Respiratory Drugs Flashcards
guaifenesin
Therapeutic Class: expectorant
Vandermeer: loosen and thin mucous by “increasing respiratory fluid”
Client Teaching:
- avoid CNS depressants or alcohol
- no eating or drinking 30 min after syrup
- stay hydrated
- encourage cough and deep breath
- notify HCP: fever or worsen cough may indicate development of pneumonia
oxymetazoline (Afrin)
Classes/Mechanism
- Therapeutic Class: nasal decongestant
- Pharmacologic class: sympathomimetic; (activate alpha-adrenergic receptors in the sympathetic nervous system)
- (Vasoconstriction) causes arterioles in nasal passages to constrict, thus drying mucous membranes.
Adverse Effects and Patient Teaching:
- Rebound congestion common if used for longer than 3 - 5 days (do not use more than 7 days).
- Minor stinging and dryness in nasal mucosa may be experienced.
Interactions:
- Use caution with herbal supplements such as St. John’s wort that have properties of MAOIs
pseudophedrine (Sudafed)
Classes/Route/Mechaism:
- Route: PO
- Therapeutic Class: nasal decongestant, (others)
- Pharmacologic class: sympathomimetic (Adrenergic drug); acts on alpha and beta receptors
Precautions: cardiovascular diseases
ADR of PO nasal decongestants:
- HTN, dysrhythmias
- dizziness, headache
- nervousness, insomnia
- dry mouth
Interactions: MAOIs (cause HTN crisis)
Intranasal corticosteroids
flunisolide
fluticasone (Flonase, Veramyst)
beclomethasone
budesnoide (Rhinocort Aqua)
triamcinolone (Nasacort)
- intranasal corticosteroids
- ADR:
-
dry mucous membranes, epistaxis, sore throat
- provide comfort measures
- transient nasal irritation, burning, sneezing, or dryness; nasopharyngitis
- hypercorticism (only if large amounts are swallowed)
-
dry mucous membranes, epistaxis, sore throat
Antihistamines
Antihistamines
-
mild cholinergic blockers -
- drying effects (dry mouth), tachycardia, and mild hypotension occur in some pts
- urinary retention
- sedation, drowsiness
- H1-receptor ANGTAGONIST
- Contraindications: narrow-angle glaucoma, BPH, GI obstruction
- Precaution: asthma, hyperthyroidism
- Teaching:
- don’t use with alcohol; sedative effects
- increase fluid intake to 2L/day
- do not use alcohol
- operating machine and driving may be dangerous
- paradoxical CNs stimulation and excitability may occur
- may cause photosensitvity
- d/c at least 4 days prior to skin allergy tests
1st generation
- diphenhydramine (Benadryl)
2nd generation
- cetirizine
- therapeutic effects last longer
- may cause drwosiness, fatigue - but less than 1st gen antihistamine
(Inhaled) Anticholinergic
- bronchodilator and also dries you out
- used in COPD patients to reduce secretions in pts
- ??slower onset of action - not used for acute bronchospasm??
ADR:
- dry mouth, urinary retention, dry eye, and increase intraocular pressure
- produces bitter taste - may rinse the mouth after use
Precaution: careful BPH, glaucoma
Contraindication: CHECK FOR SOY/SOYBEAN AND PEANUT ALLERGIES
Administration Alerts:
- proper use of MDI
- wait 2 - 3 minutes between dosages
Misc.
- Oten combined with other drugs (combo inhaler)
methylxanthines
Pharmacologic Class: methylxanthines
- theophylline
- aminophylline
Therapeutic Class: bronchodilator?
Route: PO, IV (not inhalation)
Use: today, primarily used for long-term management/oral prophylaxis of asthma that is unresponsive tobeta agonists or inhaled corticosteroids
- chemically-related to caffeine
- avoid caffeine - potentiates…
- significant interactions with numerous other drugs
- have narrow safety margin so infrequently prescribed
- therapeutic index 10 - 20 mcg/mL
- toxicity over 20 mcg/mL
-
s/s toxicity
- n/v (assess for other signs of toxicity, last blood draw)
- restless, tremors, insomnia
- seizure
- ADR:
- n/v
-
CNS stimulation
- like caffeine, can cause nervousness and insomnia
- dysrhythmias at high doses
Inhaled corticosteroid
give beta 2 adrenergic agonist inhaler first
use spacer
swish and spit
oral steroid
other types of antiinflammatory drugs
- leukotriene modifier - montelukast (Singulair)
- mast cell stabilizer - cromolyn
Asthma
Quick-Relief Medications
Long-term Control Medications
Quick-Relief Medications
- SABA
- Inhaled anticholinergic
- systemic corticosteroids - although not rapida cting, these oral drugs are used for short periods to reduce frequency of acute exacerbation
Long-term Control Medications
- inhaled corticosteroids
- mast cell stabilizers
- leukotriene modifiers
- LABA
- methylxanthine
COPD med management
-
bronchodilators
- both short-acting and long-acting bronchodilators
- beta-2-agonist
- anticholinergics
- mucolytic and expectorants sometimsed used to reduce viscocity of bronchial mucus and to aid in its removal
- long-term O2 therapy (precaution greater than 4L)
- abx if infection
Avoid:
- COPD pts should not receive beta blockers (beta-adnergic antagonist activity) or otherwise cause bronchoconstrictionrespiratory derpssants uch as opioids and barbiturates should be avoided
- does not cure, only tx symptoms
- encourage soking cessation - slow progression of COPD and result in fewer respiratory symptoms
