Rhinitis, Coughs, Colds & Flu Flashcards
Rhinitis?
Inflammation of nasal mucous membranes
What are the two different kinds of rhinitis?
- Infectious
-Viral(colds and flu)
-Bacterial(sinusitis0 - Non-infectious:
-Allergic
-Non-allergic(vasomotor)
What is bacterial sinusitis treated with?
Treated with appropriate antibiotics & nasal irrigation(saline solution) sprays
Which immunoglobulins mediate Rhinitis?
IgE
Non-allergic rhinitis
Vasomotor or chronic?
Chronic
Symptoms of non-allergic rhinitis?
-Sneezing & Congestion
-Rhinitis
-Postnasal drip
-Phlegm
-Cough
Aetiology of non-allergic rhinitis?
Hyper-responsiveness of the nerve endings in the nostril
Triggers of non-allergic rhinitis?
-Odours
-Irritation in the air(smoke)
-Changes in the weather
-Medication(aspirin, beta-blockers, sedatives and antidepressants)
-Foods & beverages(alcohol)
-Hormonal changes
What is the treatment of non-allergic rhinitis?
-Nasal-corticosteriods
-Short-term decongestant
Allergic rhinitis symptoms?
-Itching
-Sneezing
-Rhinorrhea & ocular symptoms
-Little effect on congetsion
Which second generation antihistamines treat allergic rhinitis ?
Loratadine
Cetirizine
Fexofenadine
Rupatadine
Which receptor (classification) does the Rupatadine receptor act on?
Antagonist at the PAF receptor-G-coupled receptor
When is Rupatadine effective and what is its usage?
Early and late phase
&
Long lasting H1-antagonist
Intranasal corticosteroids drugs antihistamines?
A Long Nose
-Azelastine
-Levocabastine
-intraNasal corticosteroids
Cromoglyic acid?
Intermittent allergic rhinitis
Intranasal corticosteroids uses?
-Anti-inflammatory action
-Decreased mucosal oedema
-Decreased number of mast cells
Intranasal corticosteroids systemic effects?
Little Systemic effect
Intranasal corticosteroids S/E?
-Dry nose
-Nasal bleeding
-Irritation of the throat
-Transient stinging
-Adrenal suppression(excessive use)
Intranasal corticosteroids drugs?
BBF-CTM
Beclomethasone
Budesonide
Fluticasone
Ciclesonide
Triamcinolene
Mometasone
Which antihistamines can not be used for children?
Intranasal corticosteroids
esp: Beclomethasone
What are nasal preps?
- Mesna(Mistabron)
-Used for nasal obstruction dur to thick secretions
2.Sodium chloride(saline drops/spray)
-Safe to use in pregnancy, infants, babies and children under two
Which drug is safe to use in children under two?
Sodium Chloride
Types of influenza medication?
- Neurominidase inhibitor(Influenza A & B)
- NMDA-receptor antagonist
(Influenza A only)
Neurominidase inhibitor drugs?
Oseltamivir
Zanamivir
Neurominidase inhibitor MOA?
Inhibit the neurominidase(sialidase) enzyme in both influenza A and B virus
Neurominidase inhibitor indications?
-Used for prevention and treatment
-Ability to limit the spread of the viral infection but only modest reduction in the symptoms duration
Neurominidase inhibitor admin time?
Should be taken within 24-48hrs of the onset of symptoms
NMDA-receptor antagonists drugs?
Amantadine
Rimantadine
NMDA-receptor indications?
-Influenza A only
-Used for the prevention and treatment
NMDA-receptor MOA?
M2 protein-selective ion channel of the influenza A but ineffective agonist influenza B
What limits the usefulness of NMDA?
Widespread viral resistance and unwanted S/E limit the usefulness
Vaccine S/E?
-Flu-like symptoms within 2-24hrs after vaccination
-Pain and treatment at the site of the infection
Vaccine ADR?
Allergic reactions
Antitussive agents?
Cough suppressant mechanism to clear the throat of foreign particles and mucus
Antitussive agents drugs?
Opiodanalgesics (dextromethaphan, codeine, pholcodeine)
Antitussive agents S/E?
Sedation, constipation and nausea
Demulgents?
Consists of sugar, lemon, honey and glycerol
Demulgents increases what?
Saliva production and swallowing
Demulgent indication?
Useful for a dry irritated throat?
Expectorants?
Chesty coughs and increase the volume of bronchial secretions and reduces viscosity
Expectorants drugs?
GAS
Guaiphenesin
Ammonium citrate
Sodium Citrate
Mucolytic agents?
Alters the structure of mucus and decreases viscosity
Mucolytic agents drugs?
Nose Come Back
Carbocisteine
Bromhexine
N-acetylcysteine
Mucolytic agents S/E?
Nausea, vomiting and headaches
Which mucolytic agent is used in cystic fibrosis?
Dornase alfaf
Mucokinetics/Bronchodilators
Enhance mucocillary function
Mucokinetics/Bronchodilators CI?
Cardiac arrhythmia
Diabetes
Hyperthyroidism
Uncontrolled HT
Mucokinetics/Bronchodilators drugs?
B2 adrenergic agonists: terbutaline, orciprenaline
Xanthines: eg: theophylline
Decongestants time uses and why?
Only short-term(4-5days) for periods of congestion
DON’T USE OVER 5 days
Local decongestants drugs?
Oxymetazoline
Xylmetazoline
Phenylephrine
What are drug induced overuse of decongestant nasal sprays?
Pseudoephedrine
Which mucolytic agent splits disulphide bonds into mucoproteins?
Acetylcysteine/N-acetylcysteine
Which mucolytic agent is used in cystic fibrosis?
Acetylcysteine/N-acetylcysteine
Dornase alfa side effect?
May cause voice alterations
What is the durations the nasal decongestants?
Short duration: Phenylephrine
Longer duration:
Oxymetazoline & Xylometazoline
MOA of nasal decongestants?
Alpha-1 adrenergic receptor: Phenylephrine, Oxymetazoline & Xylometazoline
Mixed-action adrenergic agonist(alpha-1 and beta-2)- Ephedrine + Phenylpropanolaime