Antihistamine Flashcards

1
Q

Common Cold Causes?

How do they invade?

A

Most are caused by viral infection (rhinovirus or influenza virus).

Virus invades tissues (mucosa) of upper respiratory tract, causing upper respiratory infection.

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2
Q

What does the Common cold from virus invasion produce?

Cold symptoms?

A

Excessive mucus production results from the inflammatory response to this invasion (of the viruses).

Fluid drips down the pharynx into the esophagus and lower respiratory tract, causing cold symptoms: sore throat, coughing, upset stomach.

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3
Q

Irritation of nasal mucosa often triggers the?

Mucosal irritation also causes the release of several inflammatory and vasoactive substances, _______ small blood vessels in the nasal sinuses and causing _________

A

Irritation of nasal mucosa often triggers the sneeze reflex.

Mucosal irritation also causes the release of several inflammatory and vasoactive substances, dilating small blood vessels in the nasal sinuses and causing nasal congestion.

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4
Q

Treatment of common cold or URI (4)

A

Involves combined use of antihistamines, nasal decongestants, antitussives, and expectorants

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5
Q

Treatment is ________ only, not _________.

_________ treatment does not eliminate the causative _________.

A

Treatment is symptomatic only, not curative.

(Can only relieve symptoms)

Symptomatic treatment does not eliminate the causative pathogen.

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6
Q

Difficult to identify whether cause is ___ or ____

Treatment is “________” treating the most likely cause

______ and ______ may be used, but a definite viral or bacterial cause may not be easily identified.

Natural health products examples and benefits

A

Difficult to identify whether cause is viral or bacterial

Treatment is “empirical therapy,” treating the most likely cause

Antivirals and antibiotics may be used, but a definite viral or bacterial cause may not be easily identified.

Natural health products- vitamin C, echinacea, goldenseal- prevent onset of cold symptoms/ decrease severity

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7
Q

In 2009, Health Canada issued recommendations that over-the-counter (OTC) cough and cold products not be given to children younger than __ years of age.

Not effective in small children, and parents are advised to consult their pediatrician on the best ways to manage these illnesses.

A

6

OTC cough and cold products are not to be given to children younger than 6 due to sedation, seizures, hallucinations, tachycardia and abnormal heart rhythms

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8
Q

Histamines

5 functions

Histamine is a major?

A

involved in nerve impulse transmission in the CNS

DILATION of capillaries

CONTRACTION of smooth muscle

STIMULATION of gastric acid secretions

ACCELERATE HR

Histamine is a major inflammatory mediator in many allergic disorders, such as rhinitis, anaphylaxis, angioedema, drug fevers, insect bite reactions and urticaria (pale red, raised, itch bumps)

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9
Q

Histamine 1 (H1) receptors

A

mediate smooth muscle contraction and dilation of capillaries

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10
Q

H2 receptors

A

mediate acceleration of HR and gastric secretion

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11
Q

Excessive amounts of histamine can cause?

A

anaphylaxis and severe allergic symptoms

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12
Q

Anaphylaxis and severe allergic 3 symptoms

A

constriction of smooth muscles in the stomach and lungs

increase in body secretions

vasodilation and increased capillary permeability results in the movement of fluid out of the BVs and into the tissues, causing a drop in BP and edema

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13
Q

Antihistamines [histamine antagonists]

A

directly compete with histamine for receptor sites

H1 blockers/ H1 antagonists

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14
Q

H1 antagonists drugs
Medications
Treats?

A

Loratadine and Diphenhydramine

Treats nasal allergies (seasonal hay fever)

Relieves symptoms of the common cold: sneezing and runny nose (can alleviate symptoms but not destroy the virus)

Palliative but not curative

has varying degrees of antihistaminic, antichollinergic, and sedating properties

treats allergies, vertigo, motion sickness, insomnia, and cough

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15
Q

Antihistamines competes with?

Also affects?

A

histamine for the H1 receptors in the smooth muscle surrounding BVs and bronchioles

secretions of the lacrimal, salivary, and respiratory mucosal glands: primary antichollinergic effects of antihistamines

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16
Q

Loratadine and Diphenhydramine MECHANISM OF ACTION

A

Compete with histamine for specific receptor sites (Histamine Antagonist)
-Bind to histamine receptors on mast cells & basophils
-Prevent further release of histamine & actions

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17
Q

H1 BLOCKERS or H1 antagonists (known as antihistamines)

  1. ASSOCIATED WITH
  2. LOCATION
A

H1 blockers are associated with antihistamines

H1 are in areas such as smooth muscle surrounding blood vessels and bronchioles

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18
Q

Loratadine and Diphenhydramine

H1 antagonists drugs

also cause ____ effects

A

Also affects secretions of lacrimal, salivary and respiratory mucous glands which are the primary anticholinergic actions (dry mouth, etc.) of antihistamine

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19
Q

Antihistamine mechanism of action

A

during an allergic reaction, histamines are released from mast cells and basophils in response to an antigen in blood.

