You are on page 1of 63

Decongestants & AntiHistamine

MACP 2113

Disediakan oleh:
Pn. T.Nirmala Devi
Pengajar U41
Kolej Pembantu Perubatan, Ulu Kinta

OBJEKT
IF
1. Memberi definisi ubatan
decongestant dan anti-histamine.
2. Menyatakan tujuan/ indikasi ubat.
3. Menyatakan dos dan contoh ubat.

4. Menyatakan kaedah pemberian


ubat.
5. Menyatakan tindakan ubat.
6. Menerangkan kesan sampingan
dan kontraindikasi ubat.
7. Memberikan nasihat spesifik
dalam pengambilan ubat.

Decongestan
ts

Decongesta
nt
Adalah ubat yang digunakan
untuk melegakan kesempitan
dan kepadatan yang berlaku di
nasal akibat dari kongesi/
sekresi/ edema.

Tindakan
ubat

Sympathomimetic drugs
that produce localized
vasoconstriction of the small
blood vessels of the nasal
membranes.
Vasoconstrictions reduces
swelling in the nasal
passages.

Contoh
ubat
Oxymetazoline HCl
(Afrin)

1. Oxymetazoline HCl
(Afrin Nasal Spray)
Category: A

Indicatio
n

Relief of nasal congestion


Facilitate intranasal.
examination before surgery.

Dose
Adult (0.05%):
1 spray into each nostrils
bd
Peads > 1 yr (0.025%):
1 spray into each nostrils
bid

2. Oxymetazoline HCl
(Afrin Nasal Drops)
Category: A

Indicatio
Relief of n
nasal congestion

Dose
Adult (0.05%):
1-2 drops into each nostrils
bd
Peads > 1 yr (0.025%):
1-2 drops into each nostrils
bd

Kesan
sampingan
Nasal burning
Nasal Stinging
Nasal Dryness

Contraindicatio
n

Allergic to drug
Glaucoma
Thyrotoxicosis
Diabetes
Hypertension
CV Disorders

Cautious
Angina
Arrhythmias
Lactation

Interaction
MAOIs
Hypertensive crisis

AntiHistamine

Histamine
Chemical substance that act
on vascular system & smooth
muscles.
Producing dilation of
arterioles and increased
permeability of capillaries.

Dilation of arterioles results in


localized redness.
Increased in the permeability
of capillaries causes fluids
from blood vessels escape
into surrounding tissues &
produce localized swelling.
Also increases production of
mucus in respiratory tract.

Anti-Histamine
Ubat yang boleh menentang
atau mengurangkan kesankesan akibat pengeluaran
histamin dalam badan.

Tindakan
ubat
Bersaing dengan histamine
untuk bergabung dengan
reseptor histamine H1.
Gabungan anti-histamine
dengan reseptor H1 tersebut
akan mengurangkan atau
menghalang kesan histamine.

Maka anti-histamine akan


menyebabkan:
Tindakan antikolinergik
(mengurangkan mukus di
hidung & salur respiratori)
Menghalang mekanisma muntah
& batuk
Boleh menyebabkan mengantuk

Pengecutan salur darah


(vasoconstriction) membantu
mengurangkan kemerahan
Mengurangkan ketelapan salur
darah (decrease permeability)
membantu mengurangkan
pembengkakan (edema)

Histamine vs. AntiHistamine


Effects on
Histamine
Dilation, increase
permeability (fluid
leak into tissues).

sites

Anti-Histamine

Small blood Prevent dilation,


vessels
decrease
permeability (fluid
cannot enter tissues).

Mast cells release


histamine resulting in
allergic reaction.

Immune
system

Prevent histamine
release, no allergic
reaction.

Stimulate salivary,
gastric and
bronchial
secretions.

Smooth
muscle

Prevent salivary,
gastric and
bronchial secretions.

Contoh
ubat

Chlorpheniramine maleate
(Piriton)
Promethazine HCl (Phenergen)
Diphenhydramine HCl +
Ammonium Chloride
(Benadryl Expectorant)
Loratadine (Clarityne)

1. Chlorpheniramine maleate
(Piriton)
Category: C

Indicatio
n

Alergi
Selsema
Gigitan Serangga
Konjunktivitis (allergy)

Dose (tablet)
Adult:
4mg q 4-6 hr PO
Max: 24mg/day

Peads :
0.1mg/kg tds-qid

Dose (syrup)
Adult:
5-10ml tds-qid

Peads up to 1 yr:
2.5ml bd

Peads 1-5 yr:


2.5-5ml tds

Peads 6-12 yrs:


5-10ml tds

Contraindicatio
n

Allergic to drugs
Glaucoma
Peptic ulcer
Pregnancy
Lactation

2. Promethazine HCl
(Phenergen)
Category: B

Indicatio
n

Alergi
Allergic rhinitis
Control nausea & vomiting
Bahan hipnotik (kanak-kanak
Motion sickness

