cold and allergy

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Author:
samid
ID:
152486
Filename:
cold and allergy
Updated:
2012-05-06 09:34:34
Tags:
Pharm test
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Description:
antitussives, histamines, expectorant, decongestants
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  1. Opiod Antitussives
    • Codeine
    • hydrocodone

    high abuse and addictive potential
  2. Opiod Antitussive
    MOA
    • suppress cough reflex by direct action on cough center in medulla in the brain
    • Analgesic and drying effect on mucosa of respiratory effect
  3. Opiod Antitussive
    indications
    Nonproductive cough

    Harmful cough
  4. Opiod Antitussive
    contras
    • drug allergy
    • Alcohol use
    • Hypercapnea
    • Respiratory depression
  5. Opiod Antitussive
    cautions
    • Increased intracranial pressure
    • Impaired renal function
    • Liver disease
    • BPH
    • Addison’s
    • COPD
  6. Opiod Antitussive
    SE
    • Sedation
    • Nausea/vomiting
    • Lightheadedness
    • Constipation
  7. Opiod Antitussive
    Interactions
    • Opiods
    • General anesthetics
    • Tranquilizers
    • Sedatives/hypnotics
    • Trcyclic antidepressants
    • Alcohol
    • Other CNS depressants
  8. Benzonatate MOA
    • suppresses cough reflex by numbing stretch receptor cells in respiratory tract which prevents reflex stimulation of medullary cough center
    • Non opiod
  9. Benzonatate Indications
    Harmful, nonproductive cough
  10. Benzonatate SE
    • Dizziness
    • Headache
    • Sedation
    • Nausea
    • Constipation
    • Pruritus
    • Nasal congestion
  11. Dextromethorphan MOA
    • non opiod
    • suppress cough reflex through direct action on cough center in medulla, but has no analgesic or CNS depressant
  12. Dextromethorphan indications
    nonproductive, harmful cough
  13. Dextromethorphan Contras
    • Hyperthroidism
    • Advanced cardiac and vessel disease
    • Hypertension
    • Glaucoma
    • Used of MAOI’s within last 14 days
  14. Dextromethorphan SE
    • Dizzy
    • Drowzy
    • Nausea
  15. Guaifenesin (Mucinex) MOA
    • expectorant
    • stimulates respiratory tract secretions by decreasing adhesiveness and viscosity of phlegm
  16. Guaifenesin (Mucinex) Indications
    • Common cold
    • Bronchitis
    • Laryngitis
    • Pharyngitis
    • Pertussis
    • Influenza
    • measles
  17. Guaifenesin (Mucinex) SE
    GI, very minimal
  18. Antihistamines (general) MOA
    • block histamine receptors on mast and basophil cell surfaces, preventing release of histamine from these cells
    • ÷Competes for only unoccupied receptors,so GIVE EARLY!!!
  19. Antihistamines (general) indications
    Nasal allergies, hayfever, allergic reactions, symptoms of common cold, motion sickness, Parkingson’s disease, vertigo, and occasional sleep aid
  20. Antihistamines (general)
    • Allergy to drug
    • Narrow angle glaucoma
    • Cardiac disease
    • Kidney disease
    • Hypertension
    • Bronchial asthma
    • COPD
    • Peptic ulcer disease
    • Seizures
    • BPH
    • Pregnancy
  21. Antihistamines (general) Cautions
    • Liver impairment
    • Renal insufficiency
    • Lactating mothers
  22. Antihistamines (general)
    • Drowsiness
    • Anti cholinergic effects
    • Dizziness
    • Restless
    • Headache
    • Some cardiovascular effects
  23. Antihistamines (general) interactions
    • Anticholinergics : increase these effects
    • Apple Juice
    • Orange Juice
    • Grapefruit Juice
    • St. John’s Wart
  24. Traditional Antihistamines
    • Diphenhydramine (Benadryl)
    • Brompheniramine
    • Chlorpheniramine
    • Gimenhydrinate
    • Meclizine
    • promethazine
  25. Benefits of Traditional Antihistamines
    • Effect histamine receptors peripherally and centrally
    • Monitor vital signs
    • Best taken with meals
    • Anticholinergic effects = more effective
    • Used alone or in combination to treat many disorders
    • Available OTC and prescription
    • Consult MD when before use with other OTC medications
    • Less expensive
  26. Diphenhydramine (Benadryl)
    • traditional antihistamine
    • Often used as hypnotic for sedating effects
    • Can increase increase fall risk in children and elderly
    • Most commonly used
    • Pregnancy Category B
    • Many different forms available, including combinations with other drugs
  27. Diphenhydramine (Benadryl) indications
    • Prevention of allergies
    • Motion sickness
    • Parkinson’s disease
    • Promotion of sleep
    • Treatment of severe, acute allergic reaction
    • Treatment of acute dystonic reaction
  28. Diphenhydramine (Benadryl)
    • Know allergy
    • Nursing mothers
    • Neonates
    • People with lower respiratory tract symptoms or pneumonia
    • Acute asthma attack
    • use of alcohol, MOAI's, or CNS depressants
  29. Non Sedating Antihistamines
    • Loratadine (Claritin)
    • Cetirizine
    • Fexorfenadine (allergra)
  30. Non Sedating Antihistamines
    • Do not cross blood brain barrier: only work peripherally
    • Minimal adverse effects when taken correctly
    • Longer duration of action – once a day dosing
    • Should not be used in children younger than 6 years old
    • Reduced doses foe elderly or decreased renal function
  31. Loratadine (Claritin)
    • Available OTC
    • Pregnancy B
    • Drug allergy only contraincations
    • Not recommended for children under 2
  32. Loratadine (Claritin) indications
    • Hayfever
    • Chronic urticaria
  33. Adrenergic Decongestants drugs
    • naphazoline (Privine),
    • Oxymetazoline
    • tetrahyrdozoline
    • xylometazoline
  34. Adrenergic Decongestants MOA
    constrict blood vessels, especially nasal sinuses, which shrinks engorged mucous membranes and relieves stuffiness
  35. Adrenergic Decongestants Contras
    • Narrow angle glaucoma
    • Cardiovasular disease
    • Hypertension
    • Diabetes
    • Hypertyroidsim
    • Prostatitis
    • Patient unable to close their eyes
    • Hx of CVA or TIA
    • Cerebral arteriolsclerosis
    • Long standing asthma
    • BPH
  36. Adrenergic Decongestants interaction
    • MAOI
    • Methyldopa
    • Urinary acidifiers
    • Alkalinizers
  37. Adrenergic Decongestants SE
    • Generally well tolerated
    • Nervousness
    • Palpitations
    • tremor
  38. decongestants indications
    • Acute or chronic rhinitis
    • Common cold
    • Sinusitis
    • Hayfever or other allergies
    • Preoperatively for better visualization
  39. three groups of decongestants
    • adrenergics
    • anticholinergics
    • corticosteriods
  40. general teaching tips
    • increase fluids (3L)
    • use humidifier
    • avoid dry air, smoke filled enviroments, and allergens
    • medications with food

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