Upper Respiratory Tract Infection Ebook
The ideal H-, receptor antagonist should provide complete and rapid relief of allergic symptoms, have a moderate duration of action, and be devoid of adverse effects. Unfortunately, this type of agent does not exist (65). In general, first- and second-generation agents have fairly comparable antihistaminic effects in relieving common allergic symptoms, but they all have poor decongestant capabilities ( 22,66,67,68,69 and 70). H antagonists have proved useful in the treatment of allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, asthma, and anaphylaxis ( 3,10,17). The treatment of these disorders is discussed in different sections of this book. Numerous studies have compared the antihistaminic efficacy of second-generation antagonists with that of first-generation antagonists in the treatment of allergic rhinitis. Results have uniformly shown these agents to be more effective than placebo, but just as effective as first-generation agents, such as...
For the first two repetitions, you can make the sound aloud. On the third or last repetition, make the sound sub-vocally (vocalizing the sound so softly that only you can hear it) Repeat six, nine, twelve or twenty four times to alleviate extreme sadness, depression, colds, flu, toothaches, asthma and emphysema.
CNS stimulation including tremor and restlessness. Anticholinergic psychoses ataxia, euphoria, confusion, disorientation, loss of short-term memory, decreased anxiety, fatigue, insomnia, hallucinations, dysar-thria, agitation. CV Palpitations. GU Urinary retention or hesitancy, impotence. Ophthalmologic Blurred vision, dilated pupils, photophobia, cycloplegia, precipitation of acute glaucoma. Allergic Urticaria, skin rashes, anaphylaxis. Other Flushing, decreased sweating, nasal congestion, suppression of glandular secretions including lactation. Heat prostration (fever and heat stroke) in presence of high environmental temperatures due to decreased sweating.
Constipation, cramps, vomiting, flatulence, decreased appetite. CNS Headache, nervousness, insomnia, drowsiness, anxiety, dizziness, fa-tique, sedation, agitation. CV Hot flashes, palpitations. Pulmonary Infection, pharyngitis, nasal congestion, sinus headache, sinusitis, cough, dyspnea, bronchitis. GU Decreased libido, delayed ejaculation. Eyes Visual changes, eye pain, photophobia. Miscellaneous Sweating, rash, pruritus, urticaria, pain, asthenia, viral infection, fever, allergy, chills. Drug Interactions See individual agents.
Effects (dry mouth, dry eyes, urinary retention), nausea, nasal congestion, blurred vision, orthostatic hypotension, lethargy, confusion, constipation, diarrhea drowsiness, anxiety, tremor, dizziness, insomnia, vision changes, fatigue, nausea, diarrhea, dry mouth, rhinitis, painful menstruation, sweating
Inhibits platelet aggregation at higher doses than needed to reduce platelet count. Peak plasma levels 5 ng mL at 1 hr. tv2 1.3 hr terminal ty2 About 3 days. Metabolized in liver and excreted in urine and feces. Uses Reduce platelet count in essential thrombocythemia. Contraindications Lactation. Special Concerns Use with caution in known or suspected heart disease and in impaired renal or hepatic function. Safety and efficacy have not been determined in those less than 16 years of age. Side Effects CV CHF, palpitations, chest pain, tachycardia, arrhythmias, angina, postural hypotension, hypertension, cardiovascular disease, vasodilation, migraine, syncope, MI, cardiomyopathy, complete heart block, fibrillation, CVA, pericarditis, hemorrhage, heart failure, cardiomegaly, atrial fibrillation. Oral Aphthous stomatitis. GI Diarrhea, abdominal pain, pancreatitis, gastric duodenal ulcers, N&V, flatulence, anorexia, constipation, GI distress, GI hemorrhage, gastritis, melena,...
Special Concerns Use with caution during lactation and in elderly clients. There are no efficacy studies in children. GI disorders may limit absorption of atovaquone. Side Effects Since many clients taking atovaquone have complications of HIV disease, it is often difficult to distinguish side effects caused by atovaquone from symptoms caused by the underlying medical condition. Dermatologic Rash (including maculopapular), pruritus. Oral Can-didiasis, taste perversion. GI Nausea, diarrhea, vomiting, abdominal pain, constipation, dyspepsia. CNS Headache, fever, insomnia, dizziness, anxiety, anorexia. Respiratory Cough, sinusitis, rhinitis. Hematologic Anemia, neutropenia. Miscellaneous Asthenia, pain, sweating, hypo-glycemia, hypotension, hyperglyce-mia, hyponatremia. Drug Interactions Since atova-quone is highly bound to plasma proteins ( 99 9 ), caution should be exercised when giving the drug with other highly plasma protein-bound
Contraindications Myeloprolifera-tive disorders. Use with other agents known to suppress bone marrow function. Severe CNS depression or coma due to any cause. Lactation. Special Concerns Use with caution in clients with known CV disease, prostatic hypertrophy, narrow angle glaucoma, hepatic or renal disease. Side Effects Hematologie Agranu-locytosis, leukopenia, neutropenia, eosinophilia. CNS Seizures (appear to be dose dependent), drowsiness or sedation, dizziness, vertigo, headache, tremor, restlessness, nightmares, hypokinesia, akinesia, agitation, akathisia, confusion, rigidity, fatigue, insomnia, hyperkinesia, weakness, lethargy, slurred speech, ataxia, depression, anxiety, epilepti-form movements. CV Orthostatic hypotension (especially initially), tachycardia, syncope, hypertension, angina, chest pain, cardiac abnormalities, changes in ECG. Neuroleptic malignant syndrome Hyperpyrexia, muscle rigidity, altered mental status, irregular pulse or BP, tachycardia, diaphoresis,...
Viral infections, such as the common cold and flu, may lead to MS attacks. As a result, it may be helpful for people with MS to try to prevent viral infections or to shorten the time that they are affected by a viral infection. Limited options are available for the treatment or prevention of viral infections these include simple preventive measures (such as hand-washing and avoiding exposure to infected people), the flu vaccination, and recently developed prescription medications that decrease the duration and severity of the flu. Supplements of unproven effectiveness for the common cold (echinacea, garlic, zinc, vitamin C) pose a theoretical risk for people with MS because of possible immune-stimulating activity.
