DRUGS

Question 1

1) Drug ex 4: antihistamines

Answer 1

> Diphenhydramine (Benadryl) -1st gen. More effective but more reactions.
Loratadine (Claritin) 2nd gen.

Question 2

2) MOA: antihistamines

Answer 2

> Block histamine receptors (H1) throughout the body to prevent allergic responses.

Question 3

3) INDICATION: antihistamines

Answer 3

> seasonal allergies, >allergic rhinitis, >allergic conjunctivitis, >urticaria, **allergic reactions to medications, >motion sickness, >Parkinson’s symptoms (diphenhydramine ONLY), >cough relief.

Question 4

4) ADVERSE REACTIONS (rxn): antihistamines

Answer 4

> 1st Gen.: DROWSINESS, sedation, hypotension. >Thickening of bronchial secretions, >RESTLESSNESS (age extremes), > ANTICHOLINERGIC effects (“can’t see, can’t poop, can’t pee, dry mouth.) >LESS sedation and anticholinergic effects with 2nd Gen. meds.

Question 5

5) NURSING IMPLICATIONS: antihistamines

Answer 5

“Antihistamines dry you up!!!”, >diphenhydramine available multiple routes: PO, IM, IV. >monitor pt response to therapy; MONITOR BP, assess bowel and urinary pattern; Anticipate fall risk.

Question 6

6) PT TEACHING: antihistamines

Answer 6

> don’t drive while drowsy, > increase fluid intake, > consider neti-pot or humidifier, >no ETOH, see MD if no improvement after 7-10 days. >LORATADINE: ONLY take once a day; may take SEVERAL days to take affect. >diphenhydramine - every 4-6 hrs.

Question 7

7) CONTRAINDICATIONS: antihistamines

Answer 7

> 1st Gen: Glaucoma, Peptic Ulcer Disease (PUD), BPH AND/OR URINE retention; acute asthma attacks.

Question 8

8) INTERACTIONS: antihistamines

Answer 8

> other CNS depressants (Ex: ETOH – increases sedation)

Question 9

9) Drug ex 4: Decongestants “fight or flight meds”

Answer 9

> Oxymetazoline (nasal spray) – ex: Afrin, can become dependent. >Pseudoephedrine

Question 10

10) MOA: Decongestants

Answer 10

 decrease nasal swelling by providing Local VASOconstriction of small vessels on the nasal membranes.
 Sympathetic stimulant

Question 11

11) INDICATION: Decongestants

Answer 11

 congestion associated w/ the common cold, hay fever, sinusitis.

Question 12

12) ADVERSE REACTIONS (rxn): Decongestants

Answer 12

 TACHYcardia/HTN
 Nervousness
 Insomnia
 Blurred vision
 Oxymetazoline: nasal irritation & REBOUND CONGESTION w/ nasal sprays.

Question 13

13) NURSING IMPLICATIONS: Decongestants

Answer 13

 ASSESS AND MONITOR s/s, v/s, pt’s response to therapy.

Question 14

14) PT TEACHING: Decongestants

Answer 14

 Use and abuse of OTC meds – LIMIT NASAL SPRAY 3-5 days, admin. of nasal spray; AVOID w/ hx of HTN; read labels of OTC meds.

Question 15

15) CONTRAINDICATIONS: Decongestants

Answer 15

 Glaucoma, HTN, CAD, PVD, Thyroid disease, diabetes.

Question 16

16) INTERACTIONS: Decongestants

Answer 16

 Antihypertensives (beta-blockers etc.) – worsening HTN

Question 17

17) Drug ex 4: Antitussives p.371

Answer 17

 For dry cough/ congested control. -tussive = tos
 CNS depressant,
 Codeine (opioid),
 Dextromethorphan DM
 Benzonatate (works in lungs)

Question 18

18) MOA: Antitussives

Answer 18

 Decrease cough center in the medulla.
 Numbs stretch receptors in the respiratory passages.

Question 19

19) INDICATION: Antitussives

Answer 19

 Dry cough (no sputum)

Question 20

20) ADVERSE REACTIONS (rxn): Antitussives

Answer 20

 Codeine & DM: lightheadedness, dizziness, DROWSINESS, OR SEDATION.
 Benzonatate: lightheaded, dizzy.
 Codeine: constipation.