Drugs PDF: Viral Rhinitis, Influenza, Rhinosinusitis, and Pharyngitis

3/26/24, 10:01 PM Viral Rhinitis, Influenza, Rhinosinusitis and Pharyngitis if the close contact did not occur during the infectious period of the person with suspected or confirmed influenza If >4 days have elapsed since the last infectious contact Nonpharmacologic Therapy For the common cold, infl...

3/26/24, 10:01 PM Viral Rhinitis, Influenza, Rhinosinusitis and Pharyngitis if the close contact did not occur during the infectious period of the person with suspected or confirmed influenza If >4 days have elapsed since the last infectious contact Nonpharmacologic Therapy For the common cold, influenza, pharyngitis and rhinosinusitis, nonpharmacologic treatment consists of bed rest, good hydration and increased humidity (>50%). Pharmacologic Therapy Irritated nasal tissue may be soothed with commercial nasal saline solutions as they can improve symptoms and decrease medication use in rhinosinusitis.​ Petrolatum may be applied to a raw nose to increase patient comfort; however, caution is advised due to reports of exogenous lipoid pneumonia secondary to chronic inhalation of routinely applied oil-based products (e.g., petrolatum).​ Thus, saline-based products are preferred. Acetaminophen and NSAIDs are used in upper respiratory conditions to reduce associated headaches, pain and fever; usual analgesic/antipyretic doses are used. They do not alter viral shedding or antibody response.​ ​ ASA should not be used in children and adolescents with viral illnesses due to its association with Reye syndrome. Nonprescription decongestants used in the management of upper respiratory tract infections are described in Table 5. For a comparison of nonprescription product ingredients, consult the Compendium of Products for Minor Ailments— Analgesic Products: Internal Analgesics and Antipyretics; Cough, Cold and Allergy Products. Viral Rhinitis Symptomatic treatment remains the mainstay of managing the common cold, because there is no effective antiviral cure and few effective preventive measures. The literature on the common cold is extensive, but inconsistent in its rigour. These limitations restrict the ability to make confident and specific recommendations about treatments. Agents used to treat symptoms of viral rhinitis include decongestants (topical and oral) alone or in combination with antihistamines. For treatment of an accompanying cough, see Acute Cough. Decongestants Decongestants are sympathomimetic agents that can relieve nasal congestion associated with the common cold, influenza and rhinosinusitis. They are available in oral and topical formulations. Several systematic reviews have evaluated the efficacy of systemic and topical decongestants in single or repeat doses.​ ​ ​ Single doses of nasal decongestants are moderately effective in relieving nasal congestion due to the common cold in adults. The multiple dosing studies are conflicting; some show benefit while others do not. Given these results, the use of topical or oral decongestants for a few days is reasonable and consistent with standard practice.​ There is no published evidence that decongestants are effective in children