12. Mrs. L. was seen in the office several days ago with a common cold. She has

Question

12. Mrs. L. was seen in the office several days ago with a common cold. She has been on decongestant ther- apy with naphazoline nasal spray (Privine) since that time. Today she calls to say, "I thought I was getting over this, but suddenly my nose is more stuffed up than ever." Does Mrs. L. possibly need a stronger dosage of the decongestant? Explain your answer. 2. 3. 13. Keith has been using a topical nasal decongestant for the past few days. He calls the health care pro- vider's office to report that he is feeling nervous and dizzy and that his heart seems to be racing. What might be the cause of Keith's symptoms? 14. How does benzonatate (Tessalon Perles) differ from 4 other antitussive drugs in its mechanism of action? In its drug interaction profile?

Explanation / Answer

12) Naphazoline comes under the category of alpha1 agonist and it works on stimulating the alpha adrenergic receptors in the arterioles of the conjunctivaand nasal areas to produce vasoconstriction.

It creates local side effects like dryness, transient stinging, local irritation, sneezing and rebound congestion.

Re-bound congestion is very common adverse effect with extended use of the drug. So, Mrs.L is having the side effect of the Drug privine like stuffed nose because it is a common side effect of rebound congestion with Naphazoline. So she might not require high dose of other decongestant but if there is severe congestion ,can consult a physician for change in medication.

13) There could be local side effects like dryness of nasal area, stinging, irritation of nasal mucosa. There could be some serious side effects like dizziness, headache, bounding heartbeats, nausea, mood changes and serious side effect could be adverse drug reaction. Both severe an serious side effects are rare with the drug. If found one, then it has to be informed immediately to the physician.

The apha1 agonist nature of the drug can lead to this side effect like dizziness,feeling nervous and racing heart beat.

14) Antitussive s are remedies which relieves coughing, in particular to herbal terms,the appreciable level of cyanogenic glycosides. Benzonatates act pheriphally while other Antitussive act centrally. Benzonatates acts peripherally either anaesthetising the local nerve endings and vagal afferent fibres of alveoli of lungs,bronchi and act as demulcent which gives soothing effect.

Centrally acting Antitussive work on inhibiting the cough center in brain. No major interactions are found with this drug to other drugs.

17) Anti histamines which alleviate allergies are considered safer .But keep in mind that the first generation anti histamines like Benadryl and Chlor-Trimetron can cause sedation in baby as the drug pass through breast feed. On the other hand ,the second and third generation of anti histamines such as claritine and allegra are not likely to cause side effects. But ,taking over the counter anti histamines can be taken with the consultation of Pediatrician.

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