intranasal/decongestants Flashcards
What is promethazine (Phenergan) used for?
Allergic reactions, nausea, sedation.
What are serious adverse effects of promethazine?
Respiratory depression, local tissue injury at IV site.
What are contraindications for promethazine?
Cardiac dysrhythmias, hepatic disease, MAOIs, children <2 years old.
What should be used with caution when taking promethazine?
Children, older adults, asthma, seizures, cardiac disease, renal disease, urinary retention, open-angle glaucoma, HTN, BPH.
What are examples of intranasal antihistamines?
Azelastine & olopatadine.
What are adverse effects of intranasal antihistamines?
Possible somnolence, epistaxis, anticholinergic effects, unpleasant taste.
What is cromolyn used for?
Mast cell stabilizer – best as prophylaxis for allergic rhinitis.
How long does cromolyn take to work?
Usually 1-2 weeks.
What are adverse effects of cromolyn?
Sneezing, nasal burning, epistaxis, bad taste, rare bronchospasm.
What are examples of oral decongestants (sympathomimetics)?
Phenylephrine, pseudoephedrine.
What are examples of intranasal decongestants (sympathomimetics)?
Oxymetazoline, phenylephrine.
What are adverse effects of decongestants?
Rebound congestion (topical), CNS stimulation (oral), vasoconstriction (CV effects & stroke, oral > topical), abuse potential.
How do antitussives work?
They act on the CNS to elevate the cough threshold.
What are examples of opioid antitussives?
Hydrocodone & codeine.
What are examples of non-opioid antitussives?
Dextromethorphan, benzonatate, diphenhydramine.
What are the adverse effects of opioid antitussives?
CNS effects (dizziness, lightheadedness, drowsiness), respiratory depression (<12 breaths/min), GI effects (N/V/Constipation), opioid use disorder risk.
What is the antidote for opioid overdose?
Naloxone.
Who should avoid opioid antitussives?
Pregnant/lactating individuals, those with bradypnea, acute asthma, head trauma, liver/renal disease, alcohol use disorder, children, older adults, history of substance use disorder.
What are the adverse effects of non-opioid antitussives?
Mild nausea, dizziness, sedation.
What are examples of expectorants/mucolytics?
Guaifenesin (Mucinex), acetylcysteine, hypertonic saline.
What is the function of guaifenesin?
Stimulates flow & thins secretions for a more productive cough.
What are adverse effects of guaifenesin?
GI upset, drowsiness, dizziness, allergic reactions.
How do acetylcysteine & hypertonic saline work?
They work directly on secretions to thin them for a more productive cough.
What are adverse effects of acetylcysteine & hypertonic saline?
Aspiration & bronchospasm, dizziness, drowsiness, hypotension, tachycardia, hepatotoxicity.
What causes the common cold?
A viral infection of the upper respiratory tract.
Can the common cold be cured or prevented?
No, it is self-limiting.
What types of OTC drugs are commonly used for cold treatment?
Multi-symptom combos including nasal decongestants, antitussives, analgesics, antihistamines, caffeine.
How should OTC cold medications be used?
Only for all indicated symptoms to avoid unnecessary medication exposure.
