Pharm 4 Resp pt2 Flashcards
TOPICAL Nasal Decongestants causes ___, resulting in (3)
Causes vasoconstriction, resulting in
Nasal mucosa shrinkage
Promotes drainage
Ultimately, improving breathing through the nasal passages
Topical nasal decongestants compared to oral preparations.
Topical has reduced effects compared to oral: achieving decongestion without extreme changes in BP, cardiac stimulation, or vascular redistribution
Prototypical SEDATING Oral Antihistamines
Example
Indications
Routes of administration (3)
Diphenhydramine HCl (Benadryl®)
Indications: upper respiratory allergies; rhinorrhea, sneezing 2o common cold
PO, IM, or IV
Sedating Oral Antihistamines Contraindications, Precautions, Side Effects
*Makes you drowsy. It’s the active ingreident in any medication that makes you drowsy.
Contraindicated in neonates, nursing moms
Caution in asthma, lower respiratory tract infections, glaucoma, hyperthyroidism, hypertension, GI or urinary obstruction
Pregnancy not recommended (Cat. B in 3rd trimester)
Potentiates CNS depression with ETOH, potentiates anticholinergic effects with MAOIs
What would you give to kids with : seasonal allergic rhinitis, perennial allergic rhinitis, chronic episodic urticaria?
Cetirizine HCl
It’s purple and grape flavored. This is what you’d give to kids.
Prototypical Low-Moderate Sedating Oral Antihistamines
Example
Indications
Cetirizine HCl
Indications: seasonal allergic rhinitis, perennial allergic rhinitis, chronic episodic urticaria
Mod-Low Sedating Oral Antihistamines Contraindications, Precautions, Side Effects
Contraindicated in hydroxyzine sensitivity
Caution in hepatic or renal dysfunction, nursing mothers
Pregnancy Cat. B
Potentiates CNS depression w/ ETOH, large doses of theophyline may decrease cetirizine clearance
Somnolence, fatigue, dry mouth, dizziness
Prototypical Non-Sedating Oral Antihistamines
Example
Indications
Fexofenadine (Allegra®)
Indications: allergic rhinitis, chronic episodic urticaria
Prototypical Non-Sedating Oral Antihistamines-Decongestants
Example
Indications
Fexofenadine/Pseudophedrine HCl (Allegra-D®)
Indications: seasonal allergic rhinitis with nasal congestion
Non-Sedating Oral Antihistamine - Decongestants Contraindications, Precautions, Side Effects
Contraindicated in narrow-angle glaucoma, urinary retention, severe hypertension or CAD, during or within 24 hrs. of MAOIs
Pregnancy Cat. B
Nursing mothers: not recommended
Avoid use in hepatic insufficiency, DM, hypertension, ischemic heart disease, prostatic hypertrophy, GI or urinary obstruction, hyperthyroidism, increased intraoccular pressures, seizure disorders, elderly > 60 yoa
Antihistamines also have the following effects to a variable degree: (3)
Anticholinergic (drying)
Antipruritic
Sedative
What do I do in patients that need rly good control of poison ivy pruritis?
Hydroxyzine
AntihistaminesContraindications, Precautions, Side Effects
Asthma Glaucoma Hyperthyroidism Hypertension GI or urinary obstruction or retention Pregnancy: not recommended (Cat. B in third trimester Drowsiness Dizziness Anticholinergic effects Gastritis Paradoxical excitement Potentiates CNS depression with alcohol
What is Paradoxical excitement
one side effect of Antihistamines.
can happen in kids. Asthmatics who also get beta-agonists. The kid is running around like a monster after getting benedryl.
Prototypical Intranasal Steroids
Example
Indication
Fluticasone propionate
Indications: seasonal and perennial allergic and non-allergic rhinitis
Intranasal Steroids Contraindications, Precautions, Side Effects
Headache Nasal irritation and dryness or congestion Epistaxis Sneezing Throat discomfort GI upset Pregnancy Cat. C
the primary ingredients in most antitussives (2).
What do they do to the body?
Codeine and dextromethorphan
both act on the cough center of the medulla to suppress cough by ELEVATING THE COUGH THRESHOLD
What is Dextramethorphan compared to codeine?
Dextromethorphan is the d-dimer isomer of codeine, but lacks the analgesic and addictive properties of codeine
Codeine works more effectively (5x) more effectively than dextromethorphan.
Robotripping: kids drink lots of Robotissum on the way to school, and hallucinate.
Prototypical Non-Narcotic Antitussives
Example
Indication
Benzonatate
Indications: cough
Non-Narcotic AntitussivesContraindications, Precautions, Side Effects
Contraindicated with or within 14 days of MAOIs
Nursing mothers
Pregnancy Cat. C
Sedation, headache, dizziness, GI disturbance, pruritis, skin eruptions, nasal congestion
Prototypical Narcotic Antitussives
Example (2)
Indication
Hydrocodone bitartrate, homatropine methylbromide
Indications: cough
This is now a Schedule 2 cough syrup antitussive. It’s kind of like Vicodin as a cough syrup.
These will stop your cough, and make you loopy. The dosing depends on what the patient needs for their job/lifestyle.
Narcotic AntitussivesContraindications, Precautions, Side Effects
Glaucoma Head injury, increased ICP Respiratory impairment Elderly, debilitated GI, urinary obstruction Acute abdomen Nursing mothers Pregnancy Cat. C Potentiates CNS depression w/ ETOH Increased toxicity of TCAs, MAOIs Respiratory depression Sedation, drowsiness GI disturbances Orthostatic hypotension
Prototypical Oral Expectorants
Example
Indication
Guaifenesin (Robitussin®)
Indications: cough, bronchitis
A tsp contains how much fluid?
5 ml aka 5 cc
Expectorants Contraindications, Precautions, Side Effects
Precaution in ASTHMA**, Pregnancy not recommended, GI disturbance, headache, rash
