Causes of Upper Respiratory Infections

1. Describe causes of Upper respiratory infections and drug therapy
2. Discuss triggers of asthma and treatment options
3. Discuss corticosteroids 
4. Describe chronic bronchitis and treatment options
5. Describe diagnostic criteria for nausea and vomiting and treatment recommendations
6. Discuss symptoms of GERD, complications, and drug management
7. Compare and contrast Crohn’s disease and Ulcerative colitis
8. Discuss Diabetes, its causes, symptoms, and treatment

Causes of Upper Respiratory Infections (URIs) and Drug Therapy

Causes:

• Viruses (most common): Rhinovirus, coronavirus, adenovirus, influenza, parainfluenza, respiratory syncytial virus (RSV)

• Bacteria (less common): Streptococcus pyogenes, Haemophilus influenzae, Moraxella catarrhalis

Drug Therapy:

• Symptomatic treatment:

  • Analgesics/antipyretics: Acetaminophen, ibuprofen

  • Decongestants: Pseudoephedrine, oxymetazoline

  • Antihistamines: Diphenhydramine, loratadine

  • Cough suppressants: Dextromethorphan

• Antibiotics (only if bacterial infection is confirmed or suspected):

  • Amoxicillin or penicillin for strep throat

  • Macrolides (azithromycin) if penicillin allergy

---

2. Triggers of Asthma and Treatment Options

Common Triggers:

• Allergens (dust mites, pollen, pet dander)

• Air pollutants (smoke, ozone)

• Respiratory infections

• Cold air, exercise

• Stress or strong emotions

• Medications (NSAIDs, beta-blockers)

Treatment Options:

• Quick-relief (rescue):

  • Short-acting beta-agonists (SABAs): Albuterol

• Long-term control:

  • Inhaled corticosteroids (ICS): Budesonide, fluticasone

  • Long-acting beta-agonists (LABAs): Salmeterol (used with ICS)

  • Leukotriene receptor antagonists: Montelukast

  • Biologics: Omalizumab (anti-IgE), mepolizumab (anti-IL-5)

---

3. Corticosteroids

Definition:
Corticosteroids are synthetic analogs of hormones produced by the adrenal cortex. They reduce inflammation and suppress the immune system.

Types:

• Systemic: Prednisone, methylprednisolone

• Inhaled: Fluticasone, budesonide

• Topical: Hydrocortisone

• Intranasal: Fluticasone, mometasone

Uses:

• Asthma, COPD

• Autoimmune diseases (e.g., lupus, RA)

• Allergic reactions

• Inflammatory bowel disease

• Adrenal insufficiency

Side Effects:

• Weight gain, osteoporosis, hyperglycemia, increased infection risk, adrenal suppression (long-term)

---

4. Chronic Bronchitis and Treatment Options

Definition:
A form of COPD defined by chronic productive cough for at least 3 months in 2 consecutive years.

Causes:

• Smoking (most common)

• Air pollution

• Occupational exposure

Symptoms:

• Persistent cough with mucus

• Wheezing, dyspnea

• Fatigue

Treatment:

• Smoking cessation (most important)

• Bronchodilators:

  • SABA, LABA

  • Anticholinergics (ipratropium, tiotropium)

• Inhaled corticosteroids (for frequent exacerbations)

• Pulmonary rehabilitation

• Oxygen therapy (if hypoxemic)

---

5. Diagnostic Criteria for Nausea and Vomiting & Treatment Recommendations

Diagnostic Evaluation:

• History and physical exam

• Rule out causes: GI obstruction, infection, pregnancy, CNS disorders, medications, metabolic issues

• May require labs, imaging, or endoscopy

Treatment:

• Identify and treat underlying cause

• Symptomatic treatment:

  • Antiemetics:

    • Ondansetron (5-HT3 antagonist)

    • Metoclopramide (prokinetic, dopamine antagonist)

    • Promethazine, prochlorperazine (phenothiazines)

    • Antihistamines: Diphenhydramine, meclizine (especially for motion sickness)

• Hydration and electrolyte correction

---

6. GERD (Gastroesophageal Reflux Disease): Symptoms, Complications, Drug Management

Symptoms:

• Heartburn

• Regurgitation

• Chest pain

• Chronic cough, sore throat

Complications:

• Esophagitis

• Barrett’s esophagus

• Strictures

• Increased risk of esophageal cancer

Drug Management:

• Antacids: Calcium carbonate

• H2 blockers: Ranitidine (withdrawn in some markets), famotidine

• Proton Pump Inhibitors (PPIs): Omeprazole, esomeprazole (mainstay)

• Prokinetics: Metoclopramide (less common)

---

7. Compare and Contrast: Crohn’s Disease vs. Ulcerative Colitis

---

8. Diabetes: Causes, Symptoms, and Treatment

Types:

• Type 1: Autoimmune destruction of β-cells → insulin deficiency

• Type 2: Insulin resistance + relative insulin deficiency

• Gestational: During pregnancy

• Others: MODY, secondary diabetes

Causes:

• Type 1: Genetic + autoimmune

• Type 2: Genetics, obesity, sedentary lifestyle, age

Symptoms:

• Polyuria, polydipsia, polyphagia

• Fatigue, blurred vision

• Weight loss (type 1), infections

Treatment:

Type 1:

• Insulin therapy (basal + bolus)

• Blood glucose monitoring

Type 2:

• Lifestyle changes (diet, exercise)

• Oral agents: Metformin (first-line), SGLT2 inhibitors, GLP-1 receptor agonists, sulfonylureas

• Insulin (if needed)

Monitoring:

• HbA1c every 3–6 months

• Blood pressure, lipids, kidney function