| 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) |
