Question | Answer |
Inflammation of nasal mucous membrane
Causes of acute symptoms: common cold, bacterial infection, presence of foreign body, drug-induced congestion (rhinitis medicamentosa) | Rhinitis |
Caused by allergic reaction on exposure to allergens such as pollens, grasses, dust mites
Releases large amounts of histamine | Allergic rhinitis |
Identify allergens (skin testing)
Avoid exposure to allergens, if possible
Antihistamines, decongestants, intranasal anti-inflammatory agents
Saline nasal spray to reduce nasal irritation | Allergic rhinitis |
Most common in midwinter, spring, and fall | Cold Virus |
Clear, watery nasal discharge, sneezing
Cough, mild sore throat
Headache, malaise, chills, and fever
Should resolve over 5 to 7 days | Cold Virus |
Thick, tenacious mucus obstructs sinus ducts | Sinusitis |
nfection of the middle ear | Otitis media |
Contact health care provider if symptoms worsen, or additional symptoms appear with a cold | Exacerbations of obstructive lung disease, asthma |
Limited to relief of symptoms
Decongestants are most effective agents
Antihistamines are of some benefit
Analgesics, antipyretics, expectorants, antitussive agents also beneficial, depending on symptoms | Common cold |
Emphasize importance of adequate rest, hydration, personal hygiene, prevention of spread
Discuss specific medications prescribed and when to take medication . Explain proper technique in administering medications . Teach to monitor temperature, pulse, re | Patient Education and Health Promotion |
Stimulate alpha-adrenergic receptors of nasal mucous membranes causing vasoconstriction | Actions Sympathomimetic Decongestants |
Relieve congestion associated with rhinitis | Sympathomimetic Decongestants |
Reduced nasal congestion, easier breathing | Therapeutic outcomes Sympathomimetic Decongestants |
Mild nasal irritation | Adverse effects Sympathomimetic Decongestants |
Serious adverse effect: hypertension | Sympathomimetic Decongestants |
Used with caution in patients with hypertension, hyperthyroidism, diabetes mellitus, cardiac disease, increased intraocular pressure, or prostatic hyperplasia | Sympathomimetic Decongestants |
State laws regulate purchase of pseudoephedrine, one ingredient in methamphetamine manufacture | Sympathomimetic Decongestants |
Combining with MAOIs results in significant hypertension | Sympathomimetic Decongestants |
Actions
Compete with allergy-liberated histamine for H1 receptor sites | Antihistamines |
Uses
Treat allergic rhinitis, conjunctivitis | Antihistamines |
Therapeutic outcomes
Reduced symptoms of allergic rhinitis | Antihistamines |
Common adverse effects
Sedative effects, cognitive impairment, drying effects | Antihistamines |
Anticholinergic adverse effects
Dry mouth, stuffy nose
Blurred vision
Constipation, urinary retention
May make respiratory mucus thicker | Antihistamines |
Patients with history of asthma, prostatic enlargement, or glaucoma should take antihistamines only with health care provider supervision | Antihistamines |
intranasal corticosteroids
cromolyn sodium (Nasalcrom) | Respiratory Anti-inflammatory Agents |
Actions
Reduce inflammation; mechanism of action unknown | intranasal corticosteroids |
Uses
For patients who do not respond to antihistamines or sympathomimetic agents | intranasal corticosteroids |
Therapeutic outcomes
Reduced rhinorrhea, rhinitis, itching, sneezing | intranasal corticosteroids |
Common adverse effect
Nasal burning | intranasal corticosteroids |
Actions
Stabilize mast cells, reducing the release of histamine and other mediators | cromolyn sodium (Nasalcrom) |
Uses
In conjunction with other drugs to treat severe allergic rhinitis | cromolyn sodium (Nasalcrom) |
Common adverse effect
Nasal burning | cromolyn sodium (Nasalcrom) |
Serious adverse effects
Bronchospasm, coughing | cromolyn sodium (Nasalcrom) |
Usefulness is often limited because of the need for frequent dosing. | cromolyn sodium (Nasalcrom) |
May be most beneficial when used as a prophylactic treatment before an anticipated allergen exposure or in patients whose medical conditions do not allow the use of other medications (e.g., pregnancy). | cromolyn sodium (Nasalcrom) |