T3-Allergic Rhinitis, Colds, and Coughs-MJ

Question 1

What are the three main topics of this lesson?

Answer 1

Intranasal glucocorticoids
Sympathomimetics (decongestants)
Cough medicines

Question 2

The intranasal glucocorticoids have inhibitory effects on what 6 things?

Answer 2

Histamine
Cytokines
Prostaglandins
Tryptases
Chemokines
Leukotrienes

Question 3

What are two common examples of intranasal glucocorticoids?

Answer 3

Mometasone

Fluticasone

Question 4

What are two adverse effects of intranasal glucocorticoids?

Answer 4

Epistaxis

Increased risk of URI

Question 5

Adverse effect of intranasal glucocorticoids: Epistaxis

What is this and why does it happen?

Answer 5

Epistaxis is a nose bleed. It happens because the intranasal glucocorticoid nose spray dries up the nasal mucosa and can cause nose bleeds

Question 6

Adverse effect of intranasal glucocorticoids: Increased risk of URI

Why is there an increased risk of an upper respiratory infection when taking a intranasal glucocorticoid?

Answer 6

A glucocorticoid is a steroid

Steroids weaken the immune response, so that leads to an increase risk for infection

Question 7

How do you administer intranasal glucocorticoids? (5 steps)

Answer 7

1. Clear out nostrils (blow nose)
2. Tilt head FORWARD, close on nostril
3. Spray into nostril while breathing in SLOWLY
4. Repeat in other nostril
5. Clean applicator (can clean off with tissue)

Question 8

Are intranasal glucocorticoids PRN?

Answer 8

No, these should be taken daily

Question 9

What do the sympathomimetics work on?

Answer 9

The sympathetic nervous system (flight or flight). The work on alpha1, beta1, and beta2 receptors but PRIMARILY effects are on the alpha1

Question 10

What is the MOA of sympathomimetics?

Answer 10

Working on the alpha1 adrenergic receptors (arteries that are vasodilated-which is why it is a stuffy nose)

Question 11

Sympathomimetics: What happens when the alpha1 adrenergic receptors are stimulated?

Answer 11

Vasoconstriction–makes it easier to breathe!

Question 12

Sympathomimetics: Is there any beta stimulation with these drugs?

Answer 12

Yes

Question 13

What are two common examples of sympathomimetics?

Answer 13

Pseudoephedrine

Phenylephrine

Question 14

Sympathomimetics: What are the adverse effects?

Answer 14

CNS excitation (oral sympathos)–[restlessness, irritability, anxiety, insomnia]

Cardiovascular effects- Alpha1 receptors are activated on systemic blood vessels, and that can cause WIDESPREAD vasoconstriction
*Hazardous for people with heart problems

Question 15

Sympathomimetics: Rebound congestion strategies. What are they?

Answer 15

1. Abrupt withdrawal
2. Discontinue one nostril at a time
3. Starting intranasal glucocorticoid (best option)

Question 16

Cough medicines: What are the 3 common antitussives?

Answer 16

Codeine
Hydrocodone
Dextromethorphan

Question 17

Cough medicines: Codeine

What kind of drug is this?

Answer 17

Prodrug

Question 18

Cough medicines: What is hydrocodone?

Answer 18

A pain med that is also a really good cough suppressant

Question 19

Cough meds: How is dextromethorphan a drug of abuse?

Answer 19

Robotripping

Question 20

Dextromethorphan: What are the robotripping effects?

Answer 20

Hallucinations
Slurred speech 
Lethargy
Euphoria
Resp. Depression

Question 21

Cough meds: Is dextromethorphan a clean or dirty drug?

Answer 21

Dirty–activates a lot of receptors–one of which is serotonin

Question 22

Cough meds: Dextromethorphan acts on a lot of receptors, one of which is serotonin. What does that mean?

Answer 22

There is risk for serotonin syndrome

Question 23

What is guaifenesin?

Answer 23

An expectorant

Question 24

Guaifenesin: What is an expectorant?

Answer 24

Helps make thins secretions so you can cough them up