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NRSG Pharm CH 39
Allergic Rhinitis, cold
| Question | Answer |
|---|---|
| URT immunologic defenses | Ciliated epithelium, nasal mucous, mast cells lining nasal mucosa |
| Allergic Rhinitis | Inflam. of nasal mucosa, exposure to antigen causes histamine release 1. Exposure to antigen (pollen). 2> Plasma cell release iGE antibodies. 3>IgE binds to mast. 4> antigen (pollen) binds to IgE antibodies, causes histamine release. 5>Histamine -> s/sx |
| Allergic Rhinitis Preventers | Antihistamines, IN corticosteroids, mast cell stabalizers |
| Allergic Rhinitis Relievers | Oral / IN decongestants, usually sympathomimetic |
| Histamine | Chem mediator of inflammatory response |
| H1 | Smooth muscle of vascular system and bronchial tree, many of s/s of allergic rhinitis |
| H2 | Found in stomach, responsible for peptic ulcers |
| Diphehydramine (Benadryl) classes, mech | Drug for allergies, H1 receptor antagonist; antihistamine |
| Diphenhydramine (Benadryl) uses | Minor s/sx of allergy, common cold, sneezing, runny nose, motion sickness, insomnia often OTC combined w/ analgesic, decongestant, expectorant - topic rashes, IV for severe |
| Diphenhydramine (benadryl) adverse | Significant drowsiness, paradoxical CNS stim and excitability. Anticholinergic effects - dry mouth, tachy, mild hypo |
| IN corticosteroids | Choice for allergic rhinitis, high efficacy, good safety, admin 2-3 wk prior to exposure, dec sec of inflammatory mediators, reduce edema, mild vasoconstriction |
| fluticasone (flonase) classes, mech | Allergic rhinitis, asthma, corticosteroid. IN corticosteroids for seasonal. Also available inhalation and topical - dec local inflam in nasal passage -> red. nasal stuffiness |
| Inhalation corticosteroid to reduce bronchial inflammation for asthma | Flovent |
| fluticasone (Flonase) side/adverse | IN, few adverse. Swallowing large amounts = inc potential for systemic corticosteroid adverse. IN nasal = irritation, epistaxis |
| IN decongestants | More efficacious, only 3-5 days for rebound, OTB sprays and drops. Local action in min, few systemic |
| Oral decongestants | More systemic effects, slower response time, less effective at severe congestion, often combined w/ antihistamine prep |
| oxymetazoline (Afrin) classes, mech | Nasal decongestant, sympathomimetic. Stim alpha-adrenergic receptors in SNS -> vasoconstrict arterioles in nasal, drying mucous membranes - relief in minutes, lasts up to 10 hr |
| oxymetazoline (Afrin) adverse | Rebound congestion if used more than 3-5 days, minor stinging and dryness in nasal mucosa |
| Antitussives | Inhibit cough, dextromethorphan (Delsym, Robitussin DM) |
| Opioids to inhibit severe cough | Codeine |
| Expectorants | Inhibit mucous prod, guaifenesin (Mucinex) |
| Mucolytics | Loosen bronchial secretions, dornase alfa (Pulmonzyme) |
| Dextromethorphan (Delsym, Robitussin DM) classes, mech | Antitussive, centrally acting antitussive Nonopioid drug acts in medulla, lacks analgesic and euphoric effects, does not produce dependance In many OTC cold and flu prep |
| Dextromethorphan (Delsym, Robitussin DM) onset | rapid onset, 15-30 min. not relieved after several days should notify healthcare provider |
| Dextromethorphan (Delsym, Robitussin DM) side/adverse | Therapeutic = rare. Dizziness, drowsiness, GI upset. Contraindicated in chronic cough r/t excessive bronchial secretions ex asthma, smoking, emphysema. Do not want to suppress cough in these pt |
Created by:
kmulla
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