Upper Respiratory Tract Infection Treatment Management Approach Considerations, Epiglottitis, Laryngotracheitis. Treatment of an uncomplicated URI is focused on specific measures to reduce symptoms, including use of the following Oral or topical decongestants. Ipratropium bromide. Antihistamines. Topical and systemic steroids. Saline nasal drops. Guaifenesin. Topical phenol or lidocaine. Cromolyn. Oral and topical decongestants. Oral decongestants may provide symptom relief for patients with persistent rhinorrhea or sneezing associated with URI. However, despite common usage, evidence regarding the effectiveness of oral decongestants in acute sinusitis is scarce. Adverse effects of oral decongestants include the following Anxiousness. Insomnia. Tachycardia and dysrhythmias. Elevated blood pressure. Palpitations. Tremor. Urinary retention. Exercise caution in patients with heart disease, hypertension, prostate enlargement, glaucoma, anxiety, hyperthyroidism, or other medical conditions and in pregnant or lactating women. Unlike topical nasal decongestants, oral decongestants do not appear to cause rebound phenomena after cessation of use. The risk to benefit ratio for using cough and cold medicines in children younger than 2 years requires careful consideration because serious adverse events, including fatalities, have been reported with the use of over the counter preparations. Numerous over the counter cough and cold preparations are labeled do not use in children younger than 4 years. Topical decongestants such as phenylephrine an alpha. Respiratory Tract Infections Pdf' title='Respiratory Tract Infections Pdf' />
Katolen Yardley, MNIMH, Medical Herbalist www. Member of the National Institute of Medical Herbalists Vancouver and Coquitlam Office Ph 604683. File Formats Help How do I view different file formats PDF, DOC, PPT, MPEG on this site Adobe PDF file Microsoft PowerPoint file Microsoft Word file. Upper Respiratory Tract Infections Online Medical Reference from definition and diagnosis through risk factors, treatments and prevention. Authored by Sherif B. Respiratory syncytial sinSISHuhl virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Respiratory tract infection RTI refers to any of a number of infectious diseases involving the respiratory tract. An infection of this type is normally further. However, rebound congestion may occur after cessation of use. To avoid this rebound congestion, limit topical agents to 3 4 days of use. In addition, these decongestants may cause throat irritation in some individuals. One study, in which oxymetazoline was administered to patients with a nasal bellows, suggested that oxymetazoline did not accelerate the rate of healing of acute maxillary sinusitis, as judged by sinus radiographs and subjective symptom scores. The researchers concluded that decongestion of the sinus ostia may not be of primary importance in the healing of acute sinusitis. Ipratropium bromide. This agent, which is an anticholinergic, has been evaluated in adults and young adults with rhinorrhea of moderate or greater severity. In one study, ipratropium reduced the severity of sneezing and rhinorrhea, but it did not appear to reduce nasal congestion. Rates of blood tinged mucus and nasal dryness were higher in the treated group than in the control group. Antihistamines. Histamines are not thought to play a role in generating URI symptoms therefore, newer, nonsedating antihistamines are not useful in reducing URI symptoms. Most upper respiratory tract infections URIs are selfdiagnosed and selftreated at home. Patients who present with URIs often benefit from reassurance. When Should I Worry is a booklet developed by researchers at Cardiff University. It provides information for parents about the management of respiratory tract. Microsoft Word Math Symbol Shortcuts For Laptops. US.jpg' alt='Lower Respiratory Tract Infections Pdf' title='Lower Respiratory Tract Infections Pdf' />However, first generation oral antihistamines eg, diphenhydramine, chlorpheniramine, clemastine have some anticholinergic effects, which, in theory, could reduce sneezing and rhinorrhea. Such effects have been reported for clemastine fumarate in patients with the common cold. These older antihistamines, however, are sedating. In nonallergic children with acute bacterial rhinosinusitis, data regarding the efficacy of H1 blockers as adjuvants to antibiotics are insufficient. In theory, antihistamines may thicken secretions and thus reduce sinus drainage. Steroids. Topical and systemic steroids are often prescribed with the intention of reducing mucosal swelling in patients with acute viral or bacterial rhinosinusitis. However, little evidence supports their use for this indication. In children who are taking antibiotics for acute bacterial rhinosinusitis, intranasal steroids do not appear to dramatically improve symptoms. However, for adults with recurrent acute rhinosinusitis or acute rhinosinusitis superimposed on chronic rhinosinusitis, adjunctive use of high dose nasal corticosteroids may decrease symptom duration and improve clinical success rates. Saline nasal drops. Saline nasal drops may provide relief from thick secretions and mobilize nasal crusting. Game Crystal Saga Offline'>Game Crystal Saga Offline. Upper Respiratory Tract Infections Pdf' title='Upper Respiratory Tract Infections Pdf' />Nasal saline irrigation is effective and well tolerated as an adjunct to persistent rhinosinusitis symptoms. Guaifenesin. The use of guaifenesin, a mucolytic, is commonly suggested with the intention of thinning secretions. However, data regarding its effectiveness in reducing secretions and promoting drainage in persons with nasopharyngitis or rhinosinusitis are limited. Topical phenol and lidocaine. Lozenges, gargles, or sprays that contain phenol may provide temporary relief of sore throat. In young children, however, lozenges may pose a choking hazard. Gargles of viscous lidocaine may numb the throat, providing relief however, swallowing may be impaired if sensation is reduced. Saline gargles may reduce swelling in individuals with pharyngitis. Cromolyn. Intranasal cromolyn sodium is typically used for relief of allergic rhinitis. Data are insufficient, however, to permit evidence based recommendations regarding its use to treat URI related nasal symptoms in nonallergic patients. Cough relief. Cough suppression may increase comfort when cough is severe or when it prevents sleep. As stated earlier, the risk to benefit ratio for using cough and cold medicines in children younger than 2 years requires careful consideration because serious adverse events, including fatalities, have been reported with the use of over the counter preparations in young children. Since 2. 00. 8, many nonprescription cough and cold product labels state do not use in children younger than 4 years. Cough associated with the common cold may be treated with a first generation antihistamine combined with a decongestant eg, brompheniramine with pseudoephedrine. Older generation histamines have anticholinergic effects, which may account for cough reduction. Newer generation nonsedating antihistamines are ineffective for cough. Inhaled ipratropium, an anticholinergic, may be useful in postinfectious cough 3 8 wk after the onset of the URI in adults. Inhaled steroids may be considered in postinfectious cough 3 8 wk after URI onset if ipratropium fails to control it. If postinfectious cough remains severe and if other causes eg, rhinosinusitis, cough asthma, gastroesophageal reflux disease have been excluded, a short, time limited course of oral steroids may be considered. Several agents eg, codeine, guaifenesin, dextromethorphan are intended for the symptomatic relief of cough. However, evidence is mixed regarding effectiveness of these agents. While codeine may inhibit cough under various circumstances, data are limited regarding its effectiveness in reducing acute cough from URI. As an expectorant, guaifenesin is intended to mobilize secretions. However, consistent data regarding its effectiveness in reducing discomfort from cough associated with URIs are scarce. Dextromethorphan, a centrally acting cough suppressant, may be considered for the treatment of postinfectious cough in adults if other medications fail. However, this agent may have limited efficacy in treating cough related to acute URI. One study showed that honey was superior to dextromethorphan in reducing cough symptoms and improving sleep in children with URI. Over the counter cough suppressants may cause notable adverse effects in young children. Additional data are required to permit evidence based recommendations for the use of central acting antitussives in URI related cough in children. Codeine is an effective, centrally acting cough suppressant in adults.