylaxis
Intranasal Cromolyn Sodium:
Nasalcrom
Sympathomimetics:
Decongestantsphenylephrine (Neo-synephrine), pseudoephedrine (Sudafed, Afrin), oxymetazoline (Afrin) [not zertex or allergra]
Sympathomimetics reduce
nasal congestion by activating alpha 1 adrenergic receptors on nasal blood vessels
Sympathomimetics major adverse effect
Rebound congestion
limit Sympathomimetics
to 3-5 days use then off for a few days (3 days on 2-3 days off) [there could be scar tissue and long term problems if on med for too long]
other side effects of Sympathomimetics
CNS stimulation; Cardiovascular; Hemorrhagic Stroke
CNS stimulation with sympathomimetics
(more common with oral sympthomimetics) restlesness, insomia, irritability, anxiety; CNS effects may lead these drugs to be drugs of abuse
Cardiovascular effects with sympathomimetics
HTN, tachycardia-use with caution in heart, hypertensive population;
Hemorrhagic Stroke with sympathomimetics
phenylpropanolamine (an alpha adrenergic agent) shown to cause hemorrhagic stroke in women
Anti-histamine/Sympathomimetic Combination Drugs
Loratadine/pseudoephedrine: Claritin D; Fexofenadine/pseudoephedrien: Allegra-D
D in Claritin D and Allegra D
sudafedrin
Antitussives:
opioids suppress cough reflex in brain- codeine, hyrodcodone
Codeine-
most effective; watch for respiratory suppression
For overdose of Codeine-
naloxone (Narcan)
Non-opioid:
dextromethorphan-also acts on the CNS suppressing cough reflex
Expectorants- guaifenesin (Mucinex)
Stimulates flow of secretions, rendering a more productive cough
Mucolytics:
make secretions more watery; helps produce more productive cough- acetylcysteine (Mucomyst), administered by inhalation [makes secretions so then you can cough them out]
