Special Aspects of ANS and Respiratory Drugs

Question 1

Atropine

Answer 1

• Increased effect w/ antihistamines,
• decreased effect of levodopa.
• pupil dilation

Question 2

Bethanechol

Answer 2

• Do not give to pt with GI/urinary obstruction, GI ulcer, COPD, asthma, Epilepsy/parkinsons, hyperthyroidism

Question 3

Phenylephrine

Answer 3

• 3 routes (Nasal, Topical/eye, Parenteral).
• Parenteral for anesthesia/shock hypotension.
• Watch for rebound congestion, glaucoma, and reflex bradycardia.
• BBB IV infusion can cause death due to strength of reaction.
• Antidote phentolamine (alpha blocker)

Question 4

Prazosin

Answer 4

• Advantage is little effect on CO/HR (except reflex bradycardia) so it can be used with heart drugs.
• Hypotension=dizziness, unconsciousness, so give a small 1st dose 30 mins before bed

Question 5

Diphenhydramine

Answer 5

• Used as pre-med for blood transfusions, other meds, and chemotherapy.
• Children = CNS excitation.
• Anticholinergic effects and corresponding contradictions

Question 6

Loratadine

Answer 6

• Children and elderly (not under 2),
• loratadine toxicity = cardiac, renal, hepatic

Question 7

Fluticasone

Answer 7

• Nasal irritation and epistaxis (nose bleeds),
• treats allergic rhinitis (preferred over antihistamines), asthma, and skin inflammation

Question 8

What’s the major difference between intranasal decongestants and intranasal corticosteroids when it comes to treating congestion?

Answer 8

Intranasal corticosteroids do not cause rebound congestion

Question 9

dextromethorphan

Answer 9

• caution using with CNS depressants and MAOI’s (breakdown dopamine and serotonin),
• do not use in children under 6,
• Asthma and COPD, Grapefruit juice

Question 10

Oxymetazoline

Answer 10

• ALSO eye drops for redness,
• watch for rebound congestion 3-5 days
• Do not use in pts with thyroid disorder (BUST), HTN, DM, heart disease

Question 11

Albuterol

Answer 11

• Mimics sympathetic stimulation (caution with HTN, seizures, DM)
• do not use with beta blockers

Question 12

Beclomethasone

Answer 12

• asthma and allergic rhinitis.
• RINSE MOUTH
• monitor children’s growth

Question 13

Montelukast

Answer 13

• leukotriene receptor blocker
• decreases reliance on Beta 2 agonist
• prophylactic asthma
• Child suicide

Question 14

Ipratropium

Answer 14

• Anticholinergic
• combined w/ albuterol
• soy and peanut