Side Effects CNS Side effects are due mainly to the psychoactive effects of the drug and, in addition to those listed in the preceding, include dizziness, muddled thinking, coordination difficulties, irritability, weakness, headache, ataxia, can-nabinoid high, paresthesia, hallucinations, visual distortions, deperson-alization, confusion, nightmares, disorientation, and confusion. CV Palpitations, tachycardia, vasodila-tion, facial flush, hypotension. Oral Dry mouth. GI Abdominal pain, N&V, diarrhea, fecal incontinence, anorexia. Respiratory Cough, rhinitis, sinusitis. Other Asthenia, conjunctivitis, myalgias, tinnitus, speech difficulty, vision difficulties, chills, headache, malaise, sweating, elevated hepatic enzymes.
Upper respiratory tract infections, pharyngitis, cough, dyspnea, rhinitis, bronchitis, nasal congestion, sinusitis, sinus headache, yawn. Skin Rash, pruritus, excessive sweating. Muscu-loskeletal Muscle, joint, or back pain. Miscellaneous Flu-like symptoms, asthenia, fever, chest pain, allergy, visual disturbances, blurred vision, weight loss, bacterial or viral infection, limb pain, chills.
CLINICAL FEATURES These compounds are responsible for dermal, pulmonary, gastrointestinal, and neurologic findings. Allergy, however, is their most common effect. Allergic reactions manifest as dermatitis, asthma, allergic rhinitis, hypersensitivity pneumonitis, and anaphylaxis. Dermal absorption is minimal, but these compounds are well absorbed from the gastrointestinal tract. Skin contact may lead to tingling and burning within 30 min of exposure and persisting up to 8 h. Contact dermatitis syndromes and allergic rhinitis result from both compounds. Allergic reactions including fatal asthma attacks have been reported. Upper and lower airway irritation occurs with local inhalation exposure. When absorbed, these compounds are metabolized rapidly in the liver, thus resulting in minimal systemic toxicity. These compounds are responsible for occasional systemic occupational poisonings. Systemic symptoms of paresthesias, hyperexcitability, tremors, incoordination, seizures, muscle...
Special Concerns Geriatric clients may manifest more CNS effects. Use with caution in liver or kidney disease. Side Effects The type and incidence of side effects depend on the use of the drug. When used for hyperprolactinemia. Oral Dry mouth. GI N&V, abdominal cramps, diarrhea, constipation. CNS Headache, dizziness, fatigue, drowsiness, light-headedness, psychoses. Other Nasal congestion, hypotension, CSF rhin-orrhea.
Uses Inhalation Prophylactic and adjunct in the management of severe bronchial asthma in selected clients. Prophylaxis of exercise-induced bronchospasms and bron-chospasms due to allergens, cold dry air, or environmental pollutants. Ophthalmologic Conjunctivitis, including vernal keratoconjunctivitis, vernal conjunctivitis, and vernal ker-atitis. Nasal, OTC Prophylaxis and treatment of allergic rhinitis. PO Mastocytosis (improves symptoms including diarrhea, flushing, headaches, vomiting, urticaria, nausea, abdominal pain, and itching). Non-FDA Approved Uses PO to treat food allergies. Following nebulization Sneezing, wheezing, itching, nose bleeds, burning, nasal congestion. Following nasal solution Burning, stinging, irritation of nose sneezing, nose bleeds, headache, bad taste in mouth, postnasal drip. Following ophthalmic use Stinging and burning after use. Also, conjunctival injection, watery or itchy eyes, dryness around the eye, puffy eyes, eye irritation, styes.
Uses Dry, nonproductive cough due to colds and minor upper respiratory tract infections when there is mucus in the respiratory tract. Contraindications Chronic cough (e.g., due to smoking, asthma, or emphysema), cough accompanied by excess secretions. Use in children under age 12 for persistent or chronic cough due to asthma or cough accompanied by excessive mucus (unless prescribed by a provider). Special Concerns Persistent cough may indicate a serious infection thus, the provider should be con-
Action Kinetics Following intranasal use, a small amount is absorbed into the general circulation. Onset Approximately 12 hr. Maximum effect May take several days. Absorbed drug is metabolized in the liver and excreted in the urine. Uses Maintenance treatment of asthma in adults and children over four years of age. To manage seasonal and perennial allergic rhinitis in Contraindications Use for nonaller-gic rhinitis. Use following nasal sep-tal ulcers, nasal surgery, or nasal trauma until healing has occurred. Special Concerns Safety and efficacy in children less than 12 years of age Side Effects Allergic Rarely, immediate hypersensitivity reactions or contact dermatitis. Respiratory Epistaxis, nasal burning, blood in nasal mucus, pharyngitis, irritation of nasal mucous membranes, sneezing, runny nose, nasal dryness, sinusitis, nasal congestion, bronchitis, nasal ulcer, nasal septum excoriation. CNS Headache, dizziness. Ophthalmolog-ic Eye disorder, cataracts,...
As noted above, CoA is required for Golgi function, involved in protein transport. Pantothenate deficiency can therefore cause reductions in the amounts of some secreted proteins. Other metabolic responses to deficiency include a reduction in urinary 17-ketosteroids, a reduction in serum cholesterol, a reduction in drug acetylation, a general reduction in immune response, and an increase in upper respiratory tract infection.
An associated acute suppurative upper respiratory tract infection Of all the medical treatments that have been advocated, a trial of an antimicrobial agent would appear to be most appropriate in those children who have not received an antibiotic recently. A meta-analysis of the effect of antimicrobial agents in the treatment of otitis media with effusion was reported by Rosenfeld and Post, which confirmed their efficacy.17 Two other meta-analyses also verified their short-term effect, but as expected, there was no long-term efficacy.16'18 Other strategies, such as antimicrobial prophylaxis or surgery, is required for long-term control, since the disease is frequently recurrent due to repeated exposure to upper respiratory tract infections. A 10- to 14-day course of amoxicillin is recommended.15 Repeated courses of a variety of antibiotics are not appropriate, as this common practice is also probably contributing to the rising resistant bacteria problem.
