Drugs for Upper Resp (40) Flashcards by Alex Sudacov

Cold

___ Infection that invades the respiratory tract –> ____ cell injury –> _____ response –> ____ & ____.

Viral…. Local… Inflammatory… Signs and Symptoms

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Cold Signs and Symptoms:
____ blood flow to area
Local ____
Nasal ____

Increased… Edema… Discharge

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Cold may develop ____ bacterial infection –> ____ of the throat –> ____ / ____ (sore throat).

Secondary… Irritation… Coughing/Pharyngitis

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Allergic Rhinitis:
\_\_\_\_ (environmental):
1. \_\_\_\_
2. \_\_\_\_
3. \_\_\_\_ dander

Allergen… Dust… Pollen… Animal

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Allergic Rhinitis - Immunologic Response:

____ Response –> ____ Release –> Increased secretion of ____, which leads to ____ and ____.

Inflammatory… Histamine… Mucus… Congestion and Sneezing.

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Drug classifications:
\_\_\_\_ (H1 blockers)
Decongestants
\_\_\_\_ - cough relief
Expectorants

Antihistamines… Antitussives

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Histamines:
H1 receptors - ____ extra-vascular smooth muscle
H2 receptors - ___ in gastric secretions –> ____ ____.

Constricts… Increase… Peptic Ulcer

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Histamines ___ arterioles, which increase ____ ____ to capillaries & tissues –> ____ & itching

Dilate… blood supply… swelling.

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Antihistamines ____ action of histamine at ____ receptor sites… Tx: allergic ____.

block… H1 Histamine… rhinitis

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1st Generation antihistamines cause ____ symptoms:

Dry ____
____
Blurred Vision

Anticholinergic… mouth… constipation

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1st Generation antihistamine ex: diphenhydramine (Benadryl) could be taken p.o and IM/IV. Treats allergic ____ and prevents ____ sickness. Active ingredient is in ____ .

Rhinitis… motion… OTC sleep aids.

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Side Effects of 1st Gen. antihistamines (anticholinergic effects):

Drowsiness
____, fatigue
____ retention & ____
Dry mouth
Blurred vision

___ take with ___ or other CNS depressants.

Dizziness… Urinary… Constipation… DO NOT… alcohol

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Contraindications of 1st Gen. Antihistamines:

Acute ____ –> ____ effect on Resp tract –> may ____ secretion –> more ____ breathing.
Narrow-angle ____
____, urinary retention.
____/nursing mother (inhibits lactation)

Asthma… Drying… thicken… difficult… BPH… Pregnant

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2nd Gen. Antihistamines:

Little to no effect on ____.
More specific to ____ receptor.
Fewer ____ symptoms.

Sedation… H1 histamine… Anticholinergic

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Examples of 2nd Gen. Antihistamines
cetirizine (Zyrtec)
fexofenadine (Allegra)
loratadine (Claritin)
*** \_\_\_\_ may develop over time so switch between \_\_\_\_

Tolerance… Drugs.

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Nursing Diagnoses:

Ineffective ____ clearance r/t ____ congestion.
Sleep ____ r/t frequent ____.

airway… nasal…deprivation…coughing.

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Nasal Decongestants (sympathomimetic amines):
\_\_\_\_ alpha-adrenergic receptors --> \_\_\_\_ in nasal mucosa --> Nasal mucous membranes \_\_\_\_ --> \_\_\_\_ fluid secretion (runny nose effect)

Stimulate… Vasoconstriction… Shrink… Decrease.

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Nasal Decongestants:

Administer through nasal ___ / ____

spray / drops.

