1. Pediatric cough & cold, use caution...
1.1. Children < 18
1.1.1. Avoid codeine- & hydrocodone-containing products
1.2. Children < 4
1.2.1. Avoid OTC cough & cold products
1.3. Children < 2
1.3.1. Avoid OTC cough & could
1.3.2. Avoid promethazine
1.3.3. Avoid topical menthol & camphor
2. Intranasal steroids
2.1. :arrow_down: inflammation
2.2. Considered 1st line for moderate-severe symptoms
2.2.1. **Budesonide (Rhinocort)**
2.2.1.1. Preferred in **pregnancy**
2.2.2. **Fluticasone (Flonase)**
2.2.3. **Triamcinolone (Nasocort)**
2.2.4. Beclamethasone (Beconase, QNasl)
2.2.4.1. Preferred in **pregnancy**
3. Antihistamines
3.1. 1st Gen
3.1.1. Diphenhydramine, chlorpheniramine, doxylamine (Unisom SleepTabs)
3.2. 2nd Gen
3.2.1. Cetirizine
3.2.1.1. Preferred in **pregnancy** along w/ Loratadine
3.2.2. Levocetirizine (Xyzal)
3.2.2.1. C/I in ESRD, hemodialysis
3.2.3. Fexofenadine (Allegra)
3.2.3.1. Take w/ water & avoid coadministration w/ aluminum/mg-containing products
3.3. Intranasal
3.3.1. Azelastine (Astepro)
3.3.1.1. Can be combined w/ intranasal steroid
4. Decongestants
4.1. Alpha-adrenergic agonists (sympathomimetics)
4.1.1. Max sudafed purchase per day: 3.6g; per 30 days: 9g
4.1.2. Phenylephrine nasal spray (neo-synephrine)
4.2. Cause vasoconstriction which :arrow_down: sinus vessel engorgement
5. Misc. allergy meds
5.1. **Intranasal cromolyn (NasalCrom)**
5.1.1. OTC Mast cell stabilizer
5.1.2. Safe in pregnancy
6. Cough suppressants
6.1. DM
6.1.1. Suppress cough reflex in medullary cough center
6.1.2. At high-doses, acts as NMDA blocker leading to euphoria & hallucinations similar to PCP
6.2. Codeine
6.2.1. Suppress at medullary
6.3. Benzonatate
6.3.1. Topical anesthetic on respiratory stretch receptors