Histamine then binds and activates other cells in the nose, eyes, respiratory tract, GI tract, and skin producing allergy symptoms

In the respiratory tract, histamine causes extravascular smooth muscle (bronchial tree) to contract (while antihistamines cause it to RELAX)

Histamine can cause pruritus by stimulating nerve endings (antihistamine can alleviate itching)

circulating histamine binds to histamine receptors on basophils and mast cells which further stimulates the release of histamine

Antihistamine blocks histamine receptors on surfaces of basophils and mast cells and prevents the release and action of histamine

They do not remove histamine already bound but compete for the unoccupied receptors

(better if given early in a histamine-mediated reaction before all histamine binds to cell membrane receptors)

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20
Q

consequences of histamine binding are?

A

vasodilation

increased GI, respiratory, salivary, and lacrimal secretions

increased capillary permeability with edema

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21
Q

Binding of H1 blockers (antihistamines) to these receptors PREVENTS?

A

Vasodilation

increased GI, respiratory, salivary, and lacrimal secretions

Increased capillary permeability with resulting edema

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22
Q

The allergen binds to antibodies— causes HISTAMINE SECRETION:

A
  1. swelling of BVs and releasing of fluids
  2. congestion—insufficient 02—sleepiness, weakness, drowsiness, snoring, headache

OR

  1. swelling of BVs and releasing of fluids
  2. nasal irritation—infection/ inflammation—sinusitis, asthma, inflammation of middle ear
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23
Q

ANTIHISTAMINES INDICATION

A

nasal allergy
seasonal/ perennial allergic rhinitis
common cold
allergic reactions
motion sickness
PD(due to antichollinergic effects)
Vertigo
Sleep aids

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24
Q

Antihistamines action

A

Mediate’s inflammatory response:
Rhinitis: hay fever, mold, dust
Anaphylaxis
Angioedema
Drug fevers
Insect bite reactions
Urticaria (itching)
Symptoms of common cold
-sneezing
-Runny nose

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25
Q

The anithistaminic, anticholinergic and sedative properties also make them useful for treatment of:

A

Vertigo
Insomnia
Motion sickness
cough

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26
Q

Antihistamines are most effective when

A

Most effective when given early in histamine mediated reactions

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27
Q

Antihistamines should not be used as sole therapy in?

A

Should not be used as sole therapy in acute asthma attacks

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28
Q

Antihistamines Contraindication

A

Narrow angle glaucoma
Heart disease
Hypertension
COPD
Peptic ulcer disease
Seizure disorders,
BPH (enlarged prostate)
pregnancy

NOT to be used as sole therapy for asthma attack

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29
Q

Pediatric Alert

______ is not recommended in children under 6 yrs

______ is not recommended in children

______is not recommended in children under 2 yrs

A

Fexofenadine (Allegra) is not recommended in children under 6yrs

Desloratadine (Aerius) is not recommended in children

Loratadine (Claritin) is not recommended in children under 2 yrs

Recommend to discontinue antihistamine at least 4 days prior to allergy testing

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30
Q

Antihistamines Adverse Effects

A

Drowsiness (varies amongst drug class)
Sedative effects

“Drying” effects
Dry mouth
Difficulty urinating
Constipation
Change in vision

Cardio: dysrhythmias, hypotension, palpitations, syncope, sedation, dizziness, muscular weakness, excitement, nervousness, seizures

GI: N & V, diarrhea, constipation, hepatitis

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31
Q

Antihistamines Interactions

Medications

Food

A

Loratadine drug interactions: Ketoconazole, cimetidine and erythromycin increase concentrations of fexofenadine & loratadine

Diphenhydramine: Alcohol, CNS depressants, MAOs increase depressant effects of cetirizine (Reactine) and diphenhydramine (Benadryl)

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32
Q

Cardiovascular small blood vessels

A

Histamine effects- dilates BVs, increases BVs permeability (allow substances to leak into tissues)

