allergy, cough and cold treatments

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allergy, cough and cold treatments

  1. 1. Allergy, Cough and Cold Treatments Antihistamines Decongestants Antitussives Expectorants
  2. 2. Allergy to Flora
  3. 3. Allergy to Fauna
  4. 4. How many triggers of Rhinitis do you see?
  5. 5. Causes of Rhinitis <ul><li>Allergic </li></ul><ul><ul><li>Seasonal </li></ul></ul><ul><ul><li>Perennial </li></ul></ul><ul><li>Infectious </li></ul><ul><ul><li>Viral, Bacteria, Fungal </li></ul></ul><ul><li>Occupational </li></ul><ul><ul><li>Intermittent </li></ul></ul><ul><ul><li>Persistent </li></ul></ul><ul><li>Nasal Irritants </li></ul><ul><li>Drug Induced </li></ul><ul><ul><li>ASA, NSAIDS </li></ul></ul><ul><li>Hormonal </li></ul><ul><ul><li>Pregnancy, Thyroid </li></ul></ul><ul><li>Food </li></ul><ul><ul><li>Lemon, MSG </li></ul></ul><ul><li>Anatomic </li></ul><ul><ul><li>Mucosal & bone atrophy </li></ul></ul><ul><li>Idiopathic </li></ul>
  6. 6. Symptoms of Allergic Rhinitis <ul><li>Itchy nose, ears, palate, throat </li></ul><ul><li>Red, watery eyes </li></ul><ul><li>Sneezing episodes </li></ul><ul><li>Thin, clear rhinorrhea, cough </li></ul><ul><li>Nasal congestion, post nasal drip </li></ul><ul><li>Snoring, sleep disturbances </li></ul><ul><li>Altered hearing, frontal headaches </li></ul>
  7. 7. Antihistamines <ul><li>Therapeutic Use </li></ul><ul><ul><li>Allergy,insomnia, rash,nausea, vomiting </li></ul></ul><ul><li>Mechanism - Histamine1 receptor antagonist </li></ul><ul><li>Side Effects </li></ul><ul><ul><li>Sedation, dizziness </li></ul></ul><ul><ul><li>Anticholinergic : dry mouth, blur vision, constipation & urinary retention </li></ul></ul><ul><ul><li>Hyperactivity in some children </li></ul></ul>
  8. 8. Antihistamines cont . <ul><li>First Generation </li></ul><ul><ul><li>Diphenhydramine </li></ul></ul><ul><ul><li>Dimenhydrinate </li></ul></ul><ul><ul><li>Clemastine/Meclizine </li></ul></ul><ul><ul><li>Chlorpheniramine </li></ul></ul><ul><li>Others </li></ul><ul><ul><li>Azelastine, Hydroxyzine HCL, Hydroxyzine Pamoate, Promethazine </li></ul></ul><ul><li>2nd Generation </li></ul><ul><ul><li>Fexofenadine </li></ul></ul><ul><ul><li>Loratadine </li></ul></ul><ul><ul><li>Cetirizine </li></ul></ul>
  9. 10. <ul><li>Deconsal II (phenylephrine 20mg & guaifenesin 375mg) </li></ul>
  10. 11. Decongestants <ul><li>Mechanism of action </li></ul><ul><li>Side effects & caution with concurrent dz. </li></ul><ul><li>Rhinitis Medicamentosa </li></ul>60mg q 4-6h 120 mg q 12 4-6hr SR12hr Pseudoephedrine Oral 2 puffs q 4h 4 hr Phenylephrine 2 puffs q 12 12 hr Oxymetazoline Dose Duration Topical
  11. 13. Intranasal Steroids Seasonal allergy prophylaxis 7-12 hours Mometasone Furoate ** (Nasonex) Non-allergic rhinitis 12 hours Fluticasone (Flonase) ** Non-allergic rhinitis 10 hours Budesonide (Rhinocort) ** Nasal polyp prevention Within 3 days Beclomethasone (Beconase) Special Uses Onset Medication
  12. 14. Side Effects of Intranasal Corticosteroids <ul><li>Local Reactions </li></ul><ul><ul><li>Nasal burning and stinging </li></ul></ul><ul><ul><li>Sneezing, throat irritation </li></ul></ul><ul><ul><li>Drying of the mucous membranes </li></ul></ul><ul><li>Systemic Reactions </li></ul><ul><ul><li>Headaches </li></ul></ul><ul><ul><li>Nausea, vomit, dizziness </li></ul></ul>
  13. 15. Ocular Preparations OpconA, Naphcon A AH-DG combo Acular ( Ketoralac ) NSAID Crolom ( Cromolyn ) Mast Cell Stabilizer Livostin ( Levocabastine ) Antihistamine Drug Name DRUG CLASS
  14. 16. Allergy Rhinitis Treatment Plan <ul><li>Most effective when start before onset of symptoms. </li></ul><ul><li>Compliance </li></ul><ul><li>Maintenance therapy </li></ul>Severe intranasal steroid, AH-DG combo, consider short course 3-7 days oral corticosteroid, consider immunotherapy Moderate intranasal steroid spray, antihistamine-decongestant combo, >2-3 months consider immunotherapy Mild antihistamine/decongestant or combo non sedating preferred OR intranasal steroid spray
  15. 17. Antitussives <ul><li>Suppress coughing </li></ul><ul><li>Effective in dry, non-productive </li></ul><ul><li>MOA </li></ul><ul><ul><li>CNS depression of the cough center </li></ul></ul><ul><ul><ul><li>Block transmission to the brain </li></ul></ul></ul><ul><ul><li>Suppression of the nerve receptors in the respiratory tract </li></ul></ul><ul><ul><ul><li>Block irritation of receptors </li></ul></ul></ul>
  16. 18. Side Effects Agents <ul><li>Anesthetizing </li></ul><ul><li>Drowsy </li></ul><ul><li>Impair motor co-cordination </li></ul><ul><li>Impair vision </li></ul><ul><li>Constipation </li></ul><ul><li>Urinary retention </li></ul><ul><li>Benzonatate (Tessalon) </li></ul><ul><li>Codeine </li></ul><ul><li>Dextromethrophan </li></ul><ul><li>Diphenhydramine </li></ul><ul><li>Hydrocodone-homatropine </li></ul>
  17. 20. Expectorants <ul><li>Defined </li></ul><ul><li>Mechanism of Action </li></ul><ul><li>Indication </li></ul><ul><li>Side Effects </li></ul><ul><li>Guaifenesin (Robitussin, Mucinex, Humibid) </li></ul>
  18. 21. Summary Slide <ul><li>Causes of Rhinitis </li></ul><ul><li>Symptoms of Allergic Rhinitis </li></ul><ul><li>Antihistamines, Decongestants </li></ul><ul><li>Intranasal Steroids & Side Effects </li></ul><ul><li>Ocular Preparations </li></ul><ul><li>Antitussives </li></ul><ul><li>Expectorants </li></ul>

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