Definition: inflammation of the nasal passages that occurs when the body s immune system over-responds to specific, non-infectious particles ( i.e. pollen grains, dust, animal hairs etc). Seasonal (Hay fever): during spring time and early summer (March to June).
Histamine, leukotrienes, cytokines are released during the allergic reaction leading to the following symptoms: 1. sneezing 2. runny nose 3. watery itchy eyes,nose and ears.
Definition: inflammation of the tissue that lines sinuses cavities (normally filled with air and produce mucus). This swelling may blocks them off, trapping mucus and air inside them cause pain and sometimes lead to bacterial infection. Acute sinusitis lasts up to four weeks. Chronic sinusitis lasts several weeks or years.
An inflammation of tonsils mainly caused due to infection with streptococcus bacteria. The main symptoms of tonsillitis are inflammation and swelling of the tonsils.
Female smoker patient with chronic sinusitis there was a history of allergic rhinitis with chronic use of antihistaminic and nasal steroids. Antibiotics failed to resolve the condition. she is sensitive to house dust and mites.
Treatment of previous case include management of : 1- Allergic rhinitis. 2-Chronic sinusitis.
Life style management: Treatment of seasonal allergic rhinitis must begin 6 weeks before the season starts and continued through the season. Dietary exclusion should continue for 6 weeks.
Life style management: The patient must stop smoking. Stop steroid decongestants as they may weaken the immune system and become more susceptible to infection. Patient should avoid house dust and mites. Avoid mucous producing plants (e.g. banana) and dairy products.
A 30 years old female patient with chronic persistent rhinitis, symptoms were worse in the morning with clear nasal discharge and irritated eyes. She was sensitive to house dust,mites and had suffered chronic tonsillitis, adenoids and otitis media. She regularly took antihistaminics.
Management of : 1- chronic rhinitis. 2- chronic tonsillitis.
Life style management 1-Patient must avoid house dust and mites. 2-Treatment of seasonal allergic rhinitis must begin 6 weeks before the season, starts and continued through the season and also the dietary exclusion.
Treatment A- Allergic rhinitis. 1- Antihistamines: Butterbur. 2- Decongestant: Pseudoephedrine. 3- Immune modulator: Echinacea. B- Chronic sinusitis. 1- Thyme oil. 2- Antihistamines: because many cases are due to uncontrolled allergies.
Petasite hybridus Constituents: The sesquiterpenes; petasins. Actions: 1- Anti-inflammatory Inhibit synthesis of PG 2-Anti-histaminic and mast cell stabilizer. Side effects: Hepatic damage and carcinogenic activities were reported for Petasite extracts due to the pyrrolizidine alkaloids content so, alkaloids were removed in commercial extracts.
2- Pseudoephedrine: (ephedra alkaloid) act as nasal decongestant i.e. constricts the dilated nasal vessels. Eucalyptus, Mentha also are nasal decongestant 3- Echinaceae: contains mainly polysaccharides and chicoric acid glycosides that have immunostimulant activity ( inc no. and activity of immune system cells).
Rx (Gentiana lutea, root 6 mg (Primula veris,(flowers) 18 mg (Rumicus)herb 18 mg (Sambucus nigra,) flowers,fruits 18 mg (Verbena officinalis,)herb 18 mg
Pharmacological Actions Pharmacological studies employing in vitro and animal models have found that Sinupret has antimicrobial and antiviral effects, mucolytic activity (breaks down secretions, reduces the viscosity of mucus) and anti-inflammatory activity. Indication: Acute & chronic inflammation of the sinuses & respiratory tract.
1. Gentian root contains bitter principles of secoiridoid glycosides act as mucolytic.
2- Primrose flowers (Primula veris) : Contains triterpene saponins acts through an irritation of the gastric mucosa, which provokes a reflex increase in bronchial secretion. This in turn dilutes the bronchial mucus and reduces its viscosity. Furthermore it possesses an anti-inflammatory activity.
3- Common sorrel: (Rumex acetosa) contains polysaccharides, ascorbic acid and flavonoids, act as mucolytic agents and have an anti-inflammatory effect. 4- Verbena herb contains iridoid glycosides act as mucolytic agents
contains flavonoids (kaempferol, astragalin, quercetin, rutin, isoquercitrin, hyperoside), triterpenes (a- and b-amyrin, ursolic acid, oleanolic acid), anthocyanin. Actions : 1- Antiviral: inhibits influenza virus types A and B and herpes simplex virus-1. 2- Anti-inflammatory. 3-Antioxidant.
Peppermint oil Ocimum oil Eucalyptus oil Chamomile oil Thyme oil
Indications : Inhalation use : 1- Severe and chronic sinusitis. 2- Common cold. 3- Rhinitis, laryngitis & catarrah. 4- Cough & bronchitis.
Ocimum oil: Ocimum basilicum L. (sweet basil)major constituents were identified as methyl eugenol (39.3%) and methyl chavicol (38.3%), Ocimum oil acts as antibacterial.
Eucalyptus contains v.o. (main component 1,8-cineole,eucalyptol) strong antiseptic and nasal decongestant. peppermint contains menthol as major constituent, have antiseptic and decongestant. Chamomile oil: anti-inflammatory and antibacterial activity Thyme oil: contains thymol and carvacrol and has potent antiseptic and antibacterial.
