-Antihistamines, decongestants, intranasal glucocorticoids, antitussives, expectorants

Examples: Benadryl, Dimetapp, Zyrtec, Allegra, Claritin, Astelin, Ephedrine, Sudafed, Afrin, Neo-Synephrine, Rhinocort, Decadron, Nasocort, Robitussin DM, Codeine, Tessalon, Robitussin

-antihistamine

-treat rhinitis (acute & allergic)

-po or IV

-SE: dowsiness, dizziness, fatigue, urine retention, dry mouth, excitation

drug-drug: CNS depressants, no alcohol, MAOI's

-CI: asthma, LRI, liver disease, n-a glaucoma, BPH

-H1 blockers

-contricts smooth muscles

-1st generation: drowsiness, dry mouth

-2nd generation: less anticholinergic effects, less drowsiness

Examples: Benadryl, Dimetapp, ChlorTrimetron (1st generation); (2nd generation) Zyrtec-OTC, Allegra-OTC, Claritin-OTC, Astelin (NS)

-stimulate vasoconstriction, shrinking or dilated blood vessels from allergy, infection, inflammation

-reduce rhinitis

-spray, tablet, liquid

SE: jittery, insomnia, palpitations, elevated HR & BP & glucose

-avoid caffeine

-Rebound congestion (vasodilation) if discontinued use, use 3 days only b/c of rebound swelling

-oral work longer than topical, but more SE w/ oral

-Ephedrine, pseudophedrine (Sudafed)

-long duration of action

-more SE

-Oxymetazoline (Afrin), Phenylephrine (Neo-Synephrine)

-shrinks swelling

-short duration of action

-steroids

-anti-inflammatory

-treat seasonal allergic rhinitis

-may be combined w/ a H1 antihistamine

Examples: Beconase, Rhinocort, Decadron

-dexamethasone (Decadron) - short-term use b/c potent

-flunisolide (nasalide)

-fluticasone (flonase)

-triamcinolone (nasacort)

-suppress cough reflex

-nonproductive, irritating cough should be suppressed

-non-narcotic, narcotic & combination

Examples: Robitussin DM, Codeine, Robitussin AC, Tessalon

-non-narcotic antitussive for suppressing cough

-po

-SE: n, dizziness, drowsiness, sedation

-Adverse: hallucinations at high doses

-CI: COPD

-drug-drug: avoid CNS depressants, alcohol

-narcotic antitussive

-can be combined w/ antihistamine

-tablet or syrup

-SE: n, drowsiness, resp depression

-loosen & thin bronchial secretions

-combination product

-hydration is critical...push fluids

Example: Robitussin

-expectorant for dry, unproductive cough

SE: n/v