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PathopharmA 2

CHAPTER 77 -allergic rhinitis-cough-cold

QuestionAnswer
ALLERGIC RHINITIS HAY FEVER INFLAMMATORY DISORDER OF UPPER , LOWER ARWAY AND EYES S/S =Sneezing-Rhinorrhea-Pruritus-Nasal congestion For some people: Conjunctivitis, sinusitis, and asthma
FACTORS SEASONAL AND PERINNEAL (ANNUAL BASED) TRIGGER BY ALLERGEN(IGE ON MAST CELL0 RELEASE LEUKOTRIENES, HISTAMINE AND PROSTAGLANDINS
TEACHING-INTRANASAL GLUCOCORTICOID FIRST LINE-PREVENT RHINITIS ADR DRYING NASAL MUSCOSA SORE THROAT EPISTATIS (NOSEBLEED) HEADACHE RARELY SYSTEMIC EFFECT9ADRENAL SUPPRESION-SLOWING GROWTH)
TEACHING NOSE-TOES LEAN FORWARD, LOOK DOWN ON TOES=PUFF IN EACH SIDE-SMALL SNIFF BIG SNIFFS WILL GET INTO ESOPHAGUS, NOT IN SINUS SITE
TEACHING-ORAL ANTIHISTAMINE EFFECTIVE PROPHYLACTICLLY DO NOT REDUCE NASAL CONGESTION DECREASE ALLERGIC RESPONSE TAKE MEDICATION BEFORE AND THROUGHOUT ALLERGY SEASON-STOP FOR FALL ALLERGIES SEDATION W/ 1ST GEN. LESS W/ 2ND GEN.
TEACHING-INTRANASAL ANTIHISTAMINE ADULTS+CHILDREN OVER 12 YEARS OLD SYSTEMIC ABSORPTION-DRWOSINESS-NOSEBLEED-BADTASTE(NOSE-TOES) AZELASTINE
TEACHING-INTRANASAL CROMOLYN SODIUM BETTER PROPHYLACTICALLY SUPRESS RELEASE OF HISAMINES AND OTHER INFLAMMATORY MEDIATORS FROM MAST CELLS 1-2 WEEK TO KICK IN
TEACHING-SYMPATHOMIMETICS(DECONGESANTS) REDUCE NASAL CONGESTION, STUFFINESS(NO ITCHING, ALLERGY S/S) ALLERGRA D, ZYTEC D TO TREAT ALLERGY+CONGESTION ACTIVATE ALPHA1 ADRENERGIC RECEPTOR ON NASAL BLOOD VESSEL-VASOCONSTRITION-DECREASE SWELLING CAUSE HEADACHE-BLURRED VISION-NERVOUSNESS'
DECONGESTANT ADR REBOUND CONGESTION NASAL SPRAY >3-5 DAYS S/S COME BACK CNS STIMULATION PO MUCH CUTION, HTN, CAD, ARRYTHMIAS ABUSE I.E PSEUDOPHERINE-EPHEDRINE, SINGULAIR, ATROVENT(IPRATROPIUM BROMIDE), XOLAIR(OMALUZIMAB)
TEACHING-ANTITUSSIVES SUPPRESS COUGH Opioid antitussives •Hydrocodone •Act in CNS •Potential for abuse, respiratory depression Nonopioid antitussives •Dextromethorphan •Acts in CNS
TEACHING-EXPECTORANTS MAKE PRODUCTIVE COUGH STIMULATE FLOW OF RESPIRATORY TRACT SECRETION NEED HIGHER DOSE EFFECTIVE+LOTS OF WATER I.EGUAINFENESIN(MUCCINEX, HMIBID)
TEACHING-MUCOLYTICS Hypertonic saline Can trigger bronchospasm AcetylcysteineHigh sulfur content, “rotten egg” smell  Can trigger bronchospasm Mucolytics react directly with mucus to make it more watery
TEACHING-COMMON COLD ACUTE UPPER RESPIRATORY VIRAL INFECTION S/S=Rhinorrhea, nasal congestion, cough, sneezing, sore throat, headache, hoarseness, malaise, myalgia Fever common in kids, Self-limited, usually benignNo cure; just treatment of symptoms-GONE ABOUT 7DAYS-
TEACHING-OTC-COLD REMEDIES Combination cold remedies usually contain two or more of the following: Nasal decongestant Antitussive \Analgesic Antihistamine (for cholinergic actions) Caffeine (to offset effect of antihistamine)
TEACHING-PEDIATRIC OTC COLD REMEDIES NO OTC iN <4 to 6 yearsUSE PEDIATRC ONLY Consult B4 giving these drugs Read safety before dosingUse measuring device provided STOP med + REACH MD if the child’s condition worsens or fails to improveNO antihistamine-products to sedate children
Created by: Seka_nurse
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