Hallucinations, agitation, confusion), restless legs, and convulsions. Minor adverse reactions often resemble those caused by anticholinergic agents, for example blurred vision, dryness of the mouth, insomnia, lethargy, and rash. In rare cases, photosensitization has been described. Oral or aerosol administration can be accompanied by gastrointestinal or minor neurological symptoms, such as insomnia, light-headedness, concentration difficulties, nervousness, dizziness, and headache in individuals taking 200 mg day (4). These symptoms disappear on withdrawal. More severe but rare complications include convulsions and coma (5,6). Local nasal adverse effects of the aerosolized form can mimic the symptoms of upper respiratory tract infection. In Parkinson's disease, in which doses of 200 mg day or more have been used, minor adverse effects resembling those caused by anticholinergic agents (for example blurred vision, dry mouth, as well as livedo reticularis, rash, and photosensitization,...
Data from 20 clinical studies in 5000 patients who had taken ranitidine bismuth citrate (200, 400, or 800 mg bd) have been reported (14). The incidence of adverse events was not different from that associated with placebo and was independent of dose. The most common events ( 1 of patients) were upper respiratory tract infections, constipation, diarrhea, nausea, vomiting, dizziness, and headache, the last being the only event reported by over 2 of the patients. Adverse events considered by the clinical investigator to be adverse reactions occurred with a similar frequency amongst patients given ranitidine bismuth citrate (8 ), ranitidine hydrochloride (6 ), and placebo (6 ). The incidence of adverse reactions was greater when amoxicillin (11 ) or clarithromycin (20 ) were co-prescribed.
In Eastern medicine ma huang is administered as a tea to fight fever, asthma, and the common cold but has become popular in the Western world as a stimulant and for promotion of weight loss. One study found that people using a ma huang and cola nut combination lost over four times more weight than persons using a placebo. Ma huang is marketed as a muscle builder, as
The safety profile of levetiracetam has been reviewed (7). The authors assessed the integrated summary of safety reports submitted for regulatory review in order to obtain information about abnormal laboratory test values and adverse events collected during the overall levetiracetam development program. The analysis included 3347 patients exposed to levetiracetam in clinical trials for epilepsy, cognition, and anxiety disorders. Safety data from all the studies showed a similar pattern of adverse effects, predominantly somnolence, weakness, and dizziness, which occurred most often during the first month of treatment. Laboratory tests that changed significantly in placebo-controlled trials nevertheless stayed in the reference ranges. The incidences of any types of allergic reactions were similar between levetiracetam and placebo (0.3 and 0.2 ). Cases of common cold and upper respiratory infection were significantly more frequent with levetiracetam than placebo (13 versus 7.5 ), but...
Dopamine receptor agonists are rapidly absorbed, and metabolized by the cytochrome P450 enzymes. They cause nausea, which can be relieved by domperi-done which does not cross the blood-brain barrier, dizziness and postural hypotension. These side-effects are dose related and are less common if the dose is increased gradually. Dopamine receptor agonists also lead to vivid dreams, nightmares, hallucinations, hyper-excitability, confusion and delusions. Sudden sleep attacks have been reported 12 in patients treated for Parkinson's disease. The tetracyclic ergot derivatives, such as bromocriptine, pergolide, cabergoline and lisuride, can cause serosal inflammation with pleuropulmonary fibrosis, retroperitoneal fibrosis, cardiac valve fibrosis and pericarditis. Ankle oedema, Raynaud's phenomenon and nasal congestion may also occur.
Been determined in children less than 12 years of age. Side Effects Respiratory Paradoxical bronchospasms, upper or lower respiratory tract infection, nasopharyn-gitis, disease of nasal cavity sinus, cough, pharyngitis, allergic rhinitis, laryngitis, tracheitis, bronchitis. Allergic Immediate hypersensitivity reactions, including urticaria, rash, and bronchospasm. CV Palpitations, chest pain, increased BP, tachycardia. CNS Headache, sinus headache, tremors, nervousness, malaise, fatigue, dizziness, giddiness. Oral Dry mouth, dental pain. GI Stomachache. Musculoskeletal Joint pain, back pain, muscle cramps, muscle contractions, myalgia, myo-sitis, muscle soreness. Miscellaneous Flu, dental pain, rash, skin eruption, dysmenorrhea.
Sertraline has been demonstrated to have a low incidence of anticholinergic, sedative, or cardiovascular effects because of its low affinity for adrenergic, cholinergic, histaminergic, or benzodiazepine receptors. However, sertraline was associated with a number of adverse effects in premarketing evaluation, the most common of which included gastrointestinal disturbance (nausea, 27 diarrhea loose stools, 21 ), sleep disturbance (insomnia, 22 somnolence, 14 ), headache (26 ), dry mouth (15 ), and sexual dysfunction (ejaculation failure, 14 decreased libido, 6 ). Other side effects reported by subjects, described as frequent (i.e., they occurred in at least 1 of 100 subjects) in premarketing pooled data from clinical trials, include impotence, palpitations, chest pain, hypertonia, hypoesthesia, increased appetite, back pain, asthenia, malaise, weight gain, myalgia, yawning, rhinitis, and tinnitus ( Zoloft 2001).
Frequency, micturition disorders, menstrual disorders, dysmenorrhea, dysuria, painful menstruation, intermenstrual bleeding, sexual dysfunction and decreased libido, nocturia, polyuria, dysuria, urinary incontinence. Respiratory Rhinitis, pharyngitis, yawning, bronchospasm, coughing, dyspnea, epistaxis. Ophthalmologic Blurred vision, abnormal vision, abnormal accommodation, conjunctivitis, diplopia, eye pain, xerophthalmia. Otic Tinnitus, earache. Body as a whole Asthenia, fever, chest pain, chills, back pain, weight loss or weight gain, generalized edema, malaise, flushing, hot flashes, rigors, lymphadenopathy, purpura.
Side Effects Body as a whole Headache, infection, asthenia, back pain, chest pain. CV Postural hypotension, syncope. GI Diarrhea, nausea, tooth disorder. CNS Dizziness, vertigo, somnolence, insomnia, decreased libido. Respiratory Rhinitis, pharyngitis, increased cough, sinusitis. GU Abnormal ejaculation. Miscellaneous Amblyopia. Drug Interactions Cimetidine causes significant l in clearance of tamsulosin.
