Nasal Decongestants

Question 1

Pseudoephedrine (Sudafed)
Levamfetamine (Vicks Vapor)
Propylhexadrine (Benzadrex)

Answer 1

MOA: indirectly acting sympathomimetric - releases norepinephrine from adrenergic nerves
SE: indirect stimulation of heart by released norepinephrine in heart to increase BP, increased CNS stimulation -> hallucinations and anxiety

**Behind the counter OTC due to meth use

Question 2

Phenylephrine

Answer 2

MOA: directly stimulating alpha-adrenergic receptors on postsynaptic sites
- rapidly metabolized = short duration
SE: reflex of heart by parasympathetic during increased BP to decrease HR, increased CNS stimulation -> hallucinations and anxiety

Question 3

Oxymetazoline

Answer 3

MOA: direct alpha-1 adrenergic agonist

• nasal decongestant for pregnant women
• do not use for more than 3-5 days

Question 4

Sodium Bicarbonate

Answer 4

MOA: increase the pH of mucus weakens the polysaccharide chains (expectorant)

Question 5

Dornase Alfa (Pulmozyme)

Answer 5

MOA: recombinant human DNase, reduces viscosity of secretions during an infection by breaking down extracellular DNA
- used in CF pts
Contraindications: pts hypersensitive to Chinese Hamster Ovary cell products (used to produce antibodies)

Question 6

Denufosol Tetrasodium

Answer 6

MOA: enhances mucosal hydration and mucus clearance by activating Cl- secretions and inhibiting epithelial Na+ transport via activation of P2Y2 receptors (ATP receptors)
-> ATP released during inflammation