OTC - Common Cold

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  1. Common etiology of cold
    Usually viral, most commonly rhinoviruses
  2. Transmitting of cold
    Transmitted through hand-to-hand contact followed by touching eyes or nasal mucosa
  3. Pathophysiology of cold
    A cold results in the release of numerous inflammatory mediators, primarily cytokines
  4. Clinical presentation of a COLD
    • Gradual onset with slow progression (1-2 weeks duration)
    • sore throat
    • nasal symptoms
    • watery eyes
    • sneezing
    • cough
    • malaise
    • low-grade fever
  5. Three (3) non-pharmacologic therapy of cold
    • 1. humidifiers
    • 2. increased fluid intake
    • 3. rest
  6. Four (4) types of OTC medications for symptomatic COLD
    • Decongestants - for nasal decongestant
    • Antihistamines - for excess nasal discharge
    • Analgesics - for related pain or HA
    • Loca anesthestic sprays/lozenges - for sore throat (pharyngitis)
  7. 1st-Generation antihistamines
    • chlorpheniramine (Chlor-Trimeton)
    • brompheniramine (Lodrane)
    • diphenhydramine (Benadryl)
  8. 2nd-Generation antihistamines
    • clemastine (Tavist)
    • cetirizine (Zyrtec)
    • loratidine (Claritin)
    • desloratidine (Clarinex)
    • fexofenadine (Allegra)
  9. Pharmacology of antihistamines: 1st-Generation vs. 2nd-Generation
    • Antihistamines are H1-receptor antagonists
    • 1st-gen: non-selective & sedating
    • 2nd-gen: peripherally selective, non-sedating, & no anticholinergic effects
  10. SE of antihistamines
    • sedation
    • anticholinergic effect (only for 1st-gen)
    • dry mouth
    • dry eyes
    • urinary retention
    • constipation
  11. Major concern about using antihistamine in children & elderly patients
    • paradoxical stimulation
    • decrease performance in school
    • death in children <2 y/o
  12. CI of antihistamines
    • Do not drive or operate heavy machinery
    • Avoid use with alcohol
    • Prostatic hyperplasia can occur
    • Narrow-angle glaucoma is possible
  13. Two (2) OTC oral decongestants
    • phenylephrine
    • pseudoephedrine (Sudafed)
  14. Pharmacology of oral decongestants
    • alpha-adrenergic agonist & vasoconstriction
    • constriction of blood vessels to decrease blood supply to nasal mucosa & decrease mucosal edema
    • no effect on histamine or allergy-mediated reaction
  15. Four (4) requirements of the 2005 Combat Methamphetamine Epidemic Act
    • 1. Pseudoephedrine must be kept either behind the counter or in a locked cabinet
    • 2. Quantity is limited to 3.6g/d & 9g/month per patient
    • 3. Pharmacist must maintain a logbook with the following information - product name, quantity sold, patient's name & address, & time and date sale
    • 4. Patients must show valid identification and sign a logbook
  16. Are oral decongestants safety to use long-term?
    These products are relatively safe with no dependence. They can be used long term.
  17. SE of oral decongestants
    • nervousness
    • irritability
    • restlessness
    • insomnia
    • incr HR
    • incr BP
    • irregular heart beat
    • palpitations
  18. Two (2) topical decongestant sprays
    • Short-acting: phenylephrine (Neo-Syneprine)
    • Longest-acting: oxymetazoline (Afrin)
  19. The use of topical decongestants > 3-5 days can cause what?
    Rhinitis medicamentosa (rebound congestion)
  20. This solution is very safe & good for use in infants & children. It can be used with oral decongestants.
    Nasal saline solution
  21. Pharmacology: mast cell stabilizer; prevention of the mast cells from releasing inflammatory mediators
    cromolyn sodium (Nasalcrom)
  22. Patient education of cromolyn sodium (Nasalcrom)
    Not efficacious if taken prn; must be taken on a scheduled basis (4-6 times a day)
  23. Three (3) analgesics for the treatment of pain, fever, & headaches associated with cold, flu, or allergies
    • 1. APAP
    • 2. Aspirin
    • 3. NSAIDs (ibuprofen, naproxen, ketoprofen)

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Author:
skylinezts
ID:
97829
Filename:
OTC - Common Cold
Updated:
2011-08-22 06:15:45
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OTC Common Cold
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OTC - Common Cold
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