Antihistamine effects: reduces dilation of BVs

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33
Q

Smooth muscle exocrine glands

A

Histamine: stimulate salivary, gastric, lacrimal, and bronchial secretions

Antihistamine: reduces salivary, gastric, lacrimal, and bronchial secretions

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34
Q

Immune

A

Histamine effects- released from mast cells; results in allergic reaction

Antihistamine: does not stabilize mast cells/ prevent the release of histamine; but does bind to histamine receptors and prevents the action of histamine

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35
Q

Nonsedating antihistamines medications

Function

A

Loratadine

cetrizine
fexofenadine

eliminate many adverse effects, esp. sedation

Act peripherally to block actions of histamine and therefore have significantly less CNS effects

also called peripherally acting antihistamines because they do not readily cross blood-brain barrier

has a longer duration of action

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36
Q

Loratadine:

Drug class?

A

nonsedating antihistamine [takken OD]

does not distribute to CNS which diminishes sedative effects

High doses can cause drowsy, headache, and fatigue

relieves seasonal allergic rhinitis (hay fever) and chronic urticaria

CONTRA: allergy

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37
Q

Traditional antihistamines

A

works both peripherally and centrally

has antichollinergic effects, which in some cases is more effective than non-sedating antihistamines

diphenhydramine, dimenhydrinate

used alone/ in combination

treats nausea/ motion sickness

causes drowsiness

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38
Q

Diphenhydramine hcl

A

acts peripherally and centrally

antichollinergic and sedative effects

used as a hypnotic drug because of its sedating effects

Not for OAs due to the risk of falls [hangover effects]

the greatest range of therapeutic indication

relief/ prevention of allergies, motion sickness, treatment of PD, and promotes sleep

used in conjunction with EPi for anaphylaxis and treats dystonia

CONTRA: allergy

CAUTION: nursing mothers, newborns, lower respiratory tract symptoms

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39
Q

Nasal Congestion

A

Excessive nasal secretions

Inflamed and swollen nasal mucosa

Primary causes: Allergies & Upper respiratory infection (common cold)

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40
Q

Decongestants

Three separate groups of nasal decongestants:

A

taken orally to prevent system effect (prolonged effects and delayed onset), inhaled/ topically into the nose

adrenergic (sympathomimetics)

anticholinergic (parasympatholytic)

corticosteroids (intranasal steroids)

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41
Q

Decongestants

ORAL route

NASAL

A

prolonged decongestant effects, onset is delayed and effect is less potent than topical

Nasal- can cause rebound congestion because of the rapid absorption of the drug through mucous membranes followed by a rapid decline in effectiveness

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42
Q

Adrenergics (sympathomimetics) medications 2

A

Pseudoephedrine (Sudafed) oral

**Oxymetazoline HCl (Dristan) nasal spray

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43
Q

Anticholinergics (parasympatholyitcs)

A

Ipratropium bromide (Atrovent) nasal spray

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44
Q

Corticosteriods medications

A

Fluticasone propionate (Flonase) nasal spray

Beclomethasone dipropionate (Rivanase) (nasal spray)

Budenoside (Pulmicort, pulmicort turbohaler, symbicort turbohaler)

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45
Q

Decongestants mechanism of actions

A

shrink engorged nasal mucous membranes and relive nasal stuffiness

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46
Q

Adrenergics (sympathomimetics) mechanism of action

A

Constrict small arterioles (BVs around nasal sinuses)

(when BVs are stimulated by adrenergic drugs- they constrict)

Once BVs shrink, the nasal secretions in the swollen mucous membrane are better able to drain

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47
Q

Corticosteriods mechanism of action

A

Target inflammatory response elicited by invading organisms/ antigen; the body responds to invaders by producing inflammation to isolate area and call other cells to destroy invader

Steroids exert anti-inflammatory effects by causing cells to be turned off/ rendered unresponsive

“turn off” cell response; reduce inflammatory symptoms to improve patient comfort and air exchange

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48
Q

Anticholinergics action

A

Inhibits secretions of the serous and serous-mucous membranes of the nasal passages

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49
Q

Decongestant indications

A

acute/ chronic rhinitis

common cold

sinusitis

hay fever

allergies

reduces swelling of nasal passages before surgery

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50
Q

Decongestants

Contraindications of adrenergic drugs

A

Narrow angle glaucoma
Uncontrolled cardiovascular disease
Hypertension
Diabetes
Hyperthyroidism
Prostatitis, BPH
Inability to close eyes (stroke patients)
TIAs
Asthma
Drugs allergy

