Question 1: What are the general causes of rhinitis and rhinorrhea?

Rhinitis is linked to cold and flu.

Mucosal rhinitis which is linked to sinusitis.

Allergic rhinitis is linked to allergen exposure and IgE mediated inflammation.

Non-allergic rhinitis is he physiological reaction because of stimuli like the cold or smoke.

Question 2: Which drugs can be used for the treatment of rhinorrhea? name examples of each group

• Alpha1-agonist (naphazoline)
• Corticosteroids ( Budesonide)
• Mast cell stabilizer (ketotifien)
• Antihistamines (loratidine)
• Mucolytics (Mesna)
• Diverse drugs (normal saline)
• Antibiotics (neomycin)

Question 3: How do decongestants differ with respect to the moa and duration of action? how are they administered typically?

MOA: decongestants present are alpha adrenoceptor sympathomimetics, They therefore cause vasoconstriction, as a result reducing nasal airway resistance and allows breathing through the nose.

Duration of action: they provide quick relief that can last up to 12 hours however, they can only be used for 5-7 days.

Decongestants are administered topically by metered-dose sprays, which is the safest.

Question 4: What is rhinitis medicamentosa ? How is it treated?

Rhinitis medicamentosa is a condition that develops if the topical decongestants are repeatedly used for more than 7 days. this happens when an overstimulation of the alpha receptor (in the nasal mucosa) occurs. Therefore leading to the drying of the mucosal tissue. As a result you are left with a blocked nose that can be treated with cortisone nasal sprays.

Question 5: How does the first and second gen of antihistamines differ with respect to the mechanisms according to which rhinitis and rhinorrhea are delivered? What are the advantages of the second gen of antihistamines? why should they not be used to relieve cold rhinitis?

1st gen antihistamines are used for non allergic rhinorrhea since they reduce inflammation in the nose. They also treat the symptoms.

2nd gen antihistamines are used to treat allergic rhinitis since they inhibit the release of histamine from  mast cells as well as other inflammation mediators. The advantages would be that they have almost no CNS distribution and have a low incidence to patients who have sedation and anticholinergic side effects.

However, antihistamines should never be used to alleviate cold rhinitis since symptoms which are caused by the bodys response are not related to histamine production. Antihistamines will have no effect. Therefore, we can say that histamine is not the major cause of a runny nose.

Question 6: When are corticosteroids, anti-allergic drugs, mesna and normal salt solution valid and how are they administered?

• Corticosteroids: they are acceptable for the use of allergic rhinitis and is administered topically via nasal spray.
• Anti-allergic drugs: they are acceptable for prophylactic treatment of allergic rhinitis, administered topically via nasal spray.
• Mesna: this is acceptable for sticky nasal secretion, since it aids the mucus to become more of a liquid, administered topically via nasal spray.
• Normal salt solution: acceptable for humidifying dry and swollen mucus membranes of your nose during dry, cold weather, allergy like hay fever, nose bleed and other irritants, it is administered topically via nasal drops.