ANTIHISTAMINES, NASAL DECONGESTANTS AND DRUGS FOR COUGH.pptx

Presentation

1. ANTIHISTAMINES, NASAL DECONGESTANTS AND DRUGS FOR COUGH

2. Antihistamines Antihistamines are the drugs used in the treatment od allergic disorders and some other conditions . Mechanism of action These drugs block the effect of histamine and its receptors. They also provide some sort of sedation. There are four types of antihistamines drugs. Highly sedatives. Moderate sedatives. Mild sedatives. Non sedatives.

3. Drug Example & Doses S. No Drugs Doses Highly Sedative 1 Diphenhydramine 25-50mg 2 Promethazine 25-50mg 3 Hydroxyzine 25-50mg Moderate Sedatives 4 Medizine 25-50mg 5 Buclizine 25-50mg 6 Phenivamine 25-50mg 7 Cyproheptadine 4mg

4. S. No. Drugs Doses Mild Sedatives 8 Chlorpheniramine 2-4mg 9 Cyclizine 50mg 10 Triprolidine 2.5-5mg Non Sedatives 11 Astemizole 10mg 12 Cetrizine 10mg 13 Lovatadine 10mg 14 Fexofenadine 120-180mg

5. Indications/Uses Allergic reactions (Hay fever, Vasomotor rhinitis urticaria, asthma , Anaphylaxis). Because of their anticholinergic actions they are used as antiemetics and useful in motion sickness. As hypnotics, Mild sedative/anxiolytics. Parkinsonism . Contraindications Hypersensitivity. Lactation. Hypokalemia . Neonate. Coma. Special precautions in acute asthma and pregnancy, elderly, epilepsy.

6. Adverse effects Drowsiness Dryness of mouth. Blurring of vision. Urinary retention. Constipation. Delirium. Convulsions. Severe toxicity may causes death to cardiac and respiratory failure

7. MUCOLYTICS These drugs reduced the viscosity of sputum that leads to easily expel the sputum. Mechanism of Action Decrease mucous viscosity by breaking or altering mucoproteins present in sputum. Indications To treat abnormal viscous, or thick and hard mucus. As an antidote for acetaminophen overdose ( acetylcysteine ).

8. Drug example & Doses S No. Drugs Doses 1 Acetylcysteine 2.5 ml of 10-20% solution given by inhalation or nebulization 2 Bromhexine 8-16 mg TDS. Contraindications Hypersensitivity to these drugs. Cautiously in elderly, pregnant or breastf e eding mothers

9. Adverse effect s Stomatitis. Drowsiness. Bronchospasm. Nausea/vomiting. Severe rhinorrhea. Drug interactions Activated charcoal decreases acetylcysteine effectiveness. Incompatible with chlortetracycline, erythromycin, amphotericin B, Hydrogen peroxide.

10. Decon g est a nts A Decongestant drugs used to relieve nasal congestion in upper respiratory tracts. Mechanism of action Decongestants are sympathomimetic drugs that act by stimulating the α (alpha) – adrenergic receptors. The decongestant effect due to vasoconstriction of the blood vessel in the nose sinuses etc. the vasoconstriction effect reduces swelling or inflammation and mucous formation in the nasal passage and make it easier to breath

11. Drug examples and doses S. No. Drugs Doses 1 Ox y meta z o l i n e hydrochloride 0.05% solution or nasal spray. 2 Phen y lephri n e hydrochloride 10 mg 3 Pseu d o e phedrine hydrochloride 60 mg.

12. Indications /uses For temporary relief of nasal congestion due to common cold. Hay fever. Sinusitis. Upper respiratory tract allergens. To promote nasal and sinus drainage .

13. Contraindications/precautions Hypersensitivity to these drugs. MAO (Monoamine oxidase) inhibiters drugs therapy. Use cautiously in older age patient they are more likely to experience adverse reaction. Nasal contestant should not be used for more than three days, and oral decongestant should not used more than 7days because prolonged use will result in rebound congestion.

14. Adverse Effects Arrhythmias. Tachycardia. Insomnia. Palpitation. Hypertension. Drowsiness. Hypersensitivity reactions including rash, urticaria.

15. Drug interactions If given with other s ympathomimetic amines may increase c entral nervous system stimulation. If given with MAO inhibit o rs may cause severe hypertension.

16. Drugs for cough The drug which used in cough are: Antitussive. Expectorants. Bronchodilators.

17. Antitussives (Cough center suppressant) Opioids – Codeine, pholcodine. Non opioids – Noscapine, dextromethorphan. Antihistamine – Chlorpheniramine diphenhydramine .

18. Antitussives – Introduction They are used to suppress dry cough mostly because their aim to control rather than eliminate cough. These are also called cough center suppressants . Mechanism of action These are the drugs that act in the CNS to increase threshold of cough center .

19. Drug example & Doses S. No Drugs Doses 1 Codeine (Opioids) 15-60mg up to every 4 hrs 2 Noscapine (Non opioids) PO 15-30 mg itramin maleate 3 Dextromethorphan (Non opioids) 10-30mg PO 4-8hrs max. 120/day 4 Chlor p h e nir a mine (Antihistamine) 4 mg PO 4-6 hrly 5 Dip h e n hydram i ne (Antihistamine) 25 mg PO 4hrly not to exceed 150 mg / day.

20. Indications/uses Dry & unproductive cough. Allergic cough. Spasmodic cough. Adverse effects Constipation. Drowsiness . Dryness of mouth. Irritability. Ataxia. Respiratory depression in higher doses. Addiction. Vertigo. Nausea, Headache.

21. Contraindication/precautions Respiratory Depression . Asthmatics. Convulsion disorder . Contraindicate while driving. Obstructive airway disease.

22. Expectorants Bronchial secretion enhances – sodium or potassium citrate, potassium iodide, ammonium chloride. Mucolyt ic agents – bromhexine ambroxol, acetylcysteine.

23. Expectorants These drugs help in removal of secretions of respiratory tract and mucolytic agents produce liquification of mucous making expectoration easier.

24. Mechanism of action They increase bronchial secretions or reduce its viscosity, sodium and potassium citrate increase bronchial secretion by salt action also these drugs stimulate gastric mucosa or directly acting on mucous membrane of lungs to increase the secretion of mucous.

25. Indications/uses Chronic productive cough. Thick mucous production. Combinations with antitussives drugs for relieving cough.

26. Adverse effect Allergic reactions / hypersensitivity. Rhinorrhea. Lacrimation. Gastric irritation.

27. Contraindication/precautions History of peptic ulceration. Asthmatic patients . Severe hepatic or renal function . Drug interactions They may increase the risk of bleeding when used with anticoagulants.