Sildenafil, a selective inhibitor of cGMP-specific phosphodiesterase type 5, enhances the effect of NO release into the corpora cavernosa from nonadrenergic-noncholinergic nerves of the parasympathetic system and vascular endothelium during sexual stimulation.26 Sildenafil potentiates the hypotensive effect of nitrates and is absolutely contraindicated in men using nitrates.54 Sildenafil may be hazardous to men with borderline low blood pressure, borderline low cardiac volume, or medications that can prolong its half-life.55 Adverse effects include headache, flushing, nasal congestion, dyspepsia, abnormal vision, diarrhea, and dizziness.26 To optimize the treatment outcome, sildenafil should be ingested on an empty stomach. Excessive alcohol consumption should be avoided.
Echinacea is the most-popular herbal immunostimulant in North America and Europe. In Germany, Echinacea products are commercialized as drugs and sold in pharmacies most are aerial parts or hydroalcoholic extracts of E. pallida or purpurea roots. This plant was traditionally used for treating wounds, snakebites, headache, the common cold, rheumatism, neuralgia, erysipelas, dyspepsia, tumors and boils, open wounds, vertigo, etc. E. purpurea has polysaccharides (4-0-methyl-glucoro-noarabinoxylan and an acidic arabinorhamnogalactan) with immunostimulatory properties, stimulating phagocytosis and enhancing the production of oxygen radicals by macrophages, as well as properties associated with antibacterial activity. Echinacea has also shown anti-inflammatory activity. The caffeic acid derivatives echinacoside and cichoric acid inhibit the hyaluronidase and protects type III collagen from free radical-induced degradation these compounds may also be involved in the inhibition of human...
Sildenafil has other minor adverse effects, such as headache, nasal congestion, and flushing. There are no clinically significant drug interactions between sildenafil and apomorphine. Apomorphine, like sildenafil, is orally active. However, unlike sildenafil, it exerts its action through the central nervous system. Apomorphine can produce dizziness, nausea, pallor, and hypotension, and in the presence of ethanol, it purportedly increases
Paresthesia, tremor, numbness, incoordination. GU Urinary hesitancy or frequency, enuresis, amenorrhea, pelvic inflammatory disease. Miscellaneous Tinnitus, sore throat, nasal congestion, altered smell, muscle aches or pains, skin rash, headache, sweating, hyperventilation, SOB, hair loss, galactorrhea, decreased or increased libido, delayed ejaculation.
Side Effects CV Pedal edema, flushing, increased angina, palpitations, tachycardia, other edema, abnormal ECG, hypotension, postural hypotension, syncope, MI, AV block, ventricular extrasystoles, peripheral vascular disease. CNS Dizziness, headache, somnolence, malaise, nervousness, insomnia, abnormal dreams, vertigo, depression, confusion, amnesia, anxiety, weakness, psychoses, hallucinations, paranoia. Oral Dry mouth, sore throat, gingival hyperplasia. GI N&V, dyspepsia, constipation. Neuromuscular Asthenia, myalgia, paresthesia, hyperkine-sia, arthralgia. Miscellaneous Rash, dyspnea, SOB, nocturia, polyuria, allergic reactions, abnormal liver chemistries, hot flashes, impotence, rhinitis, sinusitis, nasal congestion, chest congestion, tinnitus, equilibrium
Cow's milk contains 30 to 35 g protein per liter, which include a large number of antigens. The main antigens are P-lactoglobulin, casein (about 30 g l ), a-lactalbumin, serum lactalbumin and the immunoglobulines. P-lactoglobulin and a-lactalbumin are referred to as the whey proteins. Casein and P-lactoglobulin are the most heat-resistant. Cow's milk allergy (CMA) is most frequently seen in children. In 10 of the cases, the symptoms appear in the first week of life in 33 , in the 2nd to 4th week and in 40 , during the following months. The main symptoms are eczema and gastro-intestinal complaints such as diarrhea, cramps, vomiting, and constipation. Also, rhinitis, asthma, and rash may develop. An often obvious feature is irritability and restlessness. There are some specific syndromes (protein-mediated gastroenteropathy and the Heiner syndrome) which are attributed to CMA, but these will not be discussed in this context. In the older child, rhinitis and asthma,...
Side Effects CV Orthostatic hypotension, hypotension, MI, angina pectoris, palpitations, paradoxical pressor reaction, tachycardia. CNS Headache, dizziness, psychoses, tremors, depression, anxiety, disorientation. GI N&V, diarrhea, anorexia, constipation, paralytic ileus. Allergic Rash, urticaria, fever, chills, arthralgia, pruritus, eosinophilia. Rarely, hepatitis, obstructive jaundice. Hematologic Decrease in hemoglobin and RBCs, purpura, agranulocytosis, leukope-nia. Other Peripheral neuritis (paresthesias, numbness, tingling), dyspnea, impotence, nasal congestion, edema, muscle cramps, lacrimation, flushing, conjunctivitis, difficulty in urination, lupus-like syndrome, lym-phadenopathy, splenomegaly. Side effects are less severe when dosage is increased slowly. NOTE Hydrala-zine may cause symptoms resembling system lupus erythematosus (e.g., arthralgia, dermatoses, fever, splenomegaly, glomerulonephritis). Residual effects may persist for several years and long-term treatment with...
As mentioned previously, the smooth muscle of the bladder base and proximal urethra contain predominately alpha-adrenergic receptors. Therefore, alpha-blockers primarily affect the smooth muscle of the bladder neck and proximal urethra as well as the striated sphincter tone. Phenoxybenzamine was the original alpha-adrenolytic agent used to treat voiding dysfunction. The side effects of this medication are orthostatic hypotension, reflex tachycardia, nasal congestion, diarrhea, meiosis, sedation, nausea, and vomiting. It has also been shown to have mutagenic activity, and in animals it induced peritoneal sarcomas and lung tumors (25). Terazosin (Hytrin), doxazosin (Cardura), and prazosin (Minipress) are selective alpha-blocking drugs. These drags are selective for the alpha) receptor. Prazosin differs because it has a short duration of action and therefore must be administered every 4-6 h. The other drugs can be given once daily (26,27). The use of these drugs has been promoted for the...
