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Upper respiratory tract infections (URTI)
>Sign/symptoms - Runny notse, nasal congestion, sneezing, cough, red and dry throat
>Involves vasodilation (dilation of blood vessel) within the muscosa and submuscosa layers of respiratory tract
>common cause by virus, anitbiotic not necessary
>Remedies contain a mixture of ingredient
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What constitutes a cough
>Reflex reaction in response to irritation to the bronchial muscosa.
>beneficial mechanism that serves o clear mucous & any foreign bodies
may be productive (mucous producing) common disease such as COPD-coughing should not be suppressed.
- non-productive (dry, no mucous)
- >Acute less than 3 weeks
- >Subacute 3-8weeks
- >Chronic more than 8weeks ie. Whooping cough.
>Problem associated with coughing include insomnia, Vomiting, exhaustion, # to ribs, cold
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Zinc for colds
>Prevents binding by viruses to cells of the nasal cavity - growth is prevented and infection is prevented.
>Evident in rhinovirus (type of virus) but not other cold viruses
>suggestion that zinc can boost immune system & suppress cold related inflammatory processes
>More research required.
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Effectiveness of substances available OTC
>Vit C stimulate immune system - not effective once cold/flu has established.
>Caffeine effects central nervous system (CNS) and may reduce apathy (makes you feel good)
- >Menthol/Camphor produce a vasodilated affect to skin & gives a feeling of warmth and relief from aches/pain associated with cold/flu
- >achived by irritating the sensory nerves under the skin sending repeated messsages to brain.
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What's the difference?
>Anti tussives; suppress cough reflex
>Decongestants decrease the overproduction of muscous/secretions
>antihistamines block the action of histamines, decrease mucous production
>Expectorants increase mucous secretions.
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Anti-tussives
Cough supressants, function is to reduce the frequency & severity of a non productive cough.
- >shoud never be used to restrict a productive cough.
- >2 groups: Opioid/narcotic and non opioid
- >Opioid - codeine
- >Non opioid - dextromethorphan
BOTH meds are very effective against chronic non productive cough.
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Expectorants
>Used for unproductive cough
>Work on the nervous system stimulating lungs to increase mucous production
> To reduce dyness and irritated area of the respiratory tract
- > cough goes from unproductive to productive
- >plant derivative: Liquorice &squill
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Codeine - Opioid
Most common ingredient in anti tussive is an opioid.
>Common anti tussives are pholcodeine & Gees linctus
- >pholcodeine has little analgesic effect
- >Gees linctus combines the anti tussive effect with an analgesic
>both contain little amount of codeine due to opioid effect.
>main effect is they may depress the medulla in brain which suppress respiratory centres and may result in respiratory arrest.
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How does codeine work?
>Activates specific opioid receptors in CNS which suppress the cough centre.
>side effects include constipation, respiratory depression
>Codeine absorbed quickly and metabolised in the liver and excreted in urine.
>not recommended in pregnacy/breastfeeding, impairment to CNS, and brain injury.
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Dextromethorphan (DXM)
>active ingredient found in 140 cough remedies
>Most effective non opioid mixture used to suppress cough
>activates specific receptors in CNS that suppress cough
>Doesn't cause respiratory failure
- >Overdose may cause impaired motor function, numbness
- nausea/vomiting, tachycardia, increased BP.
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What is Rhinitis?
Is an allergic reaction that occurs via the infammatory response in the upper&lower airways and the eyes causing basodilation & increased capillary permability.
Caused by airborne allergens that activate mast cells which leads to release of histamines.
- Seasonal (hayfever) - fungi & pollen
- Non seasonal (perennial) - dust mites & pet fur.
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Rhinitis symptoms
>runny nose (rhinorrhea)
>sneezing
>Itching ( pruritus)
>Nasal congestion
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Decongestants
>short term decongestant used to relieve symptoms such as nasal congestion & runny nose
>work by activate receptors in blood vessels causing vasoconstriction reducing odema within mucous membranes.
>allows the passages to drain secretions, making breathing easier
>short term use only. if used longer thatn 3-5 days can cause nasal congestion.
> side effects include pupil dilation, consipation, hypertension.
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Glucocorticoids
- >Used for rhinitis
- >work by suppressing cells responsible for inflammation.
- >very effective against nasal congestion, runny nose, sneezing
- >1st line of treatment
- >side effects include dryness of mucosa, burning or itching sensation
- >systemic effects are rare.
- >administed via metered dose spray
- >symptoms are relieved: does should be decreased.
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Antihistamines - Oral & nasal
- >used frequently for allergic condition
- >only effective against sneezing, runny nose, nasal drip
- > not effective against nasal congestion becos histamine is only one of many of the mediators responsible for allergic rhinitis.
- >not effective against infectious symptoms associated with cold
- >side effects include drowsiness; impaired coordination and lack of concentration
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