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Upper Respiratory Drugs Flashcards

1
Q

Allergic rhinitis
Common cold
Sinusitis
Pharyngitis
Influenza

A

UR common disorders

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2
Q

Drugs drying to treat symp - no cure; trying to make it less miserable
Headache
Nasal/sinus congestion
Itchy, watery eyes
Sore throat
Cough (post-nasal drip)
Body aches

A

UR CM

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3
Q

OTC = can self-treat
Brand examples
Marketed to treat disorders
May contain multiple ingredients
May contain acetaminophen or ibuprofen - max amounts can take in a day
Caution: “D” = pseudoephedrine in the drug

A

OTC Treatment of UR disorders

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4
Q

DayQuil
NightQuil
Sudafed
Mucinex
Claritin-D
Allegra-D

A

Brand examples

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5
Q

Cold, flu, etc.

A

Marketed to treat disorders

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6
Q

Treat many symptoms

A

May contain multiple ingredients

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7
Q

Caution overuse

A

May contain acetaminophen or ibuprofen - max amounts can take in a day

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8
Q

Affect ANS
Sympathetic activity:
Anticholinergic effects:

A

Med caution: Conditions exacerbated by:

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9
Q

Glaucoma
Hypertension
Coronary artery disease
Peripheral artery disease
Diabetes
Hyperthyroidism
Enlarged prostate

A

Sympathetic activity:

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10
Q

Constipation
Enlarged prostate
Hypertension
Tachycardias
Dementia

A

Anticholinergic effects:

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11
Q

Prior to admin:
After administration:

A

UR: Nursing Assessments

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12
Q

Baseline assessment of all systems
Focus assessment: HEENT, respiratory, med specific

A

Prior to admin:

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13
Q

Therapeutic effects: decreased symptoms
Adverse effects (see specific drugs)

A

After administration:

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14
Q

Multiple preparations/combinations; read ingredient list - multiple ingredients; reading the list; decrease likelihood to cause toxicities
Best prac: Use for shortest duration to treat symptoms; decrease likelihood toxicities/overuse to occur; discontinue if no relief
Seek medical advice if symptoms persist longer than 1 week
Cough and cold medications should not be used under 4 years of age - good education piece for parents
For topical nasal route:

A

UR Drugs: Education

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15
Q

Avoid duplicate medications, alike medications

A

Multiple preparations/combinations; read ingredient list - multiple ingredients; reading the list; decrease likelihood to cause toxicities

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16
Q

Overuse increased risks for adverse effects

A

Best prac: Use for shortest duration to treat symptoms; decrease likelihood toxicities/overuse to occur; discontinue if no relief

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17
Q

Clear nasal passages prior to administration
Clean applicator after use to maintain cleanliness

A

For topical nasal route:

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18
Q

Antitussives:
Decongestants:
Antihistamines:
Expectorants:

A

Agents used to treat UR

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19
Q

Block cough reflex

A

Antitussives:

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20
Q

Shrink mucous membranes to allow drainage; decrease production of nasal secretions

A

Decongestants:

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21
Q

Block action of histamine (H1) to decrease histamine effects

A

Antihistamines:

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22
Q

Increase productive cough to clear airways

A

Expectorants:

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23
Q

Act directly on medullary cough center to control cough spasm

A

MoA: - Antitussives: Non-opioid: prototype: Dextromethorphan

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24
Q

Control nonproductive cough

A

Indications: - Antitussives: Non-opioid: prototype: Dextromethorphan

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25
dizziness, nausea
AE: - Antitussives: Non-opioid: prototype: Dextromethorphan
26
non-drowsy; does not cause respiratory depression or sedation; OTC
Nursing: - Antitussives: Non-opioid: prototype: Dextromethorphan
27
Act directly on the medullary cough center of the brain to depress the cough reflex; also used for analgesia
MoA: - Antitussives: opioid: prototypes: codeine
28
Control nonproductive cough; treat mild to moderate pain; non-infectious diarrhea
Indications: - Antitussives: opioid: prototypes: codeine
29
CNS depression
Contraindications: - Antitussives: opioid: prototypes: codeine
30
Constipation, N/V, sedation, respiratory depression
AE: - Antitussives: opioid: prototypes: codeine
31
opioid
Nursing: - Antitussives: opioid: prototypes: codeine
32
Used as an oral decongestant - works as a sympathomimetic by targeting alpha-1 of SNS to cause vasoconstriction - when cause vasoconstriction in sinus and nasal passages shrink mucous membranes not allowing drainage (not as leaky) - decreases drainage and mucous production through vasoconstriction Stimulates alpha-1 sites (sympathomimetic/vasoconstriction); Shrink mucous membrane and decrease mucous production in UR
MoA: - Oral decongestants: prototype: pseudoephedrine
33
Promotion of sinus drainage and decrease mucous production
Indications: - Oral decongestants: prototype: pseudoephedrine
34
oral; immediate and extended release available
Route: - Oral decongestants: prototype: pseudoephedrine
35
condition exacerbated by sympathetic activity
Contraindications: - Oral decongestants: prototype: pseudoephedrine
36
hypertension (BIG ONE; alpha1 receptor on blood vessels which helps vasoconstrict but if orally has systemic effects on blood vessels and vasoconstricts all over so increases BP so particularly problematic for pat with history HTN or problematic with having HTN for longer periods of time), insomnia, dizziness, anxiety
AE: - Oral decongestants: prototype: pseudoephedrine
37
OTC behind pharmacy counter - use to make meth; track how much buy
Nursing: - Oral decongestants: prototype: pseudoephedrine
38
localized anti-inflammatory action
Actions: - Topical nasal steroid decongestants: prototype: fluticasone (Flonase)
39
seasonal allergic rhinitis
Indications: - Topical nasal steroid decongestants: prototype: fluticasone (Flonase)
40
Intranasal
Route: - Topical nasal steroid decongestants: prototype: fluticasone (Flonase)
41
Lesion or erosion in the mucous membranes
Contraindications: - Topical nasal steroid decongestants: prototype: fluticasone (Flonase)
42
Local burning and irritation; dry mucous membranes; long term: break down nasal mucosa; localized effects
AE: - Topical nasal steroid decongestants: prototype: fluticasone (Flonase)
43
assess nasal mucosa; Takes 1 week to note change; stop if no effect after 3 weeks
Nursing: - Topical nasal steroid decongestants: prototype: fluticasone (Flonase)
44
H1 receptor antagonists - responsible for allergic rxn Block histamine type 