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51
Q

Adverse effect of Adrenergics (think adrenergic stimulation)

A

Nervousness
Insomnia
Palpitations
Tremor

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52
Q

AE of Corticosteriods

A

Localized dryness, nose bleeds, mucosal thinning

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53
Q

AE of anticholinergic

A

Also excessive dryness, nose bleeds

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54
Q

MAOIs may result in additive pressor effect with ______ decongestants

A

MAOIs may result in additive pressor effect with adrenergics decongestants- raise BP

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55
Q

systemic sympathomimetic drugs when combined with sympathomimetic nasal decongestant

A

cause drug toxicity

56
Q

Antitussives

A

Inhibition of cough reflex

57
Q

Cough reflex

A

stimulated when receptors in the bronchi, alveoli, and pleura are stretched

58
Q

Antitussives indication

A

Prevent harm: post surgical injury (abdominal incision)

Reduce respiratory distress in non-productive “dry cough” situations

59
Q

Antitussives

Two opioid

A

Codeine phosphate controls cough, potentially addicting, risk for CNS and respiratory depression

Hydrocodone

suppress cough reflex

if taken as prescribed, does not lead to dependency

60
Q

Antitussives

Two Nonopioid

A

Dextromethorphan hydrobromide

Diphenhydramine

less effective than opiod

61
Q

Opioid antitussives

how do they supress cough reflex?
other effects (two)

A

Suppress cough reflex through direct action on the cough centre in the medulla

Provide analgesia

Drying effect on mucosa (increase mucous viscosity) helps to reduce runny nose and postnasal drip

62
Q

Non opioid antitussives action

A

Suppress cough reflex through direct action on the cough centre in the medulla

Drying effect on mucosa (increase mucous viscosity) helps to reduce runny nose and postnasal drip

**No Analgesia and does not cause CNS depression

63
Q

Antitussives indication

A

Stop cough reflex

64
Q

Antitussives Contraindications

A

Opioid dependency, respiratory depression (older adults)
—–Alcohol use, CNS depression, anoxia, hypercapnia, COPD, respiratory depression, increased intracranial pressure, impaired kidney & liver function

Dextromethorphan: hyperthyroidism, cardiac disease, hypertension, glaucoma, MAOIs (does not cause respiratory or CNS depression)

65
Q

Antitussives Adverse Effects:

Codeine/ hydrocodone

Dextromethorphan

Diphenhydramine

A

Codeine/ hydrocodone-Sedation, nausea, vomiting dizziness, constipation

Dextromethorphan- dizzy, drowsy, and nausea

Diphenhydramine- sedation, dry mouth, antichollinergic effects

66
Q

Antitussives Interactions

A

Opioids: May potentiate other opioids, general anesthetics, tranquillizers, sedatives, hypnotics, TCAs, MAOIs, alcohol

Dextromethorphan: may potentiate MAOIs

67
Q

Dextromethorphan:

unsafe for children under?

contraindications

A

unsafe for children under 6

nonopioid

safe and non-addicting

Not addictive/does not cause CNS or respiratory depression

contraindications: allergy, asthma, emphysema/ persistent headache

68
Q

Codeine

not for children under

A

opioid antitussive

control cough

potentially addictive and can depress respiration

not for children under 12

69
Q

Expectorants

A

Aid in expectoration (coughing up & spitting out) of excessive mucous in UR tract by breaking down and thinning out the secretions

reduces the viscosity of secretions

Indication: relief of productive cough, decreased tendency of cough

AE: minimal; nausea, vomiting, gastric irritation

70
Q

Expectorants- Most common and available in Canada is?

A

guaifenesin-decrease mucus related symptoms; manages cough

beneficial in the treatment of productive coughs because it thins the mucus in the respiratory tract that is difficult to cough up

71
Q

Expectorants

MoA -Reflex stimulation (controversial and varied thought)

A

– loosening and thinning of the respiratory tract secretions occurs in response to an irritation of the GI tract produced by the drug – [vagal pathway]

72
Q

MoA – UR secretagogues

A

loosening and thinning by way of direct stimulation of secretory glands to release secretagogues that increase hydration of secretions and “unstick” them from airways. DOES NOT INCREASE MUCUS SECRETION.

