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PHARMACOLOGICAL MANAGEMENT OF SINUSITISBy: Taylor AndreNSG 6005- Advanced PharmacologyAugust 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 SINUSITISPurulent rhinorrhea (abundant amount of thick mucus fluid in nasal cavity) Nasal congestionFacial pain or pressureFeverHeadache (worsening when bending over) Postnasal dripCough (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.