Dose
Adult:
25mg tds PO

Peads 2-5 yr:


5-15mg/day PO

Peads 5-10 yr:


10-25mg/day PO

Contraindicatio
n

Allergic to drugs
Coma
Severe CNS deprssion
Bone marrow depression
MAOIs therapy
Lactation

3. Diphenhydramine HCl +
Ammonium Chloride
(Benadryl Expectorant)
Category: C

Indicatio
n

Allergic rhinitis
Allergic conjunctivitis
Angioedema
Motion sickness

Dose
Adult:
5-10ml bd-tds PO

Peads:
2.5-5ml bd-tds PO

Contraindicatio
n
Allergic to drugs
Pregnancy
Lactation

4. Loratadine
(Clarityne)
Category: A

Indicatio
n

Allergic rhinitis
Allergic conjunctivitis
Angioedema

Dose
Adult & Peads > 6 yrs:
10mg once daily PO

Peads 2-6 yrs:


5mg once daily PO

Contraindicatio
n
Allergic to drugs
Glaucoma
Peptic ulcer

Kesan Sampingan
Umum

Drowsiness
Sedation & Dizziness
Disorientation
Dry mouth, nose & throat
Photosensitivity
Hypotension
Headache

Interaction
MAOIs
Peningkatan dalam kesan
anti-cholinergic

CNS depressants (Narcotic


analgesics & alcohol)
Additive sedative effects

Cimetidine & Loratadine


(together)
Peningkatan serum loratadine

Nasihat kepada pesakit


Jangan memandu &
mengendalikan jentera bermotor &
mesin mengantuk (sedation).
Jangan mengambil ubat ini
bersama ubat tidur, alkohol &
analgesik narkotik additive
effects.

1.

Soala
n Decongestant &
Beri definisi

Anti-histamine?
2. Terangkan cara tindakan
Decongestant & Anti-histamine?
3. Senaraikan ubat Decongestant &
Anti-histamine?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat
Decongestant & Anti-histamine?

Combination
of
Decongestan
ts & AntiHistamine

Contoh
ubat
Actifed (Triprolidine HCl +
Pseudoephedrine HCl)
Clarinase (Loratadine +
Pseudoephedrine sulphate)

1. Actifed (Triprolidine HCl +


Pseudoephedrine HCl)
Category: B

Kandungan:
Triprolidine hidroklorida 2.5 mg
Pseudoephedrine hidroklorida
60 mg

Tindakan
ubat
Triprolidine:
mengurangkan kesan
histamine melalui tindakan
antagonist dengan reseptor
histamina H1.
Ia mempunyai tindakan 'central
nervous system depressant'

Pseudoephedrine:
mempunyai aktiviti
simpatomimetik secara
langsung atau tak langsung
yang berkesan sebagai
dekongestan trek pernafasan
atas.

Indicatio
n
Congestion of respiratory
tract
Allergic Rhinitis
Influenza (common cold)

Dose
Adult & > 12 yrs:
1 tab tid PO

Kesan
sampingan

CNS depression
Drowsiness (mabuk)
Sedation (mengantuk)
Skin rashes (ruam)
Tachycardia
Dry mouth
Urinary retention

Contraindicatio
n

Glaucoma
Severe Hypertension
Coronary artery disease
MAOI therapy.

Cautious

Diabetes
Hypertension
Heart disease
Hyperthyroidism
Increased IOP
Prostatic enlargement

Interaction
Anti-hypertensives
Tricyclic Antidepressants
(TCAs)
Decongestant
Appetite suppresser

Nasihat
Jangan memandu
atau mengendalikan
mesin
Elakan pengambilan
alkohol bersama ubat
actifed

2. Clarinase (Loratadine +
Pseudoephedrine sulphate)
Category: A

Kandungan:
Loratadine 5mg
Pseudoephedrine sulphate
120mg

Tindakan
ubat
Anti-histamine/dekongestan
(vasoconstriction) yang
mempunyai tindakan panjang
dan Non-Sedating'

Indicatio
n Rhinitis
Allergic
Dose
Adult & Peads > 12 yr:
1 tab bid PO

Kesan
Sampingan

Headache
Nervousness
Tachycardia
Insomnia
Dry mouth
Acne

Contraindicatio
n

Allergic to Clarinase
MAOI therapy
Severe Hypertension
Urinary retension
Glaucoma
Severe CAD

Cautious
Increased IOP
Cardiovascular
disease
Prostate Hypertrophy
Hyperthyroidism
Pregnancy
Hypertansion
Diabetes
Ischemic Heart

Interaction
Drugs that inhibit enzyme
cytochrome P 450
Mengubah kepekatan plasma
kedua-dua ubat

Soala
n

1. Senaraikan ubat kombinasi


Decongestant dan Antihistamine?
2. Nyatakan kesan sampingan dan
kontraindikasi bagi ubat
kombinasi Decongestant dan
Anti-histamine?