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Sinusitis- develops when inflammation or swelling of the mucosa blocks the…

- - - - fever
      - purulent nasal drainage
      - malaise
      - sinus pain
      - recurrent headaches
      - Halitosis
      - congestion
    - - dental pain
      - facial pain
      - nasal congestion
      - increased drainage
- - - - persistent infection usually associated with nasal polys and allergies
    - - usually begins within 1 week on upper resp. infection
  - - - seasonal
        
        occurs in spring or fall and is caused by pollen
      - perrineal
        
        occurs year-round and is caused by environmental allergens
        
        dust
        
        dust mites
        
        pet dander
        
        mold spores
        
        cockroaches
        
        fungi
    - - Episodic: exposure to allergens not in pts normal environment
      - Intermittent: symptoms present less than 4 days per week or 4 weeks per year
      - persistent: symptoms present more than 4 days a week or 4 weeks per year
- - - - Nasal dryness
      - Nasal irritation
      - Nosebleeds
      - does not cause systemic effects
  - - - Medications
        
        chlorpheniramine (ChlorTrimeton)
        
        clemastine (Tavist)
        
        dexchlorpheniramine
        
        diphenhydramine (Benadryl
        
        brompheniramine
      - Side effects
        
        SEDATION
        
        restlessness
        
        nervousness
        
        insomnia
        
        anticholinergic effects
        
        dry mouth
        
        palpatations
        
        constipation
        
        urinary hesitancy
      - Action: Bind with H1 receptors blocking histamine release; relieve acute symptoms of allergic response
    - - Oral
        
        Action: Bind with H1 receptors blocking histamine release; relieve acute symptoms of allergic response
        
        Medications
        
        cetirizine (Zyrtec)
        
        desloratadine (Clarinex)
        
        fexofenadine (Allegra)
        
        levocetirirzine (Xyzal)
        
        loratadine (Claritin)
        
        side effects
        
        few effects of psychomotor activities or bladder function
        
        minimal sedation
      - Intranasal
        
        Action: blocks histamine release; reduces nasal congestion
        
        azelastine (Astelin)
        
        olopatadine (Patanase)
        
        side effects
        
        headache
        
        bitter taste
        
        nasal irritation
        
        somnolence
  - - - nasal irritation
      - mucosal drying
      - nosebleeds
      - Rare instances, localized fungal infection with Candida albicans
  - - - side effects
        
        headache
        
        dizziness
        
        rash
        
        altered liver function
        
        GI changes
      - montelukast (Sunglulair)
      - zafirlukast (Accolate)
    - - Action: suppress leukotriene activity, thereby inhibiting airway edema, bronchoconstriction, mucus production, and inflammation
      - zileuton (Zyflo)
    - - monitor liver function
      - give on empty stomach
      - do not stop taking without consulting HCP
      - Do not use for acute attacks
      - zafirlukast and zileutin: if pt taking warfarin monitor pt levels
  - - - minimal; occasional nasal irritaion
  - - - hydrocodone, pseudophedrine (Rezira oral solution)
      - hydrocodone, chlorpheniramine, pseudoephedrine (Zutripro oral solution)
  - - - Action: stimulates adrenergic receptors; promotes vasoconstriction of superficial vessels in the nose; reduces nasal congestion
      - pseudoephedrine (Sudafed)
    - - Side effects
        
        insomnia
        
        excitation
        
        headache
        
        irritability
        
        increased blood and ocular pressure
        
        dysuria
        
        palpitations
        
        tachycardia
      - oxymetazoline
      - phenylephrine
- - - - Cough