Drugs for Rhinitis, Cough, and Colds

Question 1

Allergic rhinitis

Answer 1

Release of histamine1, leukotrienes, & prostaglandins cause inflammatory response leading to: Inflammatory disorder of the upper airway, lower airway, and eyes

Question 2

Allergic rhinitis symptoms

Answer 2

Sneezing; Rhinorrhea; Pruritus; Nasal congestion

Question 3

Antihistamines

Answer 3

First-line drugs that relieve sneezing, rhinorrhea, nasal itching

Question 4

Antihistamines do not

Answer 4

reduce nasal congestion

Question 5

Antihistamines are most effective when

Answer 5

taken prophylactically

Question 6

Antihistamines 1st generation

Answer 6

diphenhydramine (Benadryl), cyproheptadine (Periactin), chlorpheniramine (Chlor-Trimeton)

Question 7

Antihistamines 1st generation adverse effects

Answer 7

Sedation, Anticholinergic effects-dry mouth, constipation, urinary retention, increased heart rate

Question 8

rhinitis means

Answer 8

inflammation of the nasal passages

Question 9

antihistamines chemical mediators that cause

Answer 9

inflammatory responses; cause vasodilation (blood vessels become dilated so more fluid and volume, so more is stopped up)

Question 10

antihistamines release first generation to

Answer 10

keep from runny nose

Question 11

problem with first generation

Answer 11

sedation

Question 12

second generation antihistamines

Answer 12

azelastine (Astelin) * only intranasal antihistamine available (bitter taste, somnolence), cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra) [all much better than the first generation]

Question 13

Glucocorticoids end in

Answer 13

“sone”

Question 14

Glucocorticoids are

Answer 14

steroids

Question 15

Intranasal Glucocorticoids:

Answer 15

beclomethasone (Beconase), fluticasone (Flonase)

Question 16

Intranasal Glucocorticoids prevent and treat

Answer 16

seasonal/perennial rhinitis;now part of 1st line therapy

Question 17

Intranasal Glucocorticoids are

Answer 17

Anti-inflammatory action blocking histamine, prostaglandin, leukotrienes

Question 18

Intranasal Glucocorticoids adverse effects

Answer 18

Usually mild; drying of nasal mucosa, burning, sore throat, epistaxis, headache

Question 19

systemic effects of Intranasal Glucocorticoids are

Answer 19

rare at recommended doses

Question 20

Nasalcrom

Answer 20

Less effective than intranasal glucocorticoids; Blocks histamine release from mast cells; Best suited for prophylaxis

Question 21

Intranasal Cromolyn Sodium:

Answer 21

Nasalcrom

Question 22

Sympathomimetics:

Answer 22

Decongestantsphenylephrine (Neo-synephrine), pseudoephedrine (Sudafed, Afrin), oxymetazoline (Afrin) [not zertex or allergra]

Question 23

Sympathomimetics reduce

Answer 23

nasal congestion by activating alpha 1 adrenergic receptors on nasal blood vessels

Question 24

Sympathomimetics major adverse effect

Answer 24

Rebound congestion

Question 25

limit Sympathomimetics

Answer 25

to 3-5 days use then off for a few days (3 days on 2-3 days off) [there could be scar tissue and long term problems if on med for too long]

Question 26

other side effects of Sympathomimetics

Answer 26

CNS stimulation; Cardiovascular; Hemorrhagic Stroke

Question 27

CNS stimulation with sympathomimetics

Answer 27

(more common with oral sympthomimetics) restlesness, insomia, irritability, anxiety; CNS effects may lead these drugs to be drugs of abuse

Question 28

Cardiovascular effects with sympathomimetics

Answer 28

HTN, tachycardia-use with caution in heart, hypertensive population;

Question 29

Hemorrhagic Stroke with sympathomimetics

Answer 29

phenylpropanolamine (an alpha adrenergic agent) shown to cause hemorrhagic stroke in women

Question 30

Anti-histamine/Sympathomimetic Combination Drugs

Answer 30

Loratadine/pseudoephedrine: Claritin D; Fexofenadine/pseudoephedrien: Allegra-D

Question 31

D in Claritin D and Allegra D

Answer 31

sudafedrin

Question 32

Antitussives:

Answer 32

opioids suppress cough reflex in brain- codeine, hyrodcodone

Question 33

Codeine-

Answer 33

most effective; watch for respiratory suppression

Question 34

For overdose of Codeine-

Answer 34

naloxone (Narcan)

Question 35

Non-opioid:

Answer 35

dextromethorphan-also acts on the CNS suppressing cough reflex

Question 36

Expectorants- guaifenesin (Mucinex)

Answer 36

Stimulates flow of secretions, rendering a more productive cough

Question 37

Mucolytics:

Answer 37

make secretions more watery; helps produce more productive cough- acetylcysteine (Mucomyst), administered by inhalation [makes secretions so then you can cough them out]