Pharmacology of decongestants and cough medicines

Question 1

Define Rhinitis.

Answer 1

Rhinitis is inflammation of nasal mucous membranes.
Infectious Rhinitis is viral (cold/flu) and bacterial (sinusitis)

Non-infectious can be Allerfic and Non-allergic(vasomotor)

*Allergic rhinitis is IgE mediated and caused by allergen such as dust mites, pollen.

Question 2

Allergic Rhinitis

Describe the Use, Agents and Side effects of Intranasal corticosteroids

Answer 2

Indications
Anti-inflammatory. Decreases mucosal oedema. Decreases number of mast cells.
Prophyllactically used 2 weeks before onset of allergy season.

Agents
1. Beclomethasone
2. Fluticasone
3. Mometasone

Side Effects
1. Transient stinging
2. Dry nose
3. Nasal bledding
4. Throat irritation
5. Excessive use-Adrenal Suppression

Question 3

Rhinitis

Antihistamines are used to treat Rhinitis.

They are used to treat intermittenr allergic rhinitis.

Answer 3

Retrieve all the information you know about Antihistamines,

Question 4

Allergic Rhinitis

Describe the use of Sodium Chloride

Answer 4

Used as drops or spray.
it is a nasal irrigation solution.
It improves Mucociliary Clearance

Question 5

Allergic rhinitis

Describe the use and MOA of Cromoglycic Acid (Sodium Cromoglycate)

Answer 5

Used in intermittent allergic rhinitis
Inhibits release of histamine, chemotactic factors(mast cells)

Question 6

Non-allergic (vasomotor or chronic) Rhinitis

Describe triggers and treatment of Non-allergic Rhinitis.

Answer 6

Non-allergic rhinits includes sneezing, congestion and hyper-responsiveness.

Triggers
Ordours, smoke, weather
Medication: Aspirin, Beta blockers, antidepressants
Foods(spicy) and Alcohol
Hormonal Changes

Treatment
Nasal Corticosteroid Sprays

Question 7

Influenza

Describe symptoms of Influenza

Answer 7

Rapid Onset of fever, Headache, Myalgia. Bpdy aches, sore throat and rhinitis.

usually lasts for 4-5 days and is self-limiting.

Infuenza A and B are responsible for seasonal flu

Question 8

Descirbe the Symptoms of COLDS

Answer 8

this is a self-limting upper respiratory tract infection.

SYmptoms include:
Sneezing
Nasal congestion
Coughing
*there’s release of inflammatory mediators in nostril, and increased cell wall permeability and oedema in nostril.

Question 9

Decongestants

Describe the Use, MOA and agents of Decongestants.

Answer 9

Alpha-1 receptor agonists
1. Psuedoephedrine
2. Phenylephrine

Mixed-action Adrenergic Agonists (alpha and beta)
1. Phenylpropanolamine

Use
1. Rhinorrhoea
2. Nasal Congestion

MOA- Vasoconstriciton of blood vessels in the nasal mucosa.

Question 10

Decongestants

Name Oral decongestants, Side effects and Contraindications.

Answer 10

*Include:
1. Pseudoephedrine
2. Phenylpropanolamine
3. Phenylephrine

Combination with Analgesics and Antihistamines

Side Effects
1. Hypertension
2. Irritation
3. Insomnia
4. Loss of Appetite

Contraindications
1. Uncontrolled hypertension
2. Pregnancy
3. Hyperthyroidism
4. Monoamine Oxidase Inhibitors

Question 11

decongestants

Describe the Agents, side effects and caution for Local or Topical decongestants

Answer 11

Agents
1. Oxymetazoline
2. Xylometazoline
3. Phenylephrine

few side effects
Prolonged use of intransal decongestants-rebound congestion and Rhinitis Medicamentosa

DO NOT USE FOR MORE THAN 5 DAYS

Question 12

Define cough and the types of coughs(dry and wet)

Answer 12

Coughing is a protective mechanism to clear the throat of foreign particles and mucous.

Dry cough is non-productive
and wet cough is productive, it produces phlegm.

Question 13

Coughs

Describe the agents, MOA, side effects, drug interactions, contraindications and drug-diseases of Antitussive or cough suppressants.

Answer 13

*Agents
1. Dextromethorphan
2. Codeine
3. Pholcodeine
Mech Of Action
1. Suppress cough reflex (cough centre is in the medulla)
Side Effects
1. Dizziness
2. Sedation
3. Constipation
4. Nausea
Drug diseases
1. Asthma
2. Liver Impairment
Contraindications
1. Codeine and Pholcodeine-Pregnancy and Children.

Question 14

Describe the potential side effects of Antihistamines-combination OTC cough and cold preps.

Answer 14

Combination of antihistamines, decongestants, antitussives and expectorants.

*Have serious side effects in Young Children-serious side effects and death
should not be used in children less than 2

Question 15

Describe the Agents, Use, MOA and caution of Expectorants

Expectorants are medications or natural ingredients that help clear mucus from the airways

Answer 15

Treats Chesty coughs.

Mech. Of Action
1. Decrease sputum viscosity
2. Decrease bronchial sputum surface tension

Agents
1. Guaiphenesin
2. Sodium Citrate
3. Ammonium citrate

Caution
1. Gastro-intestinal ulcers

Question 16

Describe the Agents, Side effects, and Indications for each of the Mucolytic Agents

Answer 16

1. Acetylcysteine/N-acetylcysteine
   Splits disulphide bonds-mucoproteins
   treats Cystic Fibrosis
2. Bromhexine
   -Loosens and thins mucus
   -Side effects include: Asthmatics, Peptic Ulcer, Porphyria
3. Dornase Alfa
   Treats cystic fibrosis
   Recombinant Human DNase or rhDNase,

A non-pharmacological method to clear muscos is to inhale steam and maintain a good hydration status.