PHARMACOLOGICAL
MANAGEMENT OF SINUSITIS
By: Taylor Andre
NSG 6005- Advanced Pharmacology
August 19, 2019
SINUSITIS
•
Sinusitis is a condition in which the nasal passages become
irritated and inflamed by allergies, bacteria, or a virus.
•
Sinusitis affects 1 out of 8 adults every year in the United
States, with 1 out of 5 adults receiving antibiotic treatment
(Potera, 2015).
•
It is important to determine the causative factor (bacteria or
virus) as it will vary treatment in the patient.
Antibiotics
should try to be reserved due to the emerging problem of
bacterial resistance.
SIGNS/SYMPTOMS OF SINUSITIS
Purulent rhinorrhea (abundant amount of thick mucus fluid in
nasal cavity)
Nasal congestion
Facial pain or pressure
Fever
Headache (worsening when bending over)
Postnasal drip
Cough (worsening when lying down)
Diminished sense of smell (Woo & Robinson, 2015; Bergmark &
Pynnonen, 2017)
CHILDREN WITH SINUSITIS
•
Children under the age of 10 years have frontal sinuses that
are not fully developed.
Therefore, they sometimes do not
have the classic symptoms of sinusitis (Woo & Robinson, 2015).
•
Vomiting may occur due to excessive drainage of mucus and
children may also have puffy eyes and a cough that worsens
when lying down (Woo & Robinson, 2015).
•
Because children have more frequent colds than adults, it is
essential to establish sinusitis from a cold in children so that
antibiotics are not given inappropriately (Woo & Robinson,
2015).
WHEN TO TREAT
•
With emerging antibiotic resistance, the American Academy of
Otoryngology-Head and Neck Surgery Foundation has provided
new clinical practice guidelines for the treatment of sinusitis
(Potera, 2015).
•
The guidelines consist of “watchful waiting” before attempting
to prescribe antibiotics (Potera, 2015).
During this period, the
patient should be educated to use analgesics, antihistamines,
nasal saline irrigation, and intranasal steroids for symptom
relief (Potera, 2015).
•
Woo and Robinson (2015) emphasize that an upper respiratory
infection lasting more than 10 persistent days without
improvement (with purulent nasal discharge) is possible to be
bacterial sinusitis and requires antibiotics.
FIRST LINE OF TREATMENT
•
First line of treatment for sinusitis is Amoxicillin in non-penicillin allergic
patients.
