RESPIRATORY - upper respiratory drugs

Question 1

what are anti-histamines?

Answer 1

histamine receptor antagonists
- decreases allergic symptoms
- doesn’t work if infection based
- works for environmental allergies

Question 2

what is the exemplary drug for first generation anti-histamines

Answer 2

diphenhydramine

Question 3

how is diphenhydramine administered?

Answer 3

PO

Question 4

is diphenhydramine administered OTC?

Answer 4

yes

Question 5

what is the pharmacological action of diphenhydramine?

Answer 5

blocks h1 receptor –> histamine can not act on receptor –> stops vasodilation & bronchoconstriction –> relieves itching, sneezing & congestion

Question 6

what is the major adverse reactions of diphenhydramine?

Answer 6

biggest: sedation! bc it can cross BBB –> hypotension
- tinnitus
- dry mouth
- dizziness
- anticholinergic effects

Question 7

what are the nursing interventions for diphenhydramine?

Answer 7

• do not let them drive
• combat anticholinergic effects

Question 8

what should we educate about diphenhydramine?

Answer 8

• causes sedation
• should not be used with other depressants

Question 9

what are some contraindications with diphenhydramine (why should a pt not take this drug)?

Answer 9

• hypersensitivity
• closed angle glaucoma

Question 10

what are some interactions with diphenhydramine (what things can cause more problems with this drug)?

Answer 10

• alcohol
• cns depressants

Question 11

what is the exemplary drug for second gen anti-histamines?

Answer 11

cetirizine

Question 12

how is cetirizine administered?

Answer 12

PO

Question 13

is cetirizine OTC?

Answer 13

yes

Question 14

what is the pharmacological action of cetirizine?

Answer 14

blocks h1 receptor –> histamine can not act on receptor –> stops vasodilation & bronchoconstriction –> relieves itching, sneezing & congestion

Question 15

what are the major side effects of cetirizine?

Answer 15

• low drowsiness: does not cross BBB –> no sedation
• anticholinergic effects

Question 16

what are the nursing interventions for cetirizine?

Answer 16

• combar anticholinergic effects

Question 17

what should we educate about cetirizine?

Answer 17

• take it consistently & at the same time every day
• stay hydrated

Question 18

what are some contraindications of cetirizine?

Answer 18

hypersensitivity

Question 19

what are some interactions for cetirizine?

Answer 19

• sedatives
• theophylline

Question 20

what are antitussives?

Answer 20

• cough suppressants
  usually we do not given it unless:
• interferes with life
• severe non-prod cough

Question 21

what is the exemplary drug for antitussives?

Answer 21

• codeine (opioid)
• dextromethorphan (non-opioid)

Question 22

how is codeine & dextromethorphan administered?

Answer 22

PO

Question 23

is dextromethorphan OTC?

Answer 23

yes

Question 24

what is the pharmacological action of codeine & dextromethorphan?

Answer 24

• increases cough threshold –> decreases coughing action
• relieves severe non-prod cough

Question 25

what are the major adverse reactions to codeine & dextromethorphan?

Answer 25

- codeine: sedation & respiratory depression - dextromethorphan: euphoria w/high doses

Question 26

what should we educate about codeine & dextromethorphan?

Answer 26

specifically codeine: do not take opioids with other sedatives

Question 27

what are some contraindications for codeine & dextromethorphan?

Answer 27

- codeine: sleep apnea - alcohol use disorder --> cns depression --> respiratory arrest

Question 28

what are some interactions for codeine & dextromethorphan?

Answer 28

sedatives

Question 29

what are sympathomimetics (decongestants)?

Answer 29

increase vasoconstriction (bc we get vasodilation)

Question 30

what is the exemplary drug of sympathomimetics?

Answer 30

pseudoephedrine & phenylphrine

Question 31

how is pseudoephedrine administered? is it OTC?

Answer 31

PO administration, NOT OTC

Question 32

how is phenylephrine administered?

Answer 32

nasal spray administration

Question 33

what is the pharmacological action of pseudoephedrine & phenylephrine?

Answer 33

works on alpha-1 receptors --> reduces receptors --> vasoconstriction on the nasal mucosa --> increases BP & HR

Question 34

what are some adverse reactions of phenylephrine?

Answer 34

- no systemic effects - CNS stimulation - HTN - tachycardia - used > 3 - 5 days --> body used to vasoconstriction --> rebound congestion when off of medications --> pt gets hooked onto med to keep airways open

Question 35

does pseudoephedrine have rebound congestion?

Answer 35

no - has ingredients of METH --> buy behind the counter

Question 36

what are some nursing interventions with pseudoephedrine & phenylephrine?

Answer 36

monitor VS & CNS activity

Question 37

what should we educate about phenylephrine?

Answer 37

- do not use more than 3 -5 days - notify provider if excessive symptoms occurs - taper one nostril at a time

Question 38

what are some contraindications of pseudoephedrine & phenylephrine?

Answer 38

- narrow angle glaucoma - chronic rhinitis - heart disease - HTN - dysrhythmias

Question 39

what are some interactions with pseudoephedrine & phenylephrine?

Answer 39

- MAOIs - beta 2 agonists

Question 40

what are mucolytics?

Answer 40

makes mucus thinner

Question 41

what is the exemplary drug of mucolytics?

Answer 41

acetylcysteine

Question 42

how is acetylcysteine administered?

Answer 42

iv, inhaled & drink

Question 43

what is the pharmacological action of acetylcysteine?

Answer 43

makes mucus thinner specifically for disorders that make thick secretions --> mobilize --> secrete - cystic fibrosis

Question 44

what are some adverse reactions to acetylecysteine?

Answer 44

- bronchospasms - allergic reaction

Question 45

what are some contraindication of acetylecysteine?

Answer 45

hypersensitivity

Question 46

what is acetylcysteine an antidote for?

Answer 46

acetaminophen

Question 47

what kind of smell does acetylcysteine have?

Answer 47

strong sulfur smell

Question 48

what are expectorants?

Answer 48

makes mucus thinner

Question 49

what is the exemplary drug for expectorants?

Answer 49

guaifenesin

Question 50

how is guaifenesin administered?

Answer 50

PO

Question 51

is guaifenesin OTC?

Answer 51

yes

Question 52

what is the pharmacological action of guaifenesin?

Answer 52

able to make mucus thinner for severe non-prod coughs --> mobilize --> secrete

Question 53

what are some adverse reactions of guaifenesin?

Answer 53

usually minimal side effects - headache & n/v

Question 54

what are some nursing interventions of guaifenesin?

Answer 54

- instruct importance of coughing

Question 55

what should we educate about guaifenesin?

Answer 55

- can cause serious side effects for children - take guaifenesin with a full glass of water

Question 56

what are some contraindications of guaifenesin?

Answer 56

- hypersensitivity - pregnancy - PKU