Upper respiratory tract infections, treatment

Thrombolytic agents a need for improvement Thyroid preparations Trace minerals essential for health Traveler s diarrhea prevention of Tuberculosis treatment of Upper respiratory tract infection treatment of Urinary tract infections treatment of Uveitis management of Vaginal candidiasis treatment of Vasodilators effects on cardiac output (CO)... 

O Antibiotic resistance patterns affect treatment options for bacterial upper respiratory tract infections. 

First-line treatment in upper respiratory tract infections includes the use of penicillins, cephalosporins and mocrolides. Patients who are allergic to penicillins tend to be cross-sensitive to cephalosporins, so ore given mocrolides such as clarithromycin. 

Nasal symptoms The effectiveness of intranasal cyanocobalamin in patients with nasal congestion, allergic rhinitis, and upper respiratory tract infections has not been determined. Defer treatment until symptoms have subsided. 

Arroll B. Non-antibiotic treatments for upper-respiratory tract infections (common cold). Respir Med 2005 99(12) 1477-84. 

B. Status asthmaticus is a dangerous exacerbation of asthma symptoms. It requires immediate and aggressive treatment with oxygen, inhaled bronchodilators, and systemic corticosteroids. Hospitalization of the patient is often indicated. By definition, status asthmaticus is not a condition in which symptoms are well controlled. Neither cromolyn sodium nor a leukotriene modulator is indicated for the treatment of status asthmaticus, as their onset of action is too slow. Status asthmaticus often does not resolve without aggressive intervention. Indeed, the patient s condition can deteriorate rapidly to death. Upper respiratory tract infection or excessive exposure to an allergen often precedes status asthmaticus, as does increased use of inhaled bronchodilators. 

It is indicated in the treatment of lower respiratory tract infection e.g. bronchitis and pneumonia, upper respiratory tract infections e.g. pharyngitis and sinusitis, infections due to chlamydia, legionella and mycoplasma, skin and soft tissue infections and eradication of H. pylori with acid suppressants. 

Echinacea Echinacea species (E angustifolia E pallida purpurea) Roots and seeds from the echinacea plant Immune stimulant treatment of colds and upper respiratory tract infections applied topically to promote wound healing... 

Echinacea is most often used to enhance immune function in individuals who have colds and other respiratory tract infections. Systematic reviews and cold treatment trials generally report favorable results for Echinacea in reducing symptoms or time to recovery if the agent was administered within the first 24 hours of a cold. To date, however, most of these trials have contained multiple variables (eg, formulation, dose, duration) that make it difficult to make a clear therapeutic recommendation or ensure reproducible outcomes. At best, symptoms and duration may be reduced by about 25-30%. Echinacea has also been evaluated as a prophylactic agent in the prevention of upper respiratory tract infection. These trials have generally been less favorable and have reported no effect. 

In the clinical studies the most common adverse events observed with lar-onidase treatment were upper respiratory tract infection, rash, and injection site reaction. The most common adverse reactions requiring intervention were infusion-related reactions (IRRs), particularly flushing. Those requiring intervention were offset by slowing the infusion rate, temporarily stopping the infusion, and/or administering additional antipyretics and/or antihistamines. 

In a pooled analysis of safety data from double-bUnd, placebo-controUed add-on trials of levetiracetam (1-3 g/ day) in adults with refractory partial seizures, adverse events occurring in at least 3% of patients and with at least 3% higher incidence in the active treatment group were tiredness (14 versus 10%), somnolence (15 versus 10%), dizziness (9 versus 4%), and common cold or upper respiratory tract infections (13 versus 7%) (11). The proportions of patients requiring withdrawal of treatment or dosage reduction owing to adverse events were 15% with levetiracetam and 12% with placebo. The efficacy and tolerability of levetiracetam monotherapy in refractory partial seizures have been studied in a double-blind, pla-cebo-controUed study in 286 patients (12). Adverse events that were more common with levetiracetam and that occurred in more than 5% of cases included weakness, infection, and somnolence. Of 181 patients who took levetiracetam, 36 completed the study compared with only 10 of 105 who took placebo. The tolerability and efficacy of levetiracetam, 2 or 4 g/day, as add-on therapy have been studied in 119 patients with refractory epilepsy (13). Somnolence was the most common reason for withdrawal and occurred more often with levetiracetam than placebo, as did weakness. Somnolence was more common with the higher dose, which was not more effective than... 

Cephalexin occurs as a white crystalline monohydratc. It is freely. soluble in water, rcsi.stant to acid, and ab.sorbed well orally. Food does not interfere with its absorption. Because of minimal protein binding and nearly exclusive renal excretion, cephalexin is recommended particularly for the treatment of urinary tract infections. It is also sometimes used for upper respiratory tract infections. Its spectrum of activity is very similar to those of cephalodiin and ccphalori-dine. Cephalexin is. somewhat less potent than these two agents after parenteral administration and. therefore, is inferior to them for the treatment of serious systemic infections. 

It occurs us a crystalline hydrate that is readily soluble in water. Cephradine is stable to acid and absorbed almost completely after oral administration, it is minimally protein bound and excreted almost exclusively through the kidneys. It is recotnmended for the treatment nf uncomplicated urinary tract and upper respiratory tract infections caused by susceptible organisms. Cephradine is available in both oral and parenteral dosage forms. 

Modulation of epithelial cell-bacteria interaction through EPs 7630 may protect mucous membranes from microorganisms evading host defence mechanisms. This provides a rationale for the treatment of upper respiratory tract infections with EPs 7630 (727). 

Which of the following would be factors for referral to a doctor of a patient whose representative asks for an over-the-counter treatment for an upper respiratory tract infection ... 

Acute cough is a common symptom associated with viral upper respiratory tract infections (URTIs) such as the common cold (see Chapter 21), and pharmacists are most frequently asked for advice and treatment for coughs from this cause. However, cough is a symptom of many conditions, most of which require referral to a doctor for further investigation. Pharmacists must be able to distinguish between a cough from a trivial condition and one from a potentially more serious cause and make appropriate referrals. 

Snow V, Mottur-Pilson C, Gonzales R, for the American College of Physicians-American Society of Internal Medicine. Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults. Ann Intern Med 2001 134 487 89. 

Populi nipiraegemmae and Populi tremulae pemmae are the buds of these two Populus species. They are used as expectorants and circulatory stimulants for the treatment of upper respiratory tract infections and rheumatic conditions. 

Muller, O. (1996). An open comparative study of azithromycin and roxithromycin in the treatment of acute upper respiratory tract infections. J. Antimicrob. Chemother. 37, 83-92. 

---