chapter 36, Antihistamines...

Question 1

A drug that directly compete with histamine for specific receptor sites?

Answer 1

Antihistamines

Question 2

Antihistamines are most beneficial in management of?

Answer 2

nasal allergies
seasonal or perennial allergic rhinitis (eg., hay fever)
typical symptoms of the common cold
allergic reactions
motion sickness
Parkinson's disease 
vertigo
sleep aid

Question 3

H1 antagonist include drugs such as?

Answer 3

diphenhydramine 
chlorpheniramine
fexofenadine
loratadine
cetirizine

Question 4

H1 antagonists are of greatest value in the Tx of?

Answer 4

nasal allergies, particularly seasonal hay fever.

to relieve the symptoms of the common cold, such as sneezing, and runny nose (palliative)

Question 5

When H1 antagonist are given to relieve the symptoms of the common cold, such as sneezing and runny nose. They are acting as?

Answer 5

Palliative (they can help alleviate the symptoms of a cold but can do nothing to destroy the virus causing it).

Question 6

what are the primary anticholinergic actions of antihistamines?

Answer 6

they affect the secretions of the lacrimal, salivary, and respiratory mucosal glands.

Question 7

Antihistamines should not be used as the sole drug therapy during acute asthmatic attacks. True or false?

Answer 7

True

Question 8

What are some contraindications for antihistamines?

Answer 8

acute asthmatic attacks
narrow-angle glaucoma 
cardiac disease, kidney disease
hypertension
bronchial asthma, COPD
peptic ulcer
seizure disorders
benign prostatic hyperplasia
pregnancy.

Question 9

The herbal therapy Echinacea is contraindicated for patient with?

Answer 9

HIV, TB, connective tissue disease and multiple sclerosis (MS)

Question 10

Antihistamine effects may be potentiated excessively by interaction with?

Answer 10

apple
grapefruit
orange juice
St. John’s wort

Question 11

How long should an antihistamine be discontinued prior to allergy testing?

Answer 11

at least 4 days

Question 12

excessive use of decongestants whether oral forms or nasal inhaled forms may lead?

Answer 12

rebound congestion

Question 13

what happens when a patient has rebound congestion?

Answer 13

The nasal passages become more congested as the effects of the drug wear off. Patient generally uses more of the drug, precipitating a vicious cycle with more congestion.

Question 14

patient taking expectorants should not use these medication for how long?

Answer 14

longer than 1 week

Question 15

when is coughing not useful and may even be harmful

Answer 15

after surgical procedure such as hernia repair or in cases of nonproductive or dry cough

Question 16

patients with upper or lower respiratory symptoms or disease processes should avoid?

Answer 16

dry air, smoke-filled environments and allergens

Question 17

patients taking expectorants should avoid

Answer 17

alcohol and products containing alcohol

Question 18

what should the nurse assess for before administering the traditional antihistamines such as diphenhydramine, chlorpheniramine, or brompheniramine

Answer 18

The nurse must ensure the patient has no allergies to this group of medications, even though these drugs are used for allergic reactions.

Question 19

why should traditional antihistamines not be used when patients are experiencing an acute asthma attack and those with lower respiratory tract disease or at risk for pneumonia?

Answer 19

because the antihistamines dry up secretions; if the patient cannot expectorate the secretions, it may become viscous (thick), occlude airways,and lead to atelectasis or further infections or occlusion of the bronchioles.

Question 20

assessments for patients taking antitussive

Answer 20

safety because most of these drugs results in sedation, dizziness, and drowsiness.
allergies.
Respiratory assessment (rate, rhythm and depth, breath sounds, presence of cough, ABGs.

Question 21

assessments for the use of decongestants

Answer 21

BP and HR

Question 22

what is recommended or prescribed for patients who have a cough and need to bring up secretions more easily?

Answer 22

expectorants

Question 23

What should the nurse implement with patients who experience dry mouth.

Answer 23

encouraged to chew or suck on candy (sugar free), or OTC throat, cough, or cold lozenges or to chew gum.
perform frequent mouth care.

Question 24

when assessing a patient who is receiving antihistamines, the nurse will recognize that some potential contraindications are?

Answer 24

narrow-angle glaucoma
cardiac disease
kidney disease
hypertension
bronchial asthma
COPD
peptic ulcer disease
seizure disorders
BPH
pregnancy

Question 25

what are some advantages of nonsedating antihistamine?

Answer 25

they do not cross the blood-brain barrier

they have longer durations of action, which allows some of them to be taken only once a day.

Question 26

Diphenhydramine (Benadryl)

Answer 26

works both peripherally and centrally
potent anticholinergic and sedative effects
use as a hypnotic drug
“hang over” effect = increased potential for falls
most commonly used antihistamines
use for relief or prevention of histamine-mediated allergies
motion sickness
Tx of Parkinson’s disease
promotion of sleep
used in conjunction with epinephrine in the management of anaphylaxis and Tx of acute dystonic reactions

Question 27

decongestants administered by the oral route

Answer 27

pseudoephedrine

Question 28

commonly used nasal decongestant spray

Answer 28

phenylephrine

Question 29

Excessive dosages of decongestants can causes systemic effects elsewhere in the body such as?

Answer 29

hypertension
palpitations
headache
nervousness
dizziness

Question 30

what is the most common adverse effects of intranasal steroids

Answer 30

mucosal irritation and dryness

Question 31

drug interactions with decongestants

Answer 31

systemic sympathomimetic drugs and sympathomimetic
MAOIs-raising of BP
methyldopa and urinary acidifiers and alkalinizers

Question 32

what are the advantages of using oral decongestants

Answer 32

the oral route produce prolonged decongestant effects.
the effect is less potent.
no rebound congestion

Question 33

what is the disadvantages of using topical decongestants

Answer 33

rebound congestion because of the very rapid absorption of drug through mucous membranes.

Question 34

what are some advantages in using inhaled decongestants

Answer 34

not associated with rebound congestion.

used prophylactically to prevent nasal congestion in patients with chronic upper respiratory tract symptoms.

Question 35

what are the indications or antitussives

Answer 35

to stop the cough reflex when the cough is nonproductive and or harmful.

Question 36

what are some contraindications for the use of antitussives

Answer 36

drug allergy.
opioid dependency
high risk for respiratory depression.

Question 37

what are adverse effects for antitussives

Answer 37

dizziness, headache, pruritus and nasal congestion
dry mouth
sedation, constipation

Question 38

what are expectorants used for?

Answer 38

The relief of productive cough commonly associated with common cold.
bronchitis
laryngitis
pharyngitis
pertussia
influenza
measles 
loosening and thinning sputum and bronchial secretions

Question 39

how long should patients taking chewable tablets of antitussive or lozenges wait before drinking liquids

Answer 39

30 to 35 minutes afterward

Question 40

Antitussive are for nonproductive coughs True or False

Answer 40

True

Question 41

a patient with a history of asthma ask the nurse about taking an antihistamine for a “terrible cold” what should be the nurse’s best answers?

Answer 41

The antihistamine dry up secretions; if the patient cannot expectorate the secretion it may become viscous, occlude airways and lead to atelectasis or occlusion of the bronchioles.