HEENT Flashcards
Classifications of Antitussive medications and examples
Centrally acting
- Dextromethorphan
- Codeine
Peripherally acting
- Benzonatate
Dextromethorphan and Codeine Mechanism of Action
- acts centrally in the medulla to elevate the threshold for coughing
- affects serotonin
- suppresses the cough reflex
- risk for abuse
Benzonatate (Tessalan Perles) Mechanism of Action
- thought to anesthetize the stretch receptors in the respiratory passages, calming the cough
- numbs the lungs
- makes lungs more relaxed
- does cross blood-brain barrier
Antitussive medications cautions/ contraindications
- avoid in persistent/chronic cough caused by smoking, asthma, or emphysema
- additive CNS depression when dextromethorphan or codeine is used with CNS depressants - can decrease respiratory drive
- do not self-medicate for more than 7 days
- Risk for overdose with benxonatate, keep away from children
Antitussive Adverse drug reactions
- dextromethorphan and codeine: drowsiness, dizziness, and GI upset
- benxonatate: chest numbness, dizziness, GI upset, headache, and “chilly” sensation
Expectorant Mechanism of Action
Guaifenesin (Mucinex and Robitussin)
- decreases the surface tension of mucus making the mucus more thin and loose for clearance
- questionable efficacy
Expectorant/Mucinex indication for use
- for cough due to common cold or upper respiratory infections
- good for patients who have congestion but are unable to expectorate
Expectorant/Mucinex ADRs
- GI upset - diarrhea - nausea - vomiting
- drowsiness - dizziness
Expectorant cautions/ contraindications
- do not use for persistent cough
- do not use for cough r/t heart failure or ACE inhibitor therapy
Demulcents Mechanism of Action and Examples
Cough drops, honey, acacua, licorice, glycerin, wild cherry
- Act as a protective film on mucous membranes thereby reducing irritation
Name examples of decongestants
Psuedoephederine
Phynylephrine
Afrin (nasal)
Decongestants Mechanism of Action
Alpha 1 agonists (sympathomimetics) - they mimic the endogenous catecholamines of the sympathetic nervous system
- produces vasoconstriction by stimulating the Alpha 1 receptors in the mucosa of the resp. tract, thus temporarily reducing swelling and inflammation
**used to treat symptoms
Decongestants cautions and contraindications
- avoid in HTN and CAD
- oral not recommended in children < 4 years old - not recommended in pregnancy and lactation
- avoid in combination with beta blockers - potentiate CV issues
- topical/nasal: do not use for longer than 3 days (can cause rebound congestion)
Decongestants Adverse Drug Reactions
- anxiety, restlessness, headache, insomnia, psychological disturbances, tremors, HTN, tachycardia (fight or flight symptoms)
- topical: nasal irritation and rebound congestions with prolonged use
Non-pharm interventions for Allergic Rhinitis
- Avoid triggers (close windows and doors to reduce pollen exposure)
- Remove carpets
- Clean frequently (vaccuum, dust ect.)
- Keep pets out of bedroom area if possible
H1 vs H2 histamine recptors