Acute unilateral vestibulopathy is characterized by acute onset of vertigo, nausea, and vomiting lasting for several days, not associated with auditory or neurologic symptoms. Most patients gradually improve over a few weeks, but older patients can have persistent symptoms for months. About half of patients report having had a recent viral upper respiratory tract infection.
Side Effects CNS Headaches (most common) which may be severe and persistent, restlessness, dizziness, weakness, apprehension, vertigo, anxiety, insomnia, confusion, nightmares, hypoesthesia, hypokinesia, dyscoordination. CV Postural hypotension (common) with or without paradoxical bradycardia and increased angina, tachycardia, palpitations, syncope, rebound hypertension, crescendo angina, retrosternal discomfort, CV collapse, atrial fibrillation, PVCs, arrhythmias. Oral Dry mouth, burning sensation. GI N&V, dyspepsia, diarrhea, abdominal pain, involuntary passing of feces and urine, tenesmus, tooth disorder. Dermatologic Crusty skin lesions, pruritus, rash, exfoliative dermatitis, cutaneous vasodilation with flushing. GU Urinary frequency, impotence, dysuria. Respiratory Upper respiratory tract infection, bronchitis, pneumonia. Allergic Itching, wheezing, tracheobronchitis. Miscellaneous Perspiration, muscle twitching, methemoglobinemia, cold sweating, blurred vision, diplopia,...
Side effects of the vaccine found in 1 to 10 of immunized individuals are local reactions at injection site, such as induration, redness, and swelling systemic reactions, such as fatigue, fever, or malaise anorexia and nausea. Less than 1 may experience hematoma at injection site, pruritus, skin rash, pharyngitis, upper respiratory tract infections, abdominal pain, diarrhea, vomiting, arthralgia, myalgia, lymphadenopathy, insomnia, photophobia, and vertigo. Vaccines should not be administered to persons with a history of hypersensitivity reaction to alum or, for HAVRIX, reaction to the preservative 2-phenoxyethanol. The safety of hepatitis A vaccine during pregnancy has not been determined.
Hypotension, dizziness, headache, tachycardia, fatigue, edema, flushing, nausea, nasal congestion, and leg cramps have been noted. In Raynaud's phenomenon, all vasodilators may precipitate a vascular steal syndrome. Orthostatic hypotension, syncope, peripheral edema, fatigue, headache, dizziness, and nausea may occur. Rarely, urinary frequency, impotence, rash, and nasal congestion have been noted.
Treat rheumatic difficulties, colds, cough, angina, and gonorrhea. The leaves are used to calm itchiness of eczematous eruptions. The roots are used to treat colds and rheumatisms, and the stems are used to sooth burns and scalds. An infusion of the stems is drunk to treat headache, dizziness, convulsions of children, cough, mental unrest, and to promote wakefulness. In the Philippines, Vitex negundo L. is used to promote milk secretion and menses. In India, the plant is used to soothe inflammation and to calm itching. The anti-inflammatory property of Vitex negundo L. is confirmed a water extract of the leaves protects rats against carrageenan-induced rat paw edema, formaldehyde-induced rat paw edema, and hot-plate test. Although there have been many studies on the anti-inflammatory properties of the plant, much less work has been done on the psy-chopharmacological and especially dopaminergic properties of this plant (84,85). Note that the fruits of Vitex agnus-castus contain...
Solanine hydrochloride has been used as a commercial pesticide. It has sedative and anticonvulsant properties, and has sometimes been used for the treatment of asthma, as well as for cough and common cold. However, gastrointestinal and neurological disorders result from solanine poisoning. Symptoms include nausea, diarrhoea, vomiting, stomach cramps, burning of the throat, headaches and dizziness. Other adverse reactions, in more severe cases, include hallucinations, loss of sensation, paralysis, fever, jaundice, dilated pupils and hypothermia. Solanine overdose can be fatal.
Although not directly related to psychotherapy, the following research will provide further insight into the value of the animal-human bond. Mental health professionals may find this information useful in developing a clearer perception of the impact of animals in the lives of people. Over the past 30 years there have been several controlled studies documenting the correlation of pet ownership and cardiovascular health. Erika Friedman and her associates designed a study investigating pet ownership with survival rates among patients who were hospitalized for heart attacks, myocardial infarctions, or severe chest pains. The results illustrated a significant difference in life expectancy between the subjects who did have a pet versus those who did not. The results pointed out that 5.7 of the 53 pet owners compared with 28.2 of the 39 patients who did not own pets died within one year of discharge from a coronary care unit. The findings within this study have been replicated with similar...
As noted earlier, testosterone replacement therapy does not cure sexual dysfunction, and does not normalize high serum PRL levels (10). The therapeutic management of prolactinomas is primarily accomplished with dopamine agonists for the patient with a microadenoma or a macroadenoma (21). Dopamine agonist therapy was developed based on the finding that the synthesis and secretion of PRL are regulated by the tonic inhibitory effects of hypothalamic dopamine, which acts on dopamine D2 receptors on the surface of lactotrophs (16). Bromocriptine mesylate is a semisynthetic ergot alkaloid and long-acting dopamine receptor agonist. It normalizes PRL levels in 80-90 and 60-75 of patients with microprolactinomas and macroprolactinomas, respectively (14,22). Treatment should be started with a dose of 1.25 mg administered at night consumed with a snack. After 1 wk, 1.25 mg is added in the morning. An additional dose of 1.25 mg d may be added to the treatment regimen as tolerated every 7 d until...
And likely has a genetic susceptibility. Native Americans, Alaskan and Canadian Eskimos, and Australian aborigines have an extraordinary incidence and severity of otitis media. The single-most frequently recognized cause of acute otitis media is a viral upper respiratory tract infection. Others have anatomic changes (cleft palate, cleft uvula, submucous cleft), alteration of normal physiologic defenses (patulous Eustachian tube), and congenital or acquired immunologic deficiencies including acquired immunodeficiency syndrome (AIDS). The use of chemoprophylaxis (antimicrobial agents) and immunoprophylaxis (pneumococcal vaccine) should be considered for the prevention of recurrent episodes of acute otitis media. The currently available 23-type pneumococcal polysaccharide vaccine protects against the most common types of S. pneumoniae found in otitis media. Intermittent antibiotic prophylaxis (during the period of upper respiratory tract infections), using a once-a-day regimen of...
