Drugs for upper respiratory infections Flashcards
What is the most prevalent URI:
Common cold affects adults 2-4 yr; children 4-12 yr
What is the common cold caused by and what area of the body does it affect the most:
Rhinovirus affects the nasopharyngealtract
An acute inflammation of the mucous membranes of the nose commonly accompanies the Rhinovirus is defined as:
acute rhinitis
What is caused by pollen or foreign substance (animal dander) AKA hay fever:
Allergic rhinitis (NOT THE SAME AS ACUTE RHINITIS)
What does acute rhinitis and allergic rhinitis have in common:
increased nasal secretions
When is the common cold, caused by the rhinovirus, most contagious:
1-4 days before onset of symptoms (incubation period) and during the first 3 days of the cold (caught via touch)
What are the common S/S of the common cold caused by the rhinovirus:
Rhinorrhea ( watery nasal discharge); nasal congestion; cough; increased mucosal secretions
What does infected rhinitis look like and how should they be treated:
tenacious, mucoid that’s yellow-yellow/green; abx should be given
What are some home remedies used to treat a cold:
rest; chix soup; hot toddy (sugar, EtOH, tea), vitamin C, megadoses of vitamines
What are the 4 groups of drugs used to treat the common cold:
Antihistamines, antitussives, decongestants, expectorants
What is the mechanism of antihistamines:
H1 antagonists (blockers) by competing with histamine for receptor sites thus preventing a histamine response.
What are the types of histamine receptors:
H1 and H2
What occurs when the H1 receptors are stimulated:
extravascular smooth muscles of the nasal cavity are constricted
What occurs when the H2 receptors are stimulated:
increase of gastric secretions occur causing peptic ulcers
This first generation antihistamine decreases nasal itchiness/tickling, but has anticholinergic properties. What is the type of drug and what is the anticholinergic property:
Diphenhydramine (Benadryl); causes drowsiness and decreased secretions (useful in treating acute rhinitis)
These second-generation antihistamines are non-sedating and have fewer anticholinergic symptoms. What are some examples:
Allegra, claritin (loratadine), Zyrtec, optivar
What is Diphenhydramine’s mechanism of action
Absorbed in GI; antagonist; antitussive; onset=15 min; can be used as a sleeping aid
What are the common side effects of Diphenhydramine:
Drowsiness, fatigue, dizziness, anticholinergic, coordination; rashes
DILATION of nasal blood vessels d/t infection, inflammation, or allergy is defined as:
nasal congestion
What occurs when there’s DILATION of the nasal blood vessels:
transudation of fluid into the tissue spaces resulting in swelling of the nasal cavity
What are sympathomimetic amines:
nasal decongestants
What is sympathomimetic amines’ or nasal decongestant’s mechanism of action:
stimulates alpha-adrenergic receptors to produce vasoconstriction of capillaries w/in the nasal mucosa=SHRINKING reduced secretions (rhinitis)
What could occur with frequent use of nasal decongestants or sympathomimetic amines:
tolerance and REBOUND NASAL CONGESTANTS (CAUSED BY IRRITATION OF NASAL MUCOSA)
This category of decongestants is used primarily for allergic rhinitis (hay fever or acute coryza-profuse nasal discharge):
Systemic decongestants
What is the main difference of nasal decongestants from systemic decongestants:
NASAL DECONGESTANTS ACT PROMPTLY W/FEWER SIDE EFFECTS THAN SYSTEMIC DECONGESTANTS
What is the main difference of systemic decongestants from nasal decongestants:
RELIEVES NASAL CONGESTION FOR A LONGER PERIOD OF TIME THAN NASAL DECONGESTANTS
What are some examples of systemic decongestants:
ephedrine, neo-synephrine, and Sudafed
ephedrine, neo-synephrine, and sudafed is often combined with:
antihistamines, analgesics, antitussive
What are the side effects of decongestants:
INCREASED BP/GLUCOSE; jittery/nervous/restless
How long may rebound nasal congestion occur:
if a pt uses decongestants >5 days
What may occur if I take decongestants with beta-blockers:
effects of BBs are decreased
What may occur if I take decongestants with MAO inhibitors:
increases risk of HTN /dysrhythmias
What may occur if I take decongestants with lrg mounts of caffeine
palpations
Steroids effective for treating allergic rhinitis is defined as:
intranasal glucocorticoids
What is intranasal glucocorticoids mechanism of action:
antiinflammatory by decreasing allergic rhinitis s/s of rhinorrhea/sneezing/congestion
What are some examples of intranasal glucocorticoids:
FLONASE and dexamethasone
What could occur if a pt takes flonase or dexamethasone continuously:
dryness of nasal mucosa; DEXAMETHASONE SOULD NOT BE USED MORE THAN 30 DAYS
This category of medications acts on the cough center in the medulla to suppress the cough reflex:
antitussive (effective for NON-PRODUCTIVE, IRRITATING COUGH)
What are the 3 types of preparations of antitussives:
nonnarcotic, narcotic, combination
What are some examples of antitussives:
dextromethorphan (nonnarcotic), codeine (narcotic)
What type of medication is given to a pt that wants to loosen bronchial secretions:
expectorants
What is a natural expectorant:
hydration
what is a common example of an expectorant given:
guaifenesin (robitussin)
What are the comfort measures of URIs:
rest, hydration, avoid dust/allergens/fumes, petroleum jelly for nares
A pt has started taking antihistamine and diphenhydramine. What is most important to tell the pt when teaching: A) do not take this drug at bedtime to avoid insomnia, B) avoid driving until stabilized on the drug, C) Nightmares and nervousness are more likely in an adult, D) Limit use to 1-2 puffs/sprays 4-6 times per day to avoid rebound congestion:
B: avoid driving
A pt is prescribed a decongestant nasal spray. What should the nurse teach the pt: A) take this drug at bedtime as a sleeping aid, B) directly spray away from the nasal sputum and sniff, C) this drug may be used in maintenance Tx of asthma, D) limit the drug to 5 days of use to prevent rebound nasal congestion:
D) less than 5 days of use to prevent rebound congestion
Beclomethasone has been Rx to a pt w/allergic rhinitis. What is the most common side effect from continuous use: A)dizziness, B) rhinorrhea, C) hallucinations, D) dry nasal mucosa:
D) dry, nasal mucosa
The nurse is teaching a pt about diphenhydramine. What are the topics to include? Select all that applies: A) take med with food to decrease GI distress, B) Avoid EtOH and other CNS depressants, C) notify if confusion or hypotension occurs, D) take candy, gum, ice chips for temp relief of dry mouth, E) avoid handling dangerous equipment/activities until stabilized on drug:
B, C, D, E