73
Q

Expectorants

A

are defined as medications that improve the ability to expectorate purulent secretions. This term is now taken to mean medications that increase airway water or the volume of airway secretions, including secretagogues that are meant to increase the hydration of luminal secretions (eg, hypertonic saline or mannitol) and abhesives that decrease the adhesivity of secretions and thus unstick them from the airway (eg, surfactants). Expectorants do not alter ciliary beat frequency or mucociliary clearance. Oral expectorants were once thought to increase airway mucus secretion by acting on the gastric mucosa to stimulate the vagus nerve, but that is probably inaccurate.

74
Q

Expectorants indications

A

Used for relief of productive cough associated with common cold, bronchitis, laryngitis, pharyngitis, pertussis, influenza, measles

75
Q

Expectorants contraindications

A

Contraindicated if allergic and in case of hyperkalemia (for K+ containing expectorants)

Cont use with alcohol/ diuretics

76
Q

Expectorants AE

Interactions

A

No big issues with adverse effect (possible nausea, vomiting, gastric irritation)

No big issues with interactions

77
Q

Expectorants:Nursing Implications

A

Expectorants should be used with caution in older adults and patients with asthma or respiratory insufficiency.

Patients taking expectorants should receive more fluids, if permitted, to help loosen and liquefy secretions.

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

Monitor for intended therapeutic effects

78
Q

Drug of choice is based on?

A

type and sevrity of symptoms

79
Q

Nursing Considerations

A

Teach non-pharm measures and dangers of using OTC meds

Please read Natural Health Products and know about use of vitamin C, echinacea, and goldenseal for colds/flus/immune system booster

Please understand issues for older adults and people with asthma & chronic respiratory disease

Teach patients about signs and symptoms of infectious complications (secondary bacterial infections, symptoms of other infectious diseases development such flu) & to seek medical help

80
Q

Adrenergics

A

drugs that stimulate sympathetic nerve fibers of autonomic NS that use Epinephrine and NE neurotransmitters

81
Q

Antichollinergics

A

Blocks ACh; results in the inhibition of parasympathetic nerve impulses

82
Q

Antigens

A

substances capable of inducing specific immune responses

83
Q

Antihistamine

A

can reduce physiological and pharmacological effects of histamines

84
Q

Antitussives

A

drugs that reduce coughing

85
Q

Corticosteroids

A

carbohydrate and protein metabolism, maintenance of glucose levels, electrolyte and water balances, cardiovascular, skeletal, kidneys and other system functions

86
Q

Decongestants

A

reduce congestion and swelling

87
Q

Emperical therapy

A

treats disease based of observations and experience, rather than knowledge/ precise cause

88
Q

Expectorants

A

increase the flow of fluids in the respiratory tract by reducing the viscosity of secretions and facilitate removal by coughing

89
Q

Nosedating antihistamines

A

works peripherally to block histamine, NO CNS effects

do not cross blood-brain barrier

eliminate sedation

Loratadine, cetrizine

90
Q

Sympathomimetic drugs

A

mimic those resulting from the stimulation of sympathetic NS

91
Q

Allergic reaction symotoms

A

hives
wheezing
bronchospasms
tachycardia
hypotension

different when treating influenza/ cold

92
Q

Fexofenadine hcl drug interactions

A

erythromycin and other CYP450 inhibitors= increased histamine levels

phenytoin= decreased fexofenadine levels

93
Q

Loratadin drug interactions

A

antifungals, cimetidine and erythromycin= increased antihistmaine levels

94
Q

diphenhydramine and cetrizine with alcohol can cause

A

increased CNS depressant

95
Q

CONCERN: use of antihistamines with acute asthma attacks and lower respiratory tract infection (pneumonia)

A

Rationale: antihistamine dry up secretions, if the pt cannot expectorate secretions, secretions may become viscous, occlude airways and lead to atelectasis, infection/ occlusion of bronchioles

96
Q

decongestant may increase

A

BP and HR so vital signs need to be assessed

PPL with HTN can use topical decongestant short term; against oral decongestant

CAD- use of decongested must be avoided

97
Q

OTC cough and cold drugs

A

associated with oversedation, seizures, tachycardia, death

98
Q

decongestant contraindication

A

acute angle glaucoma
cardiovascular disease
HTN
diabetes
prostatitis

topically applied decongestant- may be absorbed in the circulation > Excessive usage can cause cardiovascular effects

monitor for paradoxical reactions

frequent use can lead to rebound nasal congestion

99
Q

Does H1 receptor antagonist drug cross blood brain barrier?