Side effects commonly reported in clinical trials include dry mouth, constipation, anxiety, rhinitis, and insomnia but these rarely led to withdrawal from the study. The noradrenergic actions of the drug may cause an increase in blood pressure and heart rate in some patients or prevent the expected fall in these parameters with weight loss. It should not be given in patients with uncontrolled hypertension. It should not be given concomitantly with monoamine oxidase inhibitors, nor other centrally acting anorexic drugs, or sympathomimetic agents including cold remedies such as pseudoephedrine.
Special Concerns Use with caution during lactation. Safety and efficacy have not been determined for children less than 6 years of age. Side Effects Adolescents and adults aged 15 and older. GI Dyspepsia, infectious gastroenteritis, abdominal pain, dental pain. CNS Headache, dizziness. Body as a whole Asthenia, fatigue, trauma. Respiratory Influenza, cough, nasal congestion. Dermatologie. Rash. Miscellaneous Pyu-ria.
Side Effects CNS Headache, fatigue, somnolence, insomnia, dizziness, abnormal dreams, anxiety, nervousness, confusion (rare). Oral Dry mouth. GI N&V, diarrhea, pancreatitis, constipation, abdominal discomfort, flatulence, dyspepsia, anorexia. Dermatologie. Exfoliative dermatitis, erythroderma, pruritus, urticaria, erythema multiforme. CV Asymptomatic ventricular tachycardia rarely, cardiac arrhythmias or arrest following rapid IV use. Respiratory Rhinitis, pharyngitis, sinusitis, cough. Body as a whole Asthenia, back pain, chest pain, infection, fever, myalgia. Miscellaneous Impotence, loss of libido, thrombocytopenia, sweating, gynecomastia, hyperurice-mia, eosinophilia, gout, and cholestat-ic or hepatocellular effects (resulting in increased AST, ALT, or alkaline phosphatase).
CNS Dyskinesia (common), dizziness, dystonia, hallucinations, confusion, insomnia, somnolence, anxiety, tremor, depression, abnormal dreams, psychosis, personality disorder, extrapyramidal syndrome, akathi-sia, paresthesia, incoordination, akine-sia, neuralgia, hypertonia, speech disorders. Musculoskeletal Arthralgia, bursitis, twitching, myalgia. Respiratory Rhinitis, dyspnea, hiccup, epistaxis. Dermatologic Sweating, rash. Ophthalmologic Abnormal vision, double vision, eye disorders. GU UTI, urinary frequency, hematuria. Whole body Pain in chest, abdomen, neck, or back headache, asthenia, flu syndrome, chills, facial edema, infection. Miscellaneous Peripheral edema, anemia, weight gain.
Some recreational users combine butorphanol with the common cold and allergy remedy diphenhydramine to produce a typical opiate-type stupor. Users of that combination sometimes report loss of interest in other drugs. Unwanted results can include emotional flip-flops, dizziness, nausea, vomiting, breathing difficulty, and general reduction of mental and physical abilities. Withdrawal symptoms from the combination may involve impaired concentration, mental restlessness and unease, and emotional instability and peevishness.
SIDE EFFECTS Common (10-50 ) Flushing, headache. Less common (1-10 ) Indigestion, nasal congestion, dizziness, color-tinged vision. Those requiring attention from your physician Erections lasting more than four hours require immediate medical attention, as damage to the penis can result any physical symptoms not noted here.
Common side effects include mood swings, body spasms, diarrhea, nausea, dry mouth, and body odor. Less common side effects include dizziness, fainting, headache, insomnia, nightmares, rash, itching, vomiting, irregular heartbeat, flushing of the face, blurred vision, muscle twitches, dark or discolored urine, difficulty in urinating, muscle cramps, loss of appetite, abdominal discomfort, nasal congestion, tingling and numbness of the hands and feet, constipation, and tiredness. Rare side effects include high blood pressure, hallucinations, psychosis, anemia, impotence, and hair loss. Life-threatening or overdose symptoms include muscle twitches, spastic blinking, nausea, vomiting, diarrhea, irregular and rapid pulse, weakness, fainting, confusion, agitation, hallucinations, and coma. There is evidence that bromocriptine may be addictive.
SIDE EFFECTS Common (10-50 ) Headache, flushing. Less common (1-10 ) Indigestion, nasal congestion, color-tinged visual changes. Those requiring attention by your physician Erections lasting more than four hours require immediate medical attention, as damage to the penis can result.
Sinusitis An inflammation of one or more of the sinuses, often as a complication of an upper respiratory infection or dental infection. It also may be caused by allergies, air travel, or underwater swimming. sinusitis is extremely common and afflicts some people with every bout of the common cold. In many children, once a tendency toward sinusitis develops, the condition recurs with each viral infection.
Side Effects Listed are side effects with incidence of 2 or greater. CNS Headache, dizziness. Oral Dry mouth, glossitis. GI Dyspepsia, diarrhea. Dermatologic Flushing, rash. Ophthalmic Mild and transient predominantly color tinge to vision, increased sensitivity to light, blurred vision. Respiratory Nasal congestion, respiratory tract infection. Miscellaneous UTI, back pain, flu syndrome, arthralgia.
Sildenafil is mostly well tolerated (22). In the more recent clinical trials, only 2-3 of men discontinued treatment due to adverse effects, which is a similar proportion to those taking placebo (31). Most men who discontinue treatment do so because of partner reluctance, perceived ineffectiveness of the drug, or lack of motivation. Up to one-third of men experience one or more adverse effects, but where effects do occur, they are mostly mild and transient (minutes to hours) (29,31). The frequencies of adverse effects vary from study to study and become more frequent where higher doses are used. Most common adverse effects are headaches (7-39 ), facial flushing (7-35 ), dyspepsia (7 ), and rhinitis (4 ) (22,29,32). These effects appear to be the result of a mild transient decrease in blood pressure because of the effect on peripheral vessel vasodilatation (31). Visual disturbances have also been reported by a small proportion of men, but these disturbances tend to be very transient,...
