Upper Resp Drugs Flashcards
First gen Antihistamines
Diphenhydramine and promethazine
PO,IV, IM
Side effects: crossing BBB it can be a cns depressant
Too much can cause toxicity
Anti cholinergic effects: PNS effects ( bear)
Second gen
Cetirizine and fexofenadine
PO, nasal spray
Little to no sedative effect or anti cholinergic effect
Ephedrine and pseudoephedrine (decongestants)
PO , inh mist
Limited sales with ID
PRN
Menthol (antitussives)
Cough lozenges
Local anesthetics obtained from mint
Non opioid antitussives
Benzonatate and dextromethorphan
For Benzonatate you will get a prescription and it is a PO soft gel
Dextromethorphan you will get otc and it will be lozenges
MOA: suppresses the cough center in the medulla
It can be related to opioids structurally but does not help pain
Side effects : drowsiness, dizziness, euphoria with high dose
Opioid Antitussives
Condeine
Often used in combination with anti histamine , decongestant or expectorant
Has to go through your GI tract to become active that’s why we swallow it
MOA: suppress cough by increasing cough threshold in CNS
Side effect: drowsiness , constipation
Short term risk of abuse , reversed by naloxone
Contraindications: respiratory disease, alcohol, head trauma
Expectorants
Guaifenesin
PO
You will have to increase hydration to promote drug action
Contraindication: never to children under 4
When mixing guaifenesin and dextromethorphan you want to bring up the mucus but you don’t want to cough a lot because it can irritate your tissue and create even more mucus
Intranasal glucocorticoids
Budesonide, fluticasone
Nasal spray that is scheduled , matinence drug
Takes 7-12 dats for peak effect
Side effects: dryness of nasal mucosa (epistaxis)
But you can manage dryness by saline nasal spray
You must shorten time used to prevent opportunistic infection like candidiasis
Contraindications: pregnancy and URI ( you want inflammation for upper respitory to fight the infections)
