ENT Drug Introduction ENT medications can be broken down into the following categories antihistamines antitussives/expectorants decongestants nasal steroid preparations ENT Drug Table Antihistamines Name Mechanism of Action Key Indication Key Toxicity Sedating Chlorpheniramine 1st generation antihistamine (H1 blocker) Antiserotonergic properties (cyproheptadine) Allergies Motion sickness Insomnia Serotonin syndrome (cyproheptadine) Sedation Orthostatic hypotension Antimuscarinic Confusion (cyproheptadine) Cyproheptadine Diphenhydramine Dimehydrinate Non-Sedating Cetrizine 2nd generation H1 blocker Allergies Minor sedation Fexofenadine Loratadine Antitussives/Expectorants Benzonatate Decreases sensitivity of stretch receptors in airways Cough Expectorant (guaifenesin) Pain (hydrocodone) Sedation Dysphagia Dextromethorphan NMDA antagonist Mild opioid effects Rash Nausea Sedation Constipation Guaifenesin Increases volume and decreases viscosity of oral secretions Nausea Vomiting Kidney stones Hydrocodone Opioid agonist Nausea Vomiting Constipation Sedation Decongestants Phenylpropanolamine α/β adrenergic agonist D1 partial agonist Upper airway congestion Appetite suppression Tachycardia Sweating Dry mucous membranes Arrhythmias Psuedoephedrine Adrenergic agonist (α, β2) Congestion Hypertension Insomnia Agitation Palpitations Nasal Steroid Preparations Beclomethasone Glucocorticoid Anti-inflammatory Congestion Inflammatory bowel disease (budesonide, 1st pass liver metabolism) Eczema (triamcinolone) Cushingoid effects hypertension muscle wasting central obesity psychosis) Budesonide Fluticasone Mometasone Triamcinolone