Antihistamine/ Decongestive/ Antitussive/ Expectorant/ Respiratory Flashcards
Never give kids of age ____ and below cough medicine
2
Histamine
inflammatory mediator. Transmits nerve impulses in CNS. Dilates capillaries. Contracts SM. Incr HR
Antihistamine (1st generation) med
Diphenhydramine (Benadryl)
MOA: antagonizes the effects of histamine at H1 receptor sites; does not bind to or inactivate histamine
Indications: allergies, anaphylaxis adjunct, insomnia, motion sickness, drug-induced extrapyramidal symptoms
PERIPHERAL and CENTRAL effects
A/E: significant CNS depressant, sedation, dry mucous, urinary retention, constipation (anticholinergic effects)
Antihistamine (2nd generation) Meds
Loratadine (Claritin), Fexofenadine (Allegra), Cetirizine (Zyrtec)
MOA: blocks peripheral effects of histamine released during allergic reaction.
Works PERIPHERALLY, not as sedating as first-gen
Longer duration of action
Indications: relief of allergy sex, chronic urticaria
Loratidine A/E: h/a, nasal dryness, drowsiness
Fexofenadine A/E: h/a, dysmenorrhea, drowsy, nasal dryness
Cetirizine A/E: drowsy, h/a, dizzy, nasal dryness
Adrenergic meds
Phenylephrine (Neosynephrine), Pseudoephedrine (Sudafed), Oxymetazoline (Afrin)
MOA: Cause constriction of arterioles in upper airway; allows for drainage of mucus membranes
ORALS: prolonged decongestant effects but delayed onset
Effect less potent than topical
No rebound congestion
Exclusively adrenergic
Afrin nasal spray can also be used to treat nose bleeds in the hospital
USED FOR SHORT PERIOD OF TIME, excessive use can lead to rebound swelling (Afrin)
A/E: nervousness, insomnia, palpitations, tremor
Can increase BP -> use w caution in HTN pts
Intranasal Steroid Meds
Fluticasone (Flonase), Triamcinolone (Nasacort)
MOA: antiinflammatory, prophylactic to prevent nasal congestion
Not generally systemically absorbed
A/E: h/a, epistaxis, nasal irritation, otitis media, vomiting, adrenal suppression (long-term therapy), cough
Antitussive Meds (list them)
Codeine, Dextromethorphan (Robitussin), Benzonatate (Tessalon Perles)
Codeine
MOA: suppress the cough reflex by direct action on cough center in medulla. Analgesia, drying effect on the mucosa, reduces runny nose
A/E: sedation, n/v, lightheadedness, constipation
Dextromethorphan (Robitussin)
MOA: suppresses cough center, no analgesic effect
A/E: dizzy, drowsy, nausea, restlessness
Benzonatate (Tessalon Perles)
MOA: anesthetizes stretch receptors
A/E: dizzy, h/a, sedation, nausea
Expectorant Med
Guaifenesin (Mucinex)
MOA: disintegrate/ thin secretions
A/E: dizziness, h/a, n/v/d, stomach pain, rash, urticaria
Avoid in children <4 and breastfeeding mothers
Types of Bronchodilators:
Beta-adrenergic agonist (albuterol, salmeterol), Xanthine derivatives (Theophylline), Anticholinergic (Ipratropium)
Beta Adrenergic Agonist Meds
Albuterol (Proventil), Salmeterol (Serevent)
Activation of B2 receptors activates cAMP, which relaces SM in the airway -> bronchial dilation + increased airflow
used for ACUTE phase of asthma
A/E: hpn, htn, h/a, tremor (high dose will stimulate b1)
Xanthine Derivative Med
Theophylline
MOA: inhibits phosphodiesterase -> incr cAMP -> stimulates CNS -> opens airway
used for LONG ACTING maintenance tx ONLY
NARROW therapeutic index
A/E: anorexia, hyperglycemia, arrhythmias, tachycardia, n/v, tremor
Anticholinergic Med
Ipratropium (Atrovent)
MOA: airways dilate
A/E: dry mouth, nasal congestion, palpitations, GI distress, urinary retention, incr IOP, h/a, cough, anxiety
used for COPD
