Rhinitis, Coughs, Colds
and Flu
Rhinitis
Inflammation of nasal mucous membrane
Infections:
- Viral (colds, flu)
- Bacterial (sinusitis)
Non-infectious:
- Allergic
Common symptoms:
Nasal congestion, nasal itch,
rhinorrhoea and sneezing
Allergen e.g., Dust mites, pollen
IgE mediated (Allergen
immunoglobulin=IgE)
Antihistamines – H1 Antagonists
- Itching, sneezing, rhinorrhoea, ocular symptoms
- Little effect on congestion
- Non-sedating
Second Third Intranasal Short term
Generation Generation antihistami
nes
Loratadine Fexofenadin Azelastine Intermittent
e allergic
rhinitis
Cetirizine Levocabastin
e
Intermittent or persistent
, Intranasal Corticosteroids
- Anti-inflammatory
- ↓ mucosal oedema, ↓ number of mast cells
- Little systemic effect (when given locally)
- Prophylactically – 2 weeks before onset of allergy
season
Drugs S/E
Beclomethason -Transient stinging, dry nose
e -Nasal bleeding, throat irritation
Fluticasone -Excessive use-adrenal suppression
Mometasone
Other Nasal Preps
Sodium Chloride (Saline)
- Drops (<2yrs), Spray.
- Nasal irrigation solution
- Improve mucociliary clearance.
- Irrigation solutions- flushing out-thick mucus,
crusts, debris
Cromoglycic acid (sodium cromoglycate)
- Intermittent allergic rhinitis
- Inhibits release of histamine, chemotactic factors-
mast cells
- Non-allergic (vasomotor)
Chronic
and Flu
Rhinitis
Inflammation of nasal mucous membrane
Infections:
- Viral (colds, flu)
- Bacterial (sinusitis)
Non-infectious:
- Allergic
Common symptoms:
Nasal congestion, nasal itch,
rhinorrhoea and sneezing
Allergen e.g., Dust mites, pollen
IgE mediated (Allergen
immunoglobulin=IgE)
Antihistamines – H1 Antagonists
- Itching, sneezing, rhinorrhoea, ocular symptoms
- Little effect on congestion
- Non-sedating
Second Third Intranasal Short term
Generation Generation antihistami
nes
Loratadine Fexofenadin Azelastine Intermittent
e allergic
rhinitis
Cetirizine Levocabastin
e
Intermittent or persistent
, Intranasal Corticosteroids
- Anti-inflammatory
- ↓ mucosal oedema, ↓ number of mast cells
- Little systemic effect (when given locally)
- Prophylactically – 2 weeks before onset of allergy
season
Drugs S/E
Beclomethason -Transient stinging, dry nose
e -Nasal bleeding, throat irritation
Fluticasone -Excessive use-adrenal suppression
Mometasone
Other Nasal Preps
Sodium Chloride (Saline)
- Drops (<2yrs), Spray.
- Nasal irrigation solution
- Improve mucociliary clearance.
- Irrigation solutions- flushing out-thick mucus,
crusts, debris
Cromoglycic acid (sodium cromoglycate)
- Intermittent allergic rhinitis
- Inhibits release of histamine, chemotactic factors-
mast cells
- Non-allergic (vasomotor)
Chronic