Evidence of the harmful effects of cigarette smoking also may be observed in smokers in whom frank disease has not yet developed. Shortness of breath, cough, excessive phlegm, and nasal catarrh are common symptoms that readily subside when smokers stop smoking (U.S. Department of Health, Education, and Welfare, 1979). Smokers often report a dulling of the senses of taste and smell, and smokers, as well as their family members, generally experience more colds and illness than nonsmokers (U.S. Department of Health, Education, and Welfare, 1979). Tobacco smoke and products may interact with other drugs that patients are taking (Pharmacists' Helping Smokers Quit Program, 1986). Drugs that show the most significant interactions with tobacco smoke include oral contraceptives, theophylline, propranolol, and other antianginal drugs. Drugs with moderately significant clinical interactions with smoking include propoxyphene, pentazocine, phenylbutazone, phenothiazine, tricyclic antide-pressants,...
Special Concerns Use with caution during lactation and in those with dysphagia, symptomatic esoph-ageal disease, gastritis, duodenitis, or ulcers. Safety and efficacy have not been determined in children. Side Effects Oral Dry mouth. GI Diarrhea, N&V, dyspepsia, flatulence, tooth disorder, abdominal pain, constipation, gastritis. Body as whole Pain, back pain, accidental injury, flu-like symptoms, chest pain, asthenia, syncope, fatigue, flushing. CNS Headache, dizziness, paresthesia, vertigo, anorexia, somnolence, anxiety, nervousness, insomnia. CV Dependent edema, peripheral edema, hypertension. Musculoskeletal Ar-thralgia, arthrosis, pathological fracture, involuntary muscle contractions. Respiratory Rhinitis, sinusitis, URTI, coughing, pharyngitis, bronchitis. Dermatologic Rash, skin disorder, pruritus, increased sweating. Ophthalmic Cataract, conjunctivitis, glaucoma. Miscellaneous Hyperpa-
Ziprasidone does not increase serum prolactin levels and is virtually devoid of extrapyramidal side-effects and weight gain. Its major side-effects are nasal congestion and somnolence.(80) There has been some concern of cardiovascular side-effects, for example increased QTc interval however, perusal of the available data does not reveal a significant problem in this regard. However, further study is indicated.
Treatment and Outlook The primary method of allergy treatment is the avoidance of whatever substance causes the allergic reaction. If that isn't possible or if it doesn't sufficiently control the symptoms, antihistamines may be prescribed. These drugs block the effects of allergy-symptom-producing chemicals released by the body in response to an allergen. Newer types of antihistamines approved for children have fewer side effects (such as drowsiness and behavior changes) than previously available types. Nasal steroid sprays may also be recommended for children with allergic rhinitis (sneezing and itchy, runny nose).
The history should identify the onset, duration, and frequency of the symptom as well as the presence of crucial movements or positions that precipitate it. Ask about accompanying symptoms such as nausea, vomiting, otalgia, tinnitus, hearing loss, or a sensation of aural fullness. Finally, any clearly precipitating events such as head trauma or recent upper respiratory tract infections should be identified.
Oral Dry mouth, metallic taste, furry tongue, glossitis, stomatitis (due to overgrowth of Candida). GI Nausea, vomiting, diarrhea, abdominal discomfort, constipation. CNS Headache, dizziness, vertigo, incoordination, ataxia, confusion, irritability, depression, weakness, insomnia, syncope, seizures, peripheral neuropathy including paresthesias. Hematologic Leukopenia, bone marrow aplasia. GU Burning, dysuria, cystitis, polyuria, incontinence, dryness of vagina or vulva, dyspareunia, decreased libido. Allergic Urticaria, pruritus, erythematous rash, flushing, nasal congestion, fever, joint pain. Miscellaneous ECG abnormalities, thrombophlebitis.
A 45-year-old, generally healthy female on no medications comes to your office with a 10-day history of nasal congestion, sore throat, dry cough, and initial low-grade fever, all of which were nearly resolved. However, over the past 24 to 48 h she has developed a sharp chest pain, worse with deep inspiration or cough, but no dyspnea. Due to the severity of the pain, the nurse had obtained an ECG, which showed diffuse ST elevation. On physical exam, you expect the most likely finding to be
Despite their tendency to put people in bad moods, antihistamines are among the most widely consumed of all medical drugs, and neither doctors nor patients think of them as psychoactive. Furthermore, antihistamines are common ingredients of many over-the-counter preparations, such as cold remedies and sleeping aids they sometimes even arrive in the mail in free samples of these products. Anyone suffering from chronic depression and lethargy should make sure they are not consuming these chemicals in one form or another. Allergy sufferers should also know that allergic symptoms frequently respond to nondrug treatments, such as changes in diet and mental state, making it possible to avoid antihistamines entirely.
Special Concerns Use with caution in clients who are hypersensitive to carbamates. Aplastic anemia and acute liver failure have been observed in a few clients. Use with caution during lactation. Safety and efficacy have not been established in children other than those with Lennox-Gastaut syndrome. Side Effects May differ depending on whether the drug is used as mono-therapy or adjunctive therapy in adults or for Lennox-Gastaut syndrome in children. CNS Insomnia, headache, anxiety, somnolence, dizziness, nervousness, tremor, abnormal gait, depression, paresthesia, ataxia, stupor, abnormal thinking, emotional lability, agitation, psychologic disturbance, aggressive reaction, hallucinations, euphoria, suicide attempt, migraine. Oral Dry mouth, facial edema, buccal mucous membrane swelling (rare), taste perversion. GI Dyspepsia, vomiting, constipation, diarrhea, nausea, anorexia, abdominal pain, hiccoughs, esophagitis, increased appetite. Respiratory Upper respiratory tract infection,...
