Antihistamines, Decongestants, Antitussives, and Expectorants Flashcards
Dextromethorphan (Robitussin)
Functional Classification
Antitussive, nonopioid
Dextromethorphan (Robitussin)
Mechanism of Action
Depresses cough center in medulla by direct effect
Dextromethorphan (Robitussin)
Uses
Nonproductive cough caused by colds or inhaled irritants
Dextromethorphan (Robitussin)
Contraindications
Hypersensitivity
Dextromethorphan (Robitussin)
Side Effects
CNS: Dizziness, sedation, confusion, ataxia, fatigue
GI: Nausea
Dextromethorphan (Robitussin)
Nursing Considerations
ASSESS:
-COUGH: type, frequency, character, including sputum
PERFORM/PROVIDE:
- Increased fluids to liquify secretions
- Humidification of patient’s room
Diphenhydramine (Benadryl)
Functional Classification
Antihistamine (1st generation, nonselective)
Diphenhydramine (Benadryl)
Chemical Classification
Ethanolamine derivative, H1-receptor antagonist
Diphenhydramine (Benadryl)
Mechanism of Action
Acts on blood vessels, GI, respiratory system by competing with histamine for H1-receptor site; decreases allergic response by blocking histamine
Diphenhydramine (Benadryl)
Uses
Allergy symptoms, rhinitis, motion sickness, antiparkinsonism, nighttime sedation, infant colic, nonproductive cough, insomnia in children
Diphenhydramine (Benadryl)
Contraindications
Hypersensitivity to H1-receptor antagonist, acute asthma attack, lower respiratory tract disease, neonates
Diphenhydramine (Benadryl)
Side Effects
CNS: Dizziness, Drowsiness, poor coordination, fatigue, anxiety, euphoria, confusion, paresthesia, neuritis, SEIZURES
CV: hypotension, palpitations
EENT: blurred vision, dilated pupils, tinnitus, nasal stuffiness, dry nose, throat, mouth
GI: nausea, anorexia, diarrhea
GU: Retention, dysuria, frequency
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, HEMOLYTIC ANEMIA
INTEG: photosensitivity
MISC: ANAPHYLAXIS
RESP: increased thick secretions, wheezing, chest tightness
Diphenhydramine (Benadryl)
Nursing Considerations
ASSESS:
- urinary retention, frequency, dysuria; product should be discontinued
- CBC during long-term therapy; blood dyscrasias may occur
- Respiratory status: rate, rhythm, increase in bronchial secretions, wheezing, chest tightness
Diphenhydramine (Benadryl)
Overdose Treatment
Administer diazepam, vasopressors, phenytoin IV
Guaifenesin (Mucinex)
Functional Classification
Expectorant
Guaifenesin (Mucinex)
Mechanism of Action
Increases the volume and reduces the viscosity of secretions in the trachea and bronchi to facilitate secretion removal
Guaifenesin (Mucinex)
Uses
Productive and nonproductive cough
Guaifenesin (Mucinex)
Contraindications
Hypersensitivity; chronic, persistent cough
Guaifenesin (Mucinex)
Side Effects
CNS: drowsiness, headache, dizziness
GI: nausea, anorexia, vomiting, diarrhea
Guaifenesin (Mucinex)
Nursing Considerations
ASSESS:
-COUGH: type, frequency, character, including sputum; fluids should be increased to 2L/day
PERFORM/PROVIDE:
-increased fluids, room humidification to liquefy secretions
Loratadine (Claritin)
Functional Classification
Antihistamine, 2nd generation
Loratadine (Claritin)
Chemical Classification
Selective histamine (H1)-receptor antagonist
Loratadine (Claritin)
Mechanism of Action
Binds to peripheral histamine receptors, thereby providing antihistamine action without sedation
Loratadine (Claritin)
Uses
Seasonal rhinitis, chronic idiopathic urticaria for those >/=2yr
Loratadine (Claritin)
Contraindications
Hypersensitivity, acute asthma attacks, lower respiratory tract disease
Loratadine (Claritin)
Side Effects
CNS: sedation (more common with increased doses), headache, fatigue, restlessness
CV: sinus tachycardia
RESP: wheezing
Loratadine (Claritin)
Nursing Considerations
ASSESS:
- ALLERGY: hives, rash, rhinitis; monitor respiratory status
- LFTs, serum creatinine/BUN
PERFORM/PROVIDE
- Storage in tight container at room temp
- Increased fluids to 2L/day to decrease secretions
Dextromethorphan (Robitussin)
Chemical Classification
Levorphanol derivative
