BY:
Endah Dwi Susanti, S.Si.,Apt.
Autakoid
substansi (kimia) selain transmitor yang
secara normal ada di dalam tubuh dan
punya peran atau fungsi fisiologik penting
baik dalam keadaan normal (sehat)
maupun patologik (sakit)
Histamin
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GEJALA:
Histamines
• Histamine causes blood vessel dilation
and subsequently an inflammatory
response in the area affected.
– Results in an inflammatory response noted by
the classic allergy symptoms, such as runny
nose, itchy and watery eyes, and sneezing.
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Antihistamines
• Antihistamines produce three general
effects on the body:
– Alteration of histamine action
– Sedation
– Anticholinergic activity (decreased salivation,
dry mouth, and constipation)
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• Currently there are first- and second-
generation antihistamines
• The major differences between the two
generations are:
– The time they are active
• 1st generation = 4 to 6 hrs
• 2nd generation = up to 12 hrs
– The extent to which they promote drowsiness
• 2nd generation are less sedating
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• Antihistamine drugs
– Halt increased vascular permeability
– Decrease smooth muscle constriction of the
airways
• First-generation antihistamines cross the
blood brain barrier and cause sedation
• Use a first-generation antihistamine during
the evening (less expensive) and nighttime
• Switch to a second-generation antihistamine
during the daytime
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• Antihistamines result in decreased
symptoms and increased patient comfort.
• Impeding these effects is not always a
good thing.
– The body produces mucus in an effort to
protect the respiratory system.
– Decreasing these functions may slow
recovery.
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• Antihistamines may not be effective in
decreasing nasal blockage.
• Second-generation antihistamines are
available with a decongestant.
– Claritin-D and Allegra-D
• A decongestant will assist with the
resolution of the runny nose and head
congestion.
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• Adverse effects of antihistamines
– Mucous membrane dryness
– Cardiac stimulation
– Blurred vision
– Urinary retention
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Obat Kortikosteroid
• Kortikosteroid merupakan hormon pertahanan tubuh
yang berspektrum luas dengan cara:
• Mengurangi radang dan odema
• Anti alergi
• Meningkatkan kadar gula dalam darah
• Meningkatkan kadar Hb dan eritrosit
• Mempercepat waktu pembekuan darah
• Meningkatkan asam lambung dan enzim pencernaan.
• Mengurangi efek bronkodilator
• Contoh: Kalmethason
Steroid Nasal Spray
• Nasal steroid medications are specifically
used for allergic rhinitis.
– They are not for symptoms of the common
cold.
• Drugs are delivered locally.
– Potential for nasal irritation, dryness, and
epistaxis
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Coughs and Colds
• Runny nose, mild sore throat, and watery
eyes are similar in both the common cold
and allergic reactions.
• Common cold refers to a nonbacterial
infection of the upper respiratory system.
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Cough and Cold Medications
• Decongestants
– vasoconstriction resulting in mucosal drying
• Antihistamines
– combat increased histamine = nasal congestion
and mucosal irritation
• Expectorants
– facilitate the removal of mucous from the
respiratory system
• Antitussives
– work to suppress coughing
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• Medications may contain a combination of
decongestant, antihistamine, expectorant,
and antitussive agents
– Vicks NyQuil contains:
• Acetaminophen
• Pseudoephedrine, a decongestant,
• Dextromethorphan, a cough suppressant
• Antihistamine
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Decongestants
• Prolonged use of decongestants:
– Headache
– Nausea
– Dry mouth and nose
– Dizziness
– Nervousness
• Prolonged application of nasal spray
(topical)
– Can cause a rebound effect vasodilatation after
the initial vasoconstriction decreases
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• Common decongestants
– Pseudoephedrine (Sudafed)
– Tetrahydroziline (Visine)
– Oxymetazoline (Afrin)
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Expectorants
• Cough syrup to relieve the coughing
linked to cold symptoms
• Cough syrups can contain
– Antitussive (cough suppressant)
– Expectorant (promotes mucus clearance)
• If the coughing linked with a cold is
“nonproductive,” eliminate the
nonproductive coughing
• Expectorants are available in two forms:
– Mucolytic
– Stimulant
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Antitussives
• Antitussives suppress the cough.
– Use a central or a local mechanism.
• Used for short periods of time.
• Used to inhibit a cough via a central
mechanism.
• Cough center located in the medulla is
targeted.
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• Dextromethorphan (DM):
– Robitussin products, Tylenol cold products,
and NyQuil medications.
• Physician can prescribe a narcotic
antitussive.
– Codeine or hydrocodone.
– Addictive property of narcotics.
– Duration of the prescription does not exceed
1 week.
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Adverse Effects
• relatively show few serious adverse
effects.
• Participating in a sport while in a state of
drowsiness could be dangerous.
• Antihistamines (1st generation) can result
in significant drowsiness even after the
drug’s half-life is complete.
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• Antihistamines may cause anticholinergic
effects such as
– Mucus membrane dryness
– Cardiac stimulation
– Decreased gastrointestinal activity
– Urinary retention
• Decongestants can promote
– Excessive drying of the nose and throat
– Tachycardia and restlessness
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• Guaifenesin (cough syrups)
– Dizziness
– Headache
– Nausea
• Antitussives (Dextromethorphan)
– Mild dizziness
– Drowsiness
– Nausea
– Stomach cramps
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