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With frequent use of nasal decongestants:
____.
____ Congestion ( Nasal ____ instead of ____ and shouldn’t use more than ____-____ days)

Tolerance… Rebound… vasodilation… vasoconstriction…

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Examples (sprays/drops):
oxymetazoline HCl (Afrin)
phenylephrine HCl (Neosynephrine)
naphazoline HCl (Allerest)

SEE OTHERS SIDE

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Systemic Decongestants (alpha-adrenergic agonists):
p.o.
Used to Tx: allergic \_\_\_\_ -->  Hay \_\_\_\_ / Acute \_\_\_\_ - profuse nasal discharge

Rhinitus… Fever… Coryza

Examples of Systemic Examples:
ephedrine (Ephedrine)
phenylephrine (Neo-synephrine)
pseudoephedrine (Sudafed)

SEE OTHERS SIDE

LAW OF 2006:

Bans OTC sales of cold meds containing ____. Sale limited to behind the counter and you need a photo ID

pseudoephdrine

Side Effects:
Jittery, nervous (____ as tolerance develops)
alpha-____ drug –> Increase in ____ and ____ levels.

Disappear… adrenergic… BP and blood glucose

``` Contraindications of Systemic Decongestants: Hypertension ____ Disease ____ Diabetes Mellitus ```

Hypertension... Cardiac... Hyperthyroidism.

Nasal/Systemic Decongestants are not for...

Infants and Young Children (<2 yrs)

Pseudoephedrine: 1. May ____ effect of beta blockers. 2. ____ chance of hypertension and ____.

decrease... increase.... cardiac dysrhythmias.

With decongestants you should avoid: | Large amounts of coffee / tea (____) because it increases restlessness and palpitations.

restlessness... palpatations.

Intranasal Glucocorticoids (steroids): ____ action decreases symptoms of 1. ____ 2. Sneezing 3. ____

anti-inflammatory, Rhinorrea, congestion

``` Examples of Decongestants: beclomethasone (Beconase, Vanceril) budesonide (Rhinocort) dexamethasone (Decadron) fluticasone (Flonase) triamcinolone (Nasacort) ```

SEE OTHER SIDE

Side of Effects decongestants: Continuous use --> ____ of nasal mucosa. Usually no ____ side effects. Should not use for ____ days.

dryness... systemic... >30.

____ act on cough control center in medulla --> ____ cough reflex

Antitussives... suppress

Cough is a ____ mechanism and could be productive or non productive

physiological

_____ cough should not be suppressed unless in ____ discomfort or can't ____.

Involuntary... respiratory... sleep

3 Types of antitussives 1. ____ 2. Non-narcotic 3. Combination

narcotic

Narcotic Antitussives: 1. codeine 2. ____ which have a direct action on ____ center in medulla.

hydrocodone

Major problems with Narcotic cough suppressants: 1. RISK FOR ____ 2. Respiratory ____ 3. Bronchial ____ 4. ____ depression 5. ____

DEPENDENCE... depression... constriction... CNS... constipation.

Nonnarcotic Antitussives: | ____ HBr which is the most common. It is a chemical derivative of ____. Acts on ____ center.

Dextromethorphan... opiates... cough

Dextromethorphan HBr does NOT cause: 1. ____ 2. Respiratory ____ 3. ____

Dependence... depression... analgesia

Dextromethorphan found in... 1. ____ DM 2. Benylin DM

Robitussin

Side effects of Dextromethorphan: | CNS ____ --> nausea, ____, drowsiness, ____.

depression... dizziness... sedation

Expectorants ____ flow of secretions in ____ tract --> Decrease ____ of secretions and phlegm which easier to remove by ____.

stimulate... respiratory... viscosity... coughing.

Guaifenesin is the most ____ popular expectorant. Well tolerated but may cause stomach ____ / ____.

popular... upset / nausea

Nursing diagnoses for expectorants: Ineffective airway clearance r/t nasal congestion Sleep deprivation r/t chronic coughing

VERY IMPORTANT

Goal for expectorants: Client will be free of nonproductive cough Client will be free of a secondary infection

VERY IMPORTANT

Seek medical attention with expectorants if... 1. Cough ____ week. 2. High ____, rash. 3. ____

>1... fever... HA

Asses ____ and ____ of a cough

frequency... productive

Cough syrups give a local, ____ effect and should not be given water, food, ____ administration

soothing... after

DO NOT suppress ____ cough and ____ clients

productive...post-op

When on expectorants, encourage ____ and ____ dry air (clean regular)

fluids... humidify