Antitussives and Expectorants

Question 1

Cough Physiology

Answer 1

–Respiratory secretions and foreign objects are naturally removed by the cough reflex.
–Induces coughing and expectoration
–Initiated by irritation of sensory receptors in the respiratory tract

Question 2

two basic kinds

Answer 2

productive and non-productive

Question 3

coughing purpose

Answer 3

–Most of the time, coughing is beneficial
–Removes excessive secretions
–Removes potentially harmful foreign substances
–In some situations, coughing can be harmful, such as after hernia repair surgery.

Question 4

Antituisives

Answer 4

–Drugs used to stop or reduce coughing–Opioid and non-opioid
–Primarily used only for non-productivecoughs
–May be used in cases when coughing is harmful

Question 5

Antitussives can be…

Answer 5

Opioids:
–Codeine–Hydrocodone

Non-Opioids:
–Dextromethorphan
–Less effective than opioid

Question 6

Action of opioids (Antitussives)

Answer 6

–Suppress the cough reflex by direct action on the cough centre 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

–Examples
–codeine
–hydrocodon

Question 7

Action of non-opioids

Answer 7

–Dextromethorphan: works in the same way
•Not an opioid
•No analgesic properties
•No central nervous system depression

Question 8

Contraindications of Antituisives

Answer 8

Contraindications:–Drug allergy–Opioid dependency (for opioid antitussives)
–Respiratory depression
–HTN, ETOH use

Adverse Effects:
–Diphenhydramine: Sedation, dry mouth, and other anticholinergic effects
–Dextromethorphan -Dizziness, drowsiness, nausea
–Opioids -Sedation, nausea, vomiting, lightheadedness, constipation

Question 9

Pt. teaching for Antitiusives

Answer 9

–Perform respiratory and cough assessment, and assess for allergies.
–Because of possible sedation, drowsiness, or dizziness, instruct patients to avoid driving or operating heavy equipment.
–Report any of these symptoms to the caregiver: cough that lasts more than 1 week, persistent headache, fever, rash
–Antitussive drugs are for nonproductive coughs.
–Monitor for intended therapeutic effects.

Question 10

Expectorants

Answer 10

–Drugs that aid in the expectoration (removal) of mucus
–Reduce the viscosity of secretions
–Disintegrate and thin secretions
–By loosening and thinning sputum and bronchial secretions, the tendency to cough is indirectly diminished

Question 11

Action of Expectorants

Answer 11

–Reflex stimulation
–Irritation of the gastrointestinal tract
–Loosening and thinning of respiratory tract secretions occur in response to this irritation.
–Direct stimulation
–The secretory glands are stimulated directly to increase their production of respiratory tract fluids.
–Final result: thinner mucus that is easier to remove

Question 12

Nursing considerations of Expectorants

Answer 12

–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.–Contraindications -allergy

Question 13

Indications of Expectorants

Answer 13

Used for the relief of productive coughs associated with:
–Common cold
–Bronchitis
–Laryngitis
–Pharyngitis
–Coughs caused by chronic paranasal sinusitis
–Pertussis
–Influenza
–Measles

Question 14

administration of Expectorants

Answer 14

–Guaifenesin -PO –2 years old and olde

Question 15

Administration of Antitiusives

Answer 15

–Codeine
–PO 12 years old and older

–Dextromethorphan
–PO -2 years old and olde