35+36: Upper and Lower Respiratory Meds Flashcards
guidelines for starting antibiotics for sinusitis
- sxs last 2 weeks or longer
- new/worsening sxs after 1 week of sxs
What is the drug class of diphenhydramine
antihistamine
MOA of diphenhydramine
blocks the effects of histamine by competing for and occupying H1 receptor sites (antagonizes histamine effects)
uses of diphenhydramine
- allergic rhinitis
- common cold
- cough/sneezing
- pruritus
- urticaria
- motion sickness
- sleep aid
side effects of diphenhydramine
- drowsiness (main)
- dizziness
- headache
- urinary retention
- blurred vision
- dry mouth/throat
- hypotension
- ABD pain/constipation
- photosensitivity
- palpitations
life threatening effects of diphenhydramine
- agranulocytosis
- hemolytic anemia
- thrombocytopenia
administration of diphenhydramine
- PO w/ food
- IM
- IV
pt teaching for diphenhydramine
- avoid driving or performing other dangerous activities if drowsiness occurs
- avoid alcohol and other CNS depressants
- sugarless candy for dry mouth
- not recommended for breastfeeding mothers
paradoxical side effects of diphenhydramine
- agitation/restlessness
- insomnia
explain the difference between first and second generation antihistamines
- diphenhydramine is first generation
- 2nd generation: less sedating, less side effects, longer acting BUT not as effective
examples of 2nd generation antihistamines
- fexofenadine (Allegra)
- loratadine (Claritin)
- cetirizine (Zyrtec)
at what age can you take diphenhydramine
- 2 y/o and older can take diphenhydramine
- under 2 if under direct supervision of provider
- 2nd generation approved starting at 6 months old
What class of drugs is pseudoephedrine
nasal decongestants
MOA of pseudoephedrine
- acts directly on adrenergic receptors
- produces vasoconstriction which shrinks nasal mucus membranes -> decreases nasal congestion
adverse effects of pseudoephedrine
- HTN
- dysrhythmia
- impaired coordination
- dizziness/vertigo
- excitability
- HA
- insomnia
- seizures
- urinary retention
- thrombocytopenia
- blurred vision
- tinnitus
- chest tightness
- dry nose
- wheezing
which pts are recommended not to take pseudoephedrine
cardiovascular pts (due to HTN and dysrhythmias)
administration of pseudoephedrine
- behind the counter tablets (used to make meth)
- nasal spray (only use 3 days or can cause rebound congestion)
What class of drugs is dextromethorphan
antitussives/expectorant
MOA of dextromethorphan
- suppresses cough by depressing cough center in medulla oblongata or cough receptors in the throat, trachea, or lungs
- reduces viscosity and adhesiveness of tenacious secretions
uses of dextromethorphan
- dry, hacking, nonproductive cough
- to ease expelling secretions from lower respiratory tract and to produce a productive less frequent cough
adverse effects of dextromethorphan
- nausea
- drowsiness
- rash
- difficulty breathing
what do high doses of dextromethorphan cause
- hallucinations
- disassociation
- serotonin syndrome
- respiratory depression
at what age can you take dextromethorphan
6 y/o and older (due to possible respiratory depression)
What can be used as a cough suppressant in children
honey after a year of age (prevent botulism)
What class of drugs is guaifenesin
expectorants
MOA of guaifenesin
loosens bronchial secretions so they can be eliminated by coughing
uses of guaifenesin
productive cough
side effects of guaifenesin
- skin rash
- headache
- N/V
parts of the upper respiratory tract
- nares
- nasal cavity
- pharynx
- larynx
most prevalent URI
common cold