resp drugs

Question 1

Antihistamines

Drug
Use
MOA
Side effects
Teaching

Answer 1

Diphenhydramine (1st) /// Cetirizine (2nd)

Use-relief of allergy or cold symptoms

Mechanism of Action:
- Blocks histamine at H1 receptors; inhibits smooth muscle constriction in the blood vessels, respiratory and GI tracts; decreases capillary permeability, salivation and tear formation

 Adverse/Side Effects:
- Can cause anticholinergic effects (dry mouth, UA retention, constipation, and blurred vision)

• Use caution in elderly patient

 Patient Teaching/Education:
- May cause drowsiness
- Caution with positional changes
- Do not drive or operate heavy equipment
- Avoid alcohol and other CNS depressants
- Take only recommended amount / do not exceed max dose

Question 2

Decongestants

Drug
Use
MOA
Side effects
Teaching

Answer 2

Pseudoephedrine

Used to relieve nasal obstruction due to inflammation/congestion in mucus membranes

Mechanism of Action:
- Acts directly on adrenergic receptors and indirectly by releasing epinephrine. Produces vasoconstriction, shrinking nasal mucosa.

 Nursing Considerations:
- Do not use in children < 4 years old

 Adverse/Side Effects:
- Hypertension, dysrhythmia, dizziness, headache,
insomnia, and restlessness (nervousness)
- Blurred vision, tinnitus, chest tightness, dry nose, and nasal congestion
- Contraindicated w/ severe HTN, CAD, narrow-angled
glaucoma, and some antidepressants
- Use caution w/ cardiac dysrhythmias, hyperthyroid, DM, BPH, and glaucoma

 Patient Teaching/Education:
- Take a recommended
- If exceeded, may experience nervousness, SOB,
heart rate changes, and hallucination

Question 3

Antitussives

Drug
Use
MOA
Side effects
Teaching

Answer 3

Dextromethorphan

Used for dry, hacking, non- productive cough that interferes with rest and sleep

Mechanism of Action:
- Depresses the cough center in the medulla oblongata

 Nursing Considerations:
- Do not use in children < 4 years old

 Adverse/Side Effects:
- Nausea and drowsiness
- Rash or difficulty breathing
- High doses may cause hallucinations and disassociation

Reported as a recreational drug

 Patient Teaching/Education:
- Maintain good hydration
- Avoid irritants that cause coughing
- Can cause drowsiness
- Avoid using with alcohol and other CNS depressants

Question 4

Expectorants

Drugs
Use
MOA
Side effects
Patent teaching

Answer 4

Guaifenesin

Used for productive cough and loosening mucus from the respiratory tract

Mechanism of Action:
- Reduces viscosity of thick secretions by irritating the gastric vagal receptors that stimulate the respiratory tract fluids (thin secretions)

 Adverse/Side Effects:
- Skin rash
- Headache
- Nausea
- Vomiting

 Patient Teaching/Education:
- Safe for all ages
- Only recommended in pregnancy when benefit outweighs risk
- Increase hydration (thins secretions)
- Avoid irritants that stimulate coughing
- Can cause drowsiness
- Avoid alcohol and other CNS depressan

Question 5

Beta-2 Agonist

Drug
Use
MOA
Side effects
Teaching

Answer 5

Albuterol (SABA)
Salmeterol (LABA)

Used prevent and treat bronchospasms (asthma, airway disease, E-I asthma)

Mechanism of Action:
- Stimulate beta-2 adrenergic receptors of bronchi
and bronchioles producing bronchodilation.

 Adverse/Side Effects:
- Muscle tremors
- Excessive cardiac stimulation
- CNS stimulation

 Patient Teaching/Education:
- SABA is for use in acute asthma attack
- LABA is NOT for acute asthma attack
- Take as directed
- Prime inhaler prior to first use
- Rinse mouth d/t unusual taste

Question 6

Anticholinergics

Drugs
Use
MOA
Side effects
Patent teaching

Answer 6

Ipratropium (SA)
Tiotropium (LA)

Used for maintenance therapy of bronchoconstriction (asthma, chronic bronchitis, and emphysema

Mechanism of Action:
- Blocks the action of ACH in bronchial smooth muscle, reducing bronchoconstrictive substance release.

 Adverse/Side Effects:
- Use caution with the elderly
- May cause cough, drying of the nasal mucosa,
nervousness, nausea, GI upset, headaches, and
dizziness.
- Long-acting may cause angioedema

 Patient Teaching/Education:
- Short-acting is for rapid bronchodilation
- Long-acting is for prevention of bronchospasms and
reduces exacerbation of COPD
- Take as directed, do not exceed max dose

Question 7

Corticosteroids

Drug
Use
MOA
Side effects
Teaching

Answer 7

Fluticasone (nasal/inhaler)
Prednisone (oral)
Methylprednisolone (IV)

 Mechanism of Action:
- Locally acting anti-inflammatory and immune modifier.

 Nursing Considerations:
- Fluticasone safe over 4yo, others safe for all ages

 Adverse/Side Effects:
- May cause hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis (thrush)
- CV: Fluid retention, edema, and hypertension
- Can cause an increased blood glucose with associated weight gain
- CNS: Mood swings and euphoria
- GI: Nausea, vomiting, and GI bleed
- Increased risk for fractures, bruising, thin skin, delayed wound
healing, masked infections, and risk for infection in long-term use
- Never stop abruptly because adrenal insufficiency may occur
- Oral/IV: Prevents inflammation = Immunosuppresion
- Decreased WBC – should avoid large crowds

 Patient Teaching/Education:
- Rinse and spit after inhaler use d/t risk of thrush
-do not stop suddenly
-lower wbc count

Question 8

Leukotriene Receptor Antagonists

Drug
Use
MOA
Side effects
Teaching

Answer 8

Montelukast

Used for the long-term control of asthma, decreasing
the frequency of asthma attacks. Also, for exercise- induced bronchospasm and allergic rhinitis

Mechanism of Action:
- Blocks leukotriene receptors and decreases inflammation

 Adverse/Side Effects:
- Headache
- Cough
- Nasal congestion
- Nausea
- Hepatotoxicity

 Patient Teaching / Education:
- Take at the same time each day, at least two hours prior to exercise – NOT A RESCUE MED!
- Do not discontinue without notifying PCP
- Takes 3 – 7 days for desired effect

Question 9

Xanthine Derivatives

Drug
Use
MOA
Side effects
Teaching

Answer 9

Theophylline

sed for long-term management of persistent asthma that is unresponsive to beta agonists or inhaled corticosteroids (COPD/chronic asthma)

Mechanism of Action:
- Relaxes bronchial smooth muscle by inhibition of the enzyme
- suppresses airway responsiveness that cause bronchoconstriction.

 Adverse/Side Effects:
- Nausea / vomiting
- CNS stimulation
- Nervousness
- Insomnia

 Patient Teaching / Education:
- Avoid caffeine
- Requires evaluation of therapeutic blood levels to
prevent toxicity
- Drink fluids to thin secretions, avoid irritant