A

NO

100
Q

DRY mouth from antihistamine

A

mouth care, candy, OTC cold lozanges, chew gum

101
Q

AE of antitussives

A

drowsiness/ dizziness; caution when driving/ doing activity that requires alertness

If an antitussive contains codeine- may increase the risk of CNS and respiratory depressant

report symptoms of pneumonia from taking antitussives: fever, chest tightness, colored sputum, difficulty/ noisy breathing, activity intolerance/ weakness

102
Q

Expectorants contraindication

A

avoid alcohol
not use drugs longer than. a week

103
Q

H1 blockers

A

antihistamine

prevent harmful effects of histamine and treat rhinitis, anaphylaxis reactions to insect bites,

104
Q

H2 blockers

A

treat gastric acid disorder, ulcer disease, hyperacidity

105
Q

decongestant

A

constriction of engorged and swollen BVs in the sinuses decreases pressure and allow the mucous membrane to drain

AE- palpitation, insomiinsomniana, restlessness, nervousness

106
Q

Non opiod antitussives

A

may also cause sedation, drowsiness or dizziness (large and frequent doses)

DO not drive/ avoid alert activities

107
Q

Codeine containing antitussives

A

may cause CNS depression, do not give with alcohol

108
Q

fexofenadine with erythromycin/ CYP450 inhibitors

A

leads to increased antihistamine levels

109
Q

fexofenadine with phenytoin

A

leads to decreased fexofenadine level

110
Q

loratadine given with antifungals , cimetidine, and erythromycin

A

leads to increased antihistamine level

111
Q

diphenhydramine and cetrizine with alcohil, MAOIs, and CNS depressants

A

increased CNS depression

112
Q

Why not use antihistamine in people with acute asthma attack or have lower respiratory disease?

A

dry up secretions

if the patient cannot expectorate secretions, the secretions may become viscous (thick), occlude airways and lead to atelectasis, infection, or occlusion of the bronchioles

113
Q

Antihistamine in OAs

A

result in paradoxical reactions; subsequent irritability, dizziness, confusion, sedation, and hypotension

114
Q

Decongestant may affect

May also affect

A

functional structures of eyes and nose (eyedrops/ nasal spray)

BP and HR- monitor vitals

PT with HTN can use topical decongestant short term, advised against using oral decongestant

CAD- avoid decongestant

115
Q

Decongestant contraindication

A

glaucoma
allergy
diabetes
prostatitis

116
Q

adrenergic decongestant

A

may increase BP (cardio effects)

dizziness, nervousness, headache (CNS effects)

117
Q

Inhaled intranasal steroids are contraindicated in?

A

pt with nasal mucosal infection or allergy

118
Q

Antitussive therapy

A

assess safety- can cause sedation

119
Q

Respiratory assessment

A

include rate, rhythm, and depth as well as breath sounds, presence of cough and sputum

120
Q

Reduced dosages for

A

those with kidney impairment

121
Q

Fluids

A

Helps liquefy secretions, assist in breaking thick secretions and makes it easier to cough up secretions (encourage fluid intake)

122
Q

Which medication causes rebound congestion from overuse/ dependence?

A

Oxymetazoline HCl (Dristan) nasal spray

123
Q

Ekenasia

A

does not prevent colds, reduce cold symptoms and reduce recovery time

124
Q

Golden seal

A

treats upper resp disease, antibacterial, fungal or protozoal

125
Q

Avoid alcohol in pts taking?

A

expectorants, and do not use for longer than 1 week

126
Q

H1 blockers

A

antihistamine

prevent harmful effects of histamine and used to treat seasonal allergic rhinitis, anaphylaxis, reactions to insect bites

127
Q

H2 blockers

A

treats gastric acid disorder, hyperacidity/ ulcer

128
Q

Decongestant

A

cause constriction of the engorged and swollen BVs in the sinuses, which decreases pressure and allows mucous membranes to drain

AE: heart and CNS stimulating effects- palpitations, restlessness, nervousness

129
Q

Non-opioid antitussives may also cause

A

sedation, drowsiness, and dizziness. DO not drive/ engage ifr metal alertness required

130
Q

Possible contraindication for a decongestant

A

glaucoma

131
Q

decongestant has an adrenergic stimulating effect that may result in?

A

hypertension

132
Q

drug to use for a pt with bronchitis with a productive cough?

A

expectorant

133
Q

antitussive cough medication is for patients with

A

a patient who has had a recent abd surgery

134
Q

adverse effect of decongestant

A

heart palpitations

135
Q

antihistamine adverse effects

A

dizziness, hang over effect, drowsiness, dry mouth

136
Q

dextromethorphan is for?

A

cough