Uses PO Treatment of vasomotor, perennial, or seasonal allergic rhinitis and allergic conjunctivitis. Treatment of angioedema, urticarial transfusion reactions, urticaria, pruritus. Atopic dermatitis, contact dermatitis, pruritus ani, pruritus vulvae, insect bites. Sneezing and rhinorrhea due to the common cold. Treatment of anaphy-
CV Orthostatic hypotension, syncope, tachycardia, palpitation. Respiratory Pharyngitis, rhinitis, increased cough, dyspnea. Miscellaneous Peripheral edema, sweating, leukopenia, ear pain. Note Neuroleptic malignant syndrome and seizures, although rare, may occur. Drug Interactions Barbiturates l Effect of quetia-pine due to T breakdown by liver Carbamazepine l Effect of que-tiapine due to T breakdown by liver
Gynecomastia, increased appetite, weight gain, hyper- or hypoglyce-mia, glycosuria. Delayed ejaculation, increased or decreased libido. GU Menstrual irregularities, loss of bladder control, urinary difficulty. Der-matologic Photosensitivity, pruritus, erythema, eczema, exfoliative dermatitis, pigment changes in skin (long-term use of high doses). Hematologic Aplastic anemia, leukope-nia, agranulocytosis, eosinophilia, thrombocytopenia. Ophthalmologic Deposition of fine particulate matter in lens and cornea leading to blurred vision, changes in vision. Respiratory Laryngospasm, broncho-spasm, laryngeal edema, breathing difficulties. Miscellaneous Fever, muscle stiffness, decreased sweating, muscle spasm of face, neck, or back, obstructive jaundice, nasal congestion, pale skin, mydriasis, systemic lupus-like syndrome.
In an open, single-blind, randomized study, naltrexone (50 mg day) and acamprosate (1665-1998 mg day) were used for 1 year by 157 recently detoxified alcohol-dependent men with moderate dependence (4). The time to first relapse was 63 days (naltrexone) and 42 days (acamprosate) after 1 year, 41 of those given naltrexone and 17 of those given acamprosate had not relapsed. Adverse effects were more common with nal-trexone and were worse during the first 2 weeks of treatment. They included nausea (25 versus 4 ), abdominal pain (23 versus 4 ), drowsiness (35 versus 2 ), headache (13 versus 6 ), and nasal congestion (23 versus 7 ).
Effects Has been used to treat anxiety and depression. A stimulant, it is said to benefit the stomach, intestines, and circulation, and has been used to treat cramps, indigestion, gas, motion sickness, and nausea. It is said to help cleanse the body through sweating, to stimulate the appetite, and to relieve the symptoms of colds.
Drug formulations A single dose of bus-pirone ER (extended-release) 30 mg has been compared with two doses of buspirone IR (immediate-release) 15 mg given 12 hours apart to assess differences in tolerability in an open, crossover, randomized study in 18 healthy men (21c). Blood samples were obtained at 22 times. Seven subjects reported a total of 13 adverse events during the study, but none of the events recorded was unexpected. All were mild and resolved by the end of the study without medical intervention. Three adverse events (rhinitis, headache, and light-headedness) were categorized as unrelated to the study drug. The other 10 adverse events included drowsiness, dizziness, depression, tinnitus, and increased blood pressure. There were no significant differences between the two formulations.
Pseudoephedrine hydrochloride Action Kinetics The most commonly used agents for relief of nasal congestion are the adrenergic drugs. They act by stimulating alpha-adren-ergic receptors, thereby constricting the arterioles in the nasal mucosa this reduces blood flow to the area, decreasing congestion. However, drugs such as ephedrine and pseudo-ephedrine also have beta-adrenergic effects. Both topical (sprays, drops) and oral agents may be used, although oral agents are not as effective. Uses PO. Nasal congestion due to hay fever, common cold, allergies, or sinusitis. To help sinus or nasal drainage. To relieve congestion of eustachian tubes. Topical. Nasal and nasopharyngeal mucosal congestion due to hay fever, common cold, allergies, or sinusitis. With other therapy to decrease congestion around the eustachian tubes. Relieve ear block and pressure pain during air travel. Contraindications Oral use in severe hypertension or CAD. Use with MAO inhibitors. Oral use of pseudo-ephedrine...
A thorough history is the most critical component in the evaluation of rhinosinusitis. Symptoms most commonly associated with chronic rhinosinusitis in children have been described by Parsons and Phillips as the seven cardinal symptoms. 18 These include chronic nasal congestion (100 occurrence), purulent nasal discharge (90 ), head pain discomfort (90 ), cough (71 ), fetid breath (67 ), postnasal drainage (63 ), and behavioral changes (63 ).18 The cough, most often secondary to postnasal drainage, is typically worse in the evening for younger children, and in the early morning for adolescents. Infrequent symptoms reported in less than 20 of the study population include recurrent odynophagia, intermittent fever, nausea, hoarseness, facial puffiness, epistaxis, dizziness, impaired smell, epiphora, and localized pain in the ear, eye, or maxillary teeth.18'19
It is said to be useful in the treatment of asthma (by dilating the bronchioles), narcolepsy, nasal congestion, and allergies. Some claim it helps to burn off fat and contribute to weight loss. Ephedra sinica may contain a substance that prevents the growth of the Influenza B virus. Dymetadrine 25 is an over-the-counter drug that is pure ephedrine.
The drug is usually administered intranasally, although oral preparations of equal efficacy have been developed (equivalent oral dose is 10 times the intranasal dose). It has been shown that almost 50 of children are able to stop wetting completely with a single nightly dose of 20-40 mcg of DDAVP given intranasally. A further 40 are afforded a significant reduction in the frequency of enuresis with this treatment. As with tricyclic antidepressants, however, when treatment is stopped, the vast majority of individuals relapse. Side effects of this medication include nasal pain and congestion, headache, nausea, and abdominal pain. Serious problems of water intoxication, hyponatremia, and seizures are rare. It is important to be aware that intranasal absorption is reduced when the child has a cold or allergic rhinitis. The mode of action of desmo-pressin is unknown.
SIDE EFFECTS Common (10-50 ) Headache, indigestion. Less common (1-10 ) Back pain, flushing, muscle aches, nasal congestion, color-tinged visual changes. Those requiring attention by your physician Erections lasting more than four hours require immediate medical attention, as damage to the penis can result.
Chronic rhinopathy is nose disease including chronic simple rhinitis, chronic thick rhinitis and chronic and festering nasal sinusitis, usually caused by catching cold, sysmetic diseases, or an irritative environment. These factors may attack each other and make it difficult to recover from the disease. Chronic simple rhinitis is a kind of nasal obstruction in the two nasal cavities. The nasal obstruction for chronic hyertrophic rhinitis is more severe, with more nasal discharge of mucus or festering. The symptoms of chronic nasal sinusitis are similar to the former, but the amount of the nasal discharge is greater and in a smell of stench, often accompanied with headache and dizziness.