Indications : Inhalation use : 1- Severe and chronic sinusitis 2- Common cold 3- Rhinitis, laryngitis & catarrah 4- Cough & bronchitis Internal use : 1- spastic colon & renal colic 2- flatulance, nausea & vomiting External use : Stimulate blood circulation. so it can be used in neuralgia, arthiritis, joints & back pain.
100% hypertonic seawater Eucalyptus globulus essential oil Natural wild mint extract
Composition: saline solution, propolis and thyme extract. Propolis is a mixture of different natural compounds produced by bees from substances obtained from the buds of trees and plants. It is used to protect the hive due to its natural antiseptic properties.
A male patient aged 36 with chronic sinusitis which followed a bout common cold. There was a history of allergic rhinitis with chronic use of antihistaminic and nasal steroids. Antibiotic had failed to resolve the condition. The patient is cigarette smoker.
Herbal treatment : 1- Allergic rhinitis. 2- Chronic sinusitis. 3- Common cold. Life style management: 1- Stop dairy intake (allergen) stimulate immune system. 2- Stop cigarette smoking.
COMMON COLD AND FLU Viral infection of respiratory tract. Many herbal tea suitable as symptomatic relief: 1- Diaphoretics (Lime flower). 2- Anti-inflammatory (Mallow). 3- Antiviral (Elder). 4- Demulcents (Mallow). 5-Immunstimulants (Echinacea, black seed)
A- Mallow : Contains mucilage and sulphated flavonol glycoside Used as infusion for cold and cough due to demulcent and anti-inflammatory effect of mucilage. B-Lime flower (Tilia): Contains volatile oil (linalool, geraniol, ), flavonoids, Mucilage and polyphenols Induce diaphoresis for feverish cold and demulcent for treatment of dry cough in addition sedative action.
Rx Peppermint oil (5 ml). Camphor (1 gm). Eucalyptus oil (5 ml). Tr. Benzoin. Indications :laryngitis and bronchitis
Actions : Expectorant Disinfectant Mucolytic Decongestant Tr. Benzoin: bactericidal and expectorant
Rx: Thymus vulgaris. Mentha piperita. Citrus limonum. Camphor oil. Citrus limonum : antimicrobial and immunostimulant. Camphor oil: (Cinnamomum camphora) antiseptic and decongestant. Formula actions: nasal decongestant, anti-catarrhal
Each soft gelatin capsule contains: Terpineol 60 mg Menthol 50 mg Thymol 15 mg Pine oil 10 mg Cinnamon oil 5 mg
Pine oil alleviate congestion; treat the infection of throat, lungs and sinus. Terpineol, is a naturally occurring monoterpene alcohol isolated from tea tree oil, acts as antibacterial,antiinflammatory agent Cinnamaldehyde and eugenol in cinnamon oil act as antibacterial agents
A sore throat is the inflammation of the throat (pharynx). The most common cause of a sore throat is a viral infection, such as a cold or the flu. Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires additional treatment with antibiotic drugs to prevent complications.
Treatment 1- Local treatment (lozenges or throat spray of many herbs. 2- Herb infusion (mouth wash).
1. Althea ( Marshmallow ): A.C: Rich in mucilage and flavonoids (quercetin). Act as demulcent, emollient, antimicrobial, anti-inflammatory.
2. Glycyrrhiza glabra (Liquorice) Phytoconstituents : The major constituents are triterpene saponins. Glycyrrhizin (glycyrrhizic acid,glycyrrhizinic acid) Flavonoids, Isoflavones (formononetin, )
2. Glycyrrhiza glabra (Liquorice) Experimental pharmacology Demulcent action (due primarily to glycyrrhizin) Expectorant properties (attributed to glycyrrhizin, which accelerates tracheal mucus secretion) Anti-inflammatory and antiallergic actions (attributed to the corticosteroid-like activity of glycyrrhizin and glycyrrhetic acid potentiating the activity of corticosteroids )
2. Glycyrrhiza glabra (Liquorice) Contraindications hypertension, cholestatic disorders or cirrhosis of the liver, hypokalaemia, or chronic renal insufficiency, and during pregnancy Warnings Prolonged use of large doses (50g/day) of the drug for extended periods (6 weeks) may increase water accumulation, causing swelling of the hands and feet. Sodium excretion is reduced and potassium excretion is increased. Blood pressure may rise.
2. Glycyrrhiza glabra (Liquorice) Drug interactions Thiazide and loop diuretics or cardiac glycosides Drugs used in the treatment of hypertension
3- Sage infusion: contains phenolic acids, v.o & tannins. The phenolic acids and v.o. in sage are potent against Staphylococcus aureus so act as animicrobial. 4-Myrrh : antiseptic and anti-inflammtory.
Camphor Eucalyptol Menthol Thymol
Uses : Relief sore throat Action : All have antiseptic properties. Menthol: also has local anesthetic activity.
Rx Ephedra nevadensis (brigham) Echinaceae angustifolia Hydrastis canadensis (Golden seal root) Marshmallow root
Goldenseal: used for the common cold and other upper respiratory tract infections, as well as stuffy nose and hay fever. Goldenseal contains alkaloids hydrastine, berberine, with antibacterial activity. Ephedra species: contains alkaloids ephedrine and pseudoephedrine acts as bronchodilator, dcongestant through its sympathomimetic action. It is used in treatment of asthma, hay fever and common cold.