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Pharmacotherapeutics > Anthistamines, Decongestants, Antitussives, and Expectorants > Flashcards

Anthistamines, Decongestants, Antitussives, and Expectorants Flashcards

1
Q

Common Cold

A

Most caused by viral infection

Excessive mucus production results from inflammatory response to the invasion

Treatment is SYMPTOMATIC only, not curative

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2
Q

Antihistamine Mechanism of Action

A

Drugs that compete with histamine for specific receptor sites: H1 and H2

Block action of histamines at receptor sites

Cannot push a histamine off the receptor if it is already bound

SHOULD BE GIVEN EARLY IN TREATMENT

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3
Q

Properties of Antihistamines

A

Antihistaminic
Anticholinergic
Sedative

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4
Q

Indications for Antihistamines

A 
Seasonal or perennial allergic rhinitis
Anaphylaxis
Angioedema
Drug fevers
Insect bite reactions
Urticaria
Nasal allergies
Motion sickness
Parkinson's disease
Sleep disorders
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5
Q

Contraindications of Antihistamines

A 
Narrow-angle glaucoma
Cardiac disease, HTN
Kidney disease
COPD, bronchial asthma
Sole drug therapy during acute asthma attacks
Peptic ulcer disease
Seizure disorders
Benign prostatic hyperplasia
Pregnancy (cautiously, need to know category)
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6
Q

Adverse Effects of Antihistamines

A

Anticholinergic (drying) effects are most common: dry mouth, difficulty urinating, constipation, changes in vision

Drowsiness

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7
Q

Type of Traditional Antihistamine

A

Diphenhydramine (Benadryl)

Sedating

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8
Q

Types of Nonsedating Antihistamines

A

Loratadine (Claritin)
Cetirizine (Zyrtec)
Fexofenadine (Allegra)

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9
Q

Nonsedating/Peripherally Acting Antihistamines

A

Work peripherally to block the actions of histamine; thus, fewer CNS adverse effects
Longer duration of action (increases compliance)

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10
Q

Traditional Antihistamines

A

Older
Work peripherally and centrally
Have anticholinergic effects, making them more effective than nonsedating drugs in some cases

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11
Q

Nursing Implications for Antihistamines

A

Use caution with patients with increased intraocular pressure, cardiac or renal disease, hypertension, asthma, COPD, peptic ulcer disease, BPH, or pregnancy

Instruct patients to report excessive sedation, confusion, or hypotension

Instruct patients not to take OTC medications with these medications without checking with their prescribers

Best tolerated when taken with meals

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12
Q

Nasal Congestion Properties

A

Excessive nasal secretions

Inflamed and swollen nasal mucosa

Primary causes include allergies and upper respiratory infections

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13
Q

Types of Decongestants

A

Adrenergics (largest group)

Anticholinergics (less commonly used)

Corticosteroids

Two dosage forms: oral or inhaled/topically applied

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14
Q

Oral Decongestants

A

Prolonged decongestant effects but delayed onset

NO REBOUND CONGESTION

Exclusively adrenergics

Pseudoephedrine (Sudafed)

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15
Q

Topical Nasal Decongestants

A

Prompt onset, potent

Sustained use over several days causes rebound congestion, making the condition worse

Phenylephrine

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16
Q

Intranasal Steroids

A

Beclomethasone dipropionate (Beconase)
Fluticasone (Flonase)
Triamcinolone (Nasocort)

17
Q

Mechanism of Action for Nasal Decongestants

A

Site of action: blood vessels and surrounding nasal sinuses

Adrenergics: constrict small blood vessels that supply upper respiratory tract structures to shrink tissues and allow for better drainage

Nasal steroids: antiinflammatory effect, work to turn off the immune system cells involved in the inflammatory response

18
Q

Indications for Nasal Decongestants

A

Relief of nasal congestion associated with acute/chronic rhinitis, common cold, sinusitis, hay fever, allergies

May be used after nasal surgeries

19
Q

Contraindications of Nasal Decongestants

A

Narrow-angle glaucoma, uncontrolled cardiovascular disease, hypertension, diabetes and hyperthyroidism, inability to close the eyes, history of CVA or TIA, long-standing asthma, BPH, diabetes

20
Q

Nursing Implications for Nasal Decongestants

A

Patients should avoid caffeine

Patients should report fever, cough, or other symptoms lasting longer than 1 week

21
Q

Antitussives

A

Drugs used to stop or reduce coughing
Opioid and nonopioid
USED ONLY FOR NONPRODUCTIVE COUGHS
May be used in cases where coughing is harmful

22
Q

Mechanism of Action for Antitussive Opioids

A

Suppress the cough reflex by direct action on the cough center in the medulla

Analgesia, drying effect on the mucosa of the respiratory tract, increased viscosity of respiratory secretions, reduction of runny nose and postnasal drip

CODEINE

23
Q

Mechanism of Action for Antitussive Nonopioids

A

DEXTROMETHOPHAN works in the same way as opioids
No analgesic properties
No CNS depression

BENZONATATE (TESSALON): suppresses the cough by numbing the stretch receptors in the respiratory tract and prevent reflex stimulation of the medullary cough center

24
Q

Contraindications for Antitussives

A

Opioid dependency

Respiratory depression

25
Q

Adverse Effects of Antitussives

A

Benzonatate: dizziness, headache, sedation, nausea

Dextromethorphan: dizziness, nausea, drowsiness

Opioids: sedation, nausea, vomiting, lightheadedness, constipation

26
Q

Nursing Implications for Antitussives

A

Perform respiratory and cough assessment and assess for allergies

Report cough that lasts more than 1 week, persistent headache, fever, and rash

27
Q

Expectorants

A

Drugs that aid in the expectoration of mucus

Reduce the viscosity of secretions

Example: GUAIFENESIN (MUCINEX)

28
Q

Mechanism of Action for Expectorants

A

Drug causes irritation of the GI tract and loosening and thinning of respiratory tract secretions

Secretory glands are stimulated directly to increase their production of respiratory tract fluids

THINNER MUCUS THAT IS EASIER TO REMOVE

29
Q

Indications for Expectorants

A

Common cold, bronchitis, laryngitis, pharyngitis, chronic paranasal sinusitis, pertussis, influenza, measles

30
Q

Nursing Implications for Expectorants

A

Use with caution in older adults and patients with asthma or respiratory insufficiency

PATIENTS TAKING EXPECTORANTS SHOULD RECEIVE MORE FLUIDS TO HELP LOOSEN AND LIQUEFY SECRETIONS

Report fever, cough, or other symptoms lasting longer than 1 week

Pharmacotherapeutics (37 decks)

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