3 Murphy N305 Rhinitis Cough Colds

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Welcome Everyone. Today's lesson has to do with Rhinitis, Coughs, and Colds.

6 of the drugs for Rhinitis, 2 you have learned already.

There are 4 types of drugs administered for Rhinitis. What are they?

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-->Antihistamines
block H receptors to decrease itching, sneezing, rhinorrhea)
-->Glucocorticoids
-->Cromolyn
-->Sympathomimetics
stimulate alpha 1 receptors in nasal BV. Causes vasoconstriction. Only reduce nasal congestion.

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Antihistamines:

~DIPHENHYDRAMINE [Benadryl] 1st gen & FEXOFENADINE [Allegra] 2nd gen~
Both are given orally

Mechanism of Action
Therapeutic Effects

Back 2

MOA: H1-receptor antagonists

Tx: Prevents itching, sneezing, and rhinorrhea (excess discharge of mucus from nose)
-Does not decrease nasal congestion; no value for cold treatment; best when taken prophylactically

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Diphenhydramine & Fexofenadine

Adverse Effects

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Sedation (esp w/ 1st Generation meds)
Other SE are mild: dry mouth, constipation, or urinary hesitancy

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Glucocorticoids, intranasal
~BECLOMETHASONE [Beconase] ~

You KNOW this one already: Give a quick MOA and SE on this.

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MOA: prevent inflammatory response (prevent all major symptoms of allergic rhinitis)
SE: nasal irritation

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~CROMOLYN [NasalCrom] ~, intranasal

You KNOW this one already: Give a quick MOA and SE on this.

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MOA: Mast Cell Stabilizer (which means...)
No benefit for nonallergic rhinitis
takes 1 week to see beneficial effects
SE: Do you remember?

-safest, occasional cough and bronchospasm-

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Sympathomimetics (oral/nasal):
~PSEUDOEPHEDRINE [Sudafed]& PHENYLEPHRINE [Neo-Synephrine]~

What is it's MOA?

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Pseudoephedrine & Phenylephrine:

-Stimulate alpha1-adrenergic receptors on smooth muscle of nasal blood vessels
-Leads to vasoconstriction and decreased nasal drainage

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Pseudoephedrine & Phenylephrine:
Adverse Effects?

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Pseudoephedrine & Phenylephrine SE:
-CNS stimulation (most common -effect w/oral)
-Rebound congestion (w/topical), cannot be used for chronic rhinitis b/c increase dosage requirement
-Cardiovascular effects
vasoconstriction (w/oral); could be hazardous for people w/HTN or coronary artery disease
-Hemorrhagic stroke
-Abuse potential—Effects similar to amphetamines

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Pseudoephedrine & Phenylephrine:
What was it's Class again?

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Pseudoephedrine & Phenylephrine class:
Sympathomimetics (oral/nasal)

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This next drug will be specifically for "COUGHS".

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To think you could get rid of something "simple" as a cough!

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Antitussives (Drugs that suppress cough but these are not intended to suppress "productive" coughs)

What are the two drugs that you will learn for Opioid antitussives?

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Opioid antitussives:

~CODEINE & HYDROCODONE~

Used to suppress cough be acting w/in CNS and peripherally. All opioids can do so.

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Codeine:

Most effective to decrease frequency and intensity of cough.

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Hydrocodone (Vicodin):

More potent, increased risk of abuse

*Hugh Laurie in the tv show, House, is addicted to Vicodin*

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Antitussives:

What are the two drugs that you will learn for Nonopioid antitussives?

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~DEXTROMETHORPHAN & DIPHENHYDRAMINE~

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Dextromethorphan [Robitussin DM]

Most effective nonopioid; acts in CNS
Opioid derivative; may produce analgesia, euphoria, or physical dependence; adverse effects at therapeutic concentrations are generally mild
*Popular for kids to get a swig out of this*

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Diphenhydramine [Benadryl]

Can also suppress cough
Sedative and anticholinergic properties

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COLD Remedies:
They often have 2+ of the following:
Can you name a few? We went over all of them =)

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Nasal decongestant
Antitussive
Analgesic
Antihistamine (for anticholinergic actions)
Caffeine (for offsetting sedation from antihistamine)
*DON'T use antibacterial drugs unless infection developed*

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Thats all for Rhinitis, Coughs, and Colds!

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Review to grasp these drugs better!