Drugs acting on upper respiratory Flashcards
Chapter 54
What is dextromethorphan (Benylin)?
Antitussives
What is the therapeutic action of dextromethorphan (Benylin)?
Antitussives
-Suppress cough reflex by direct action on medullary cough center of the brain
What are the indications of dextromethorphan (Benylin)?
Antitussives
Cough suppressant
What are adverse effects of dextromethorphan (Benylin)?
Antitussives
-Have a drying effect on the mucous membranes and can increase the viscosity of respiratory tract secretions.
-CNS depression ( respiratory depression, drowsiness, and sedation)
What are contras of dextromethorphan (Benylin)?
-Head injury –> due to CNS effects
-Cough needed to ensure airway (postoperative patients and those who have undergone abdominal or thoracic surgery) to avoid respiratory distress)
-Pregnancy/lactation ( adverse effects on the fetus or baby, including sedation and CNS depression.)
What are caution of dextromethorphan (Benylin)?
Asthma, emphysema( cough suppression in these patients could lead to an accumulation of secretions and a loss of respiratory reserve)
Need for alertness
What are drug to drug interactions dextromethorphan (Benylin)?
Dextromethorphan should not be used with monoamine oxidase (MAO) inhibitors; hypotension, fever, nausea, myoclonic jerks, and coma could occur. Concurrent use of the opioid medications with other medications or substances (like alcohol) can increase the risk of respiratory depression, sedation, coma, and even death.
What do decongestants do?
decrease the overproduction of secretions by causing local vasoconstriction to the upper respiratory tract . This vasoconstriction leads to a shrinking of swollen mucous membranes and tends to open clogged nasal passages, providing relief from the discomfort of a blocked nose and promoting drainage of secretions and improved airflow/ opens passages
What are 3 varieties of decongestants?
Topical nasal sprays
Oral
Topical-Nasal steroids
What is phenylephrine (Coricidan)?
Topical Nasal Decongestants
What is the therapeutic action phenylephrine (Coricidan)?
Topical Nasal Decongestants
Vasoconstriction –> decrease edema/ inflammation nasal membranes
sympathomimetics, meaning they imitate the effects of the sympathetic nervous system to cause vasoconstriction,
What are the indications phenylephrine (Coricidan)?
Topical Nasal Decongestants
Nasal congestion
common cold, sinusitis, and allergic rhinitis.
What are the indications phenylephrine (Coricidan)?
Topical Nasal Decongestants
Nasal congestion
What are the Pharmacokinetics:
phenylephrine (Coricidan)?
Topical Nasal Decongestants
-Nasal sprays, immediate onset, not generally systemic
Proper administration technique is important for assuring that drugs given nasally have the desired therapeutic effect. It is important to periodically check the nares for any signs of erosion or lesions, which could allow systemic absorption of the drug. Most patients prefer to self-administer nasal drugs, so patient teaching is important. Explain the technique, and then observe the patient using the technique.
What are the adverse effects phenylephrine (Coricidan)?
Topical Nasal Decongestants
Rebound congestion
also called rhinitis medicamentosa), which occurs when the nasal passages become congested as the drug effect wears off.
Systemic effects r/t stimulating sympathetic nervous system
What are contras of phenylephrine (Coricidan)?
Topical Nasal Decongestants
Allergy, nasal lesions
Caution should be used when there is any lesion or erosion in the mucous membranes that could lead to systemic absorption
What are cautions of phenylephrine (Coricidan)?
-Topical Nasal Decongestants
-Caution with cardiac, HTN, hyper-thyroid
Caution should also be used in patients with any condition that might be exacerbated by sympathetic activity, such as glaucoma, hypertension, diabetes, thyroid disease, coronary disease, or prostate problems, because these agents have adrenergic properties. Because there are no studies regarding the effects of these topical drugs in pregnancy or lactation, if used during pregnancy or lactation, caution is advised.
What are drug-drug interactions of phenylephrine (Coricidan)?
-Topical Nasal Decongestants
The use of topical nasal decongestants with other medications that affect the sympathetic nervous system should be monitored carefully.
Sympathomimetic drugs or sympathomimetic-blocking drugs
What is pseudoephedrine (Sudafed)?
Oral Decongestants
What is the therapeutic action of pseudoephedrine (Sudafed)?
Oral Decongestants
-Shrink nasal mucous membrane –> promoting drainage of sinuses/ improving airflow
shrink the nasal mucous membrane by stimulating the alpha-adrenergic receptors in the nasal mucous membranes. This shrinkage results in a decrease in membrane size, promoting drainage of the sinuses and improving airflow.
What is the indications of pseudoephedrine (Sudafed)?
oral decongestants
Nasal congestion
Pain associated with otitis media
relieving pressure in the middle ear.
