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Flashcards in Decongestants (Maize) Deck (15):
1

What is a stuffy nose?

Blood vessels: warm and humidify inspired air and provide nutrients to goblet glands,
Structures: arteriovenous anastomoses, arteroiles and venules and cavernous sinusoids

2

Secretions and Innervations

Secretory cells: epithelial cells, goblet cells & basal cells
- Secrete, enzymes IgA and mucous
- Sensory
- Cholinergic, vasodilation and increase mucous secretion
- Adrenergic, vasoconstriction and decreases muscus secretions

3

Location of adrenergic receptors

alpha-1: mucosal membrane vasculature of the nasopharynx, vascular smooth muscle, heart, CNS, bladder neck and piloerector muscle

4

Location of adrenergic receptors

alpha-2: mucosal membrane vasculature of nasopharnyx, vascular smooth muscle, pancreas, CNS/Peripheral NS

5

Location of adrenergic receptors

beta-1: heart and juxtaglomerular cells of kidney
beta-2: respiratory, uterine, vascular smooth muscle, liver and eye

6

What is a chronotrop?

a drug that increases the rate of something

7

What is an inotrop?

a drug that increases the strength of the contraction

8

Receptor Selectivity

Drug Class:
- phenylethylamine (alpha-1 > beta-1)
--> phenylephrine, pseudoephedrine and epinephrine
- Imidazoline (alpha-2 >> beta-1)

9

Mechanism of Action

Direct Agonist: binds to alpha and beta receptors and initiate the transduction pathway
Indirect Agonist: cause the release of NE from the nerve terminal to produce an effect
***Pseudoephedrine and illicit drugs are mixed agonists

10

Pharmacological Effect

Constriction of nasal vasculature
Reduced tissue swelling
Increased nasal drainage (initial, then dries up)
Improved airflow through nasal passages
Reduced mucus secretions by decreasing blood flow to mucus glands

11

Phenylethylamine

- epinephrine (multiple routes): only in surgical procedures to decrease blood flow
- ephedrine (oral): direct and indirect agonist
- phenylpropanolamine (oral): diet aid/appetite suppression, off the market b/c of hemorrhagic stroke and looks like amphetamine
- pseudoephedrine (oral): 1/4 as potent and 1/2 potent as a bronchodilator as compared to ephedrine
- phenylephedrine (oral): less beta activity of all the phenylethylamines does not work as well as pseudoephedrine

12

Imidazoline

Products: Naphazoline (eye), tetrahydrozoline (visine), xylometrazoline, oxymetozoline
- more specific for alpha-2
- poor oral BA
- different structure than phenyethylamines

13

Phenylethylamine Side Effects

CNS: nervousness, irritability, insomnia, athletic performance enhancements
Cardio: increase BP, increase HR, tachycardia, HTN and ischemia
GI: decrease appetite

14

Imidazoline Side Effects

Rhinitis medicamentosa: rebound congestion (use

15

Choosing a drug based on PCOL properties

Decongestants: prevent production of mucus, HR and excitation
Antihistamines: prevent cause of mucus, prevent production of muscus, anticholinergic effects of 1st gen
Anticholinergics: prevent production of mucus and anti-SLUDGE (don't give these for cough, cold, and allergies)