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23 Cards in this Set
- Front
- Back
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Which drugs to be applied as intranasal spray are important in the treatment of allergic rhinitis?
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Histamine H1 receptor antagonists: Azelastine Decongestants (α1 agonists): Oxymetazoline, xylometazoline Anticholinergics: Ipratropium (bromide) Corticosteroids: Budenoside, fluticasone |
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Which oral drugs are important in the treatment of allergic rhinitis? |
Histamine H1 receptor antagonists (2nd generation): Cetirizine, loratadine, fexofenadine Decongestants (α1 agonists): Phenylephrine, pseudoephedrine Anti-leukotrienes: Montelukast |
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Which symptoms of allergic rhinitis are treated by histamine antagonists? |
Itchy nose and eyes, sneezing, rhinorrhoea, but not nasal congestion |
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Which symptoms of allergic rhinitis are treated by anticholinergic drugs? |
Rhinorrhoea (nasal secretions) |
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What are the indications for topical steroid use in allergic rhinitis? |
Severe cases where symptoms are not treated by the first-line drugs |
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What is the mechanism of action of nasal decongestants? |
Nasal decongestants are α1 agonists. They constrict venules in the nasal mucosa. This reduces the volume of venous blood in the mucosa, thereby decreasing the oedema. |
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What is the mechanism of action of anticholinergics in relation to rhinitis?
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Anticholinergics block the M3-receptor-mediated nasal secretion. |
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What is the mechanism of action of steroids in relation to rhinitis? |
Glucocorticoids decrease the allergen-mediated inflammation. |
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Describe the tolerance which develops to nasal decongestants. |
Tolerance develops quickly to the decongestant effect of α1 agonists, most likely due to a down-regulation of α receptors. This occurs after continous use of nasal decongestant for 10 days straight and results in rebound-congestion, which causes the patient to take more and more decongestant. |
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What are the indications for anti-tussive drugs? |
We never want to stop coughing completely, but we can suppress the reflex in cases where: the cough is dry (not productive) and painful the cough is exhausting, like in patients with hypertension or heart failure |
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Name anti-tussive drugs.
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Opioids: Codeine, dihydrocodeine, hydrocodone. ethylmorphine Opioid-like drugs: Noscapine Non-opioids: Butamirate, pentoxyverine Peripherally-acting drugs: Benzonatate |
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In which population should opioid anti-tussives not be used? |
In children |
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What is the mechanism of action of opioid antitussives?
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They act on opioid receptors in the cough centre, suppressing the cough reflex centrally. |
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What is the mechanism of action of peripherally acting anti-tussives (benzonatate)? |
Benzonatate is chemically related to local anaesthetics like tetracaine. It acts by blocking receptors of the cough reflex in the lung. |
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What are the side effects of opioid antitussives? |
Addictive potential Constipation Respiratory depression Decreased mucociliary clearance |
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What are expectorants? |
Expectorants are drugs which increase the volume and decrease the viscosity of the airway secretions, thereby making them easier to cough up. |
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What are mucolytics? |
Mucolytics cleave macromolecules in the secretion which also makes it less viscous. |
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Name some expectorants |
Guaifenesin, saponines |
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Name some mucolytics |
Acetylcysteine, bromhexine |
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What is the mechanism of action of expectorants?
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Expectorants directly stimulate glands in the airways, and/or they indirectly stimulate these glands by stimulating the vagus nerve. |
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What is the mechanism of action of mucolytics?
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Acetylcysteine cleaves disulfide bonds in big macromolecules in sputum, which decreases its viscosity. Bromhexine acts by similar mechanism. |
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What are analeptic drugs and what are their indications? |
Analeptic drugs are drugs which stimulate the respiratory centre. Their respiratory stimulant effect can be useful in conditions like respiratory failure or apnoea, but nowadays they're replaced by mechanical ventilation. |
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Name some analeptic drugs |
Theophylline, doxapram |
