Exam 2 36 37 41 Flashcards
Two virus’ that cause the common cold
Rhinovirus
influenza virus
How does virus’ cause upper Respiratory infection
by invading the tissues (mucosa) of the upper respiratory tract
4 drug classifications that healthcare treat the common cold with
- antihistamines
- nasal decongestants
- antitussives
- expectorants
T/F when treating the common cold the treatment is generally curative
False it is symptomatic
Does symptomatic treatment eliminate the causative pathogen?
No it is symptomatic so it only treats the symptoms. Curative would treat the pathogen
What are some things to watch out for (s/s) regarding antihistamines (4)
- drowsiness
- dysrhythmias
- dry mouth
- hypotension
Antihistamines medications are (3)
Diphenhydramine ( Benadryl)
Hydroxyzine (Vistoril)
Cetirizine (zyrtec)
Benadryl (diphenhydramine) gives the pt freedom from? (3)
- allergies
- Nausea
- vomiting
Vistoril (Hydroxyzine) gives the pt. freedom from? (2)
Anxiety
pain
___ antagonists are commonly referred to as antihistamines
H1
2 examples of H1 antagonists antihistamine
- Diphenhydramine ( benadryl)
2. Loratadine (Claritin)
The definition of Antihistaminic
counter acts the effect of the histamine
A substance that blocks the neurotransmitter acetylcholine is
anticholinergic
a substance that induces sedation by reducing irritability or excitement
sedative
what percentage of the general population is sensitive to various environmental allergies
10 to 20%
5 histamine-related disorders are
- allergic rhinitis
- anaphylaxis
- drug fever
- insect bite reactions
- Urticaria
What is urticaria
itching
3 triggers for an allergic rhinitis
- hay fever
- mold
- dust
- block action of histamine at H1 receptor sites
- compete with histamine for binding at unoccupied receptors
- cannot push histamine off the receptor if already bound’
These 3 things are all what
mechanism of action for antihistamines
what happens in the small blood vessels to histamine (think cardio)
Dilation and increase permeability
dilation and increased permeability of the small blood vessels allows what?
substances to leak into tissues
What happens to the blood vessels when an antihistamine is given?
dilation and increased permeability
this allows substances to leak into the tissues
what happens if antihistamine is given (think cardiac)
reduced dilation of blood vessels
reduced increase permeability of blood vessels
Histamine effects on smooth muscle (exocrine glands)
stimulate salivary, gastric, lacrimal, and bronchial secretions
Antihistamine effects on smooth muscle (exocrine glands)
reduce salivary, gastric, lacrimal and bronchial secretions
Mast cells releasing histamine and other substances result in ____ in the immune system
an allergic reaction
The immune system release ____ that binds to histamine receptors, thus preventing histamine from causing a response
antihistamine
Antihistamines also effects skin… How? (3)
reduce capillary permeability, wheal-and-flare formation, itching
What is the anticholinergic effects caused by antihistamines
drying effect that reduces nasal, salivary, and lacrimal gland secretions
What are the nasal, salivary, and lacrimal gland secretions
runny nose, tearing, and itching eyes
Some antihistamines can cause __
sedation
6 adverse effects of antihistamines
- anticholinergic (drying effects)
- dry mouth
- difficulty urinating
- constipation
- changes in vision
- drowsiness
what is the most common adverse effect of antihistamines
anticholinergic
What are the two types of antihitamines
- traditional
2. nonsedating/peripherally acting
what is an important nursing implication when gathering data regarding antihistamines? (2)
gather data about the condition or allergic reaction that required treatment; also assess for drug allergies
what is a nursing implication regarding antihistamines where it is contraindicated (2 disease process)
- acute asthma attacks
2. lower respiratory diseases IE pneumonia
A nursing implication, USE WITH CAUTION, for antihistamines is (9)
- intraocular pressure (glaucoma)
- cardiac disease
- renal disease
- HTN
- asthma
- COPD
- peptic ulcer disease
- BPH
- pregnancy
a nursing implication for antihistamines that you would instruct your pt to report to you if these should occur are? (3)
- report excessive sedation
- report confusion
- report hypotension
a nursing implication for antihistamines that you would instruct your pts to avoid are
- avoid driving or operating heavy machinery
2. avoid alcohol or other CNS depressants
Should the pt. be allowed to take over the counter or other prescribed medications while taking antihistamines.
No,
the nursing implication is that we are to instruct pts to not take these medications without checking with thier HCP
A nursing implication, should be ..when do you take antihistamines?
with meals to reduce GI upset
A nursing implication should be … if dry mouth occurs teach the pt. to (3)
- perform frequent mouth care
- chew gum
- suck on hard sugar free candy
3 drug classifications for cough
- antitussives
- expectorants
- mucolytics
what is the mechanism of action for antitussive
reduces coughing in nonproductive cough
what are some signs of caution for antitussive
drowsiness, GI upset and constipation
Mucus can be so think that ___ and ___ can grow in it
bacteria and virus
___ break the links that bind mucus together so it can be coughed up
Mucolytics
What is the mechanism of action for expectorants?
irritates mucous membranes to release the mucus
what are some signs of caution for expectorants?
GI upset, nausea and vomiting
What is the drug example for antitussive
dextromethorphan
what is the drug example for expectorant
guaifenesin (robitussin)
what is the drug example for mucolytics?
acetylcysteine (mucomyst)
what are some side effects of antitussive, mucolytics and expectorant (6)
- dizziness
- drowsiness
- vomiting
- bronchospasms
- rhinorrhea
- nausea
what are two primary causes of nasal congestion
- allergies
2. upper respiratory infections ( common cold)
What is the common complaint for nasal congestion
excessive nasal secretions
3 main types of decongestants
- adrenergics
- anticholinergics
- corticosteroids
2 key points about adrenergics
- largest group of medications for decongestants
2. is a sympathomimetic
2 key points about anticholinergics
- less commonly used medication for decongestant
2. is a parasympatholytic
2 key points about corticosteroids
- they are topical
2. they are also intranasal steroids
How are decongestants given? (2)
- oral
2. inhaled/topically applied to the nasal membranes
where is the site of action for nasal decongestants
blood vessels surrounding nasal sinuses
How do adrenergic (nasal decongestants) work
constrict the small blood vessels that supply URI structures
The result of nasal decongestants (adrenergic) are (not end result)
tissues shrink, and nasal secretions in the swollen mucous membranes are better able to drain
the end result of adrenergic a nasal decongestant is
nasal stuffiness is relieved
Nasal steroids have a ___ effect
antiinflammatory
How does nasal steroids work (mechanism of action)
work to turn off the immune system cells involved in the inflammatory response
if you decrease inflammation with nasal steroids you ___ congestion
decrease
yup that easy
End result of nasal steroid
nasal stuffiness is relieved
what are the two drug effects of nasal decongestants
- shrink engorged nasal mucous membranes
2. relieve nasal stuffiness
Adverse effects of adrenergics are (4) for nasal decongestant
- nervousness
- insomnia
- palpitations
- tremors
What systems can be affected by adrenergic stimulation (3) for nasal decongestant
- heart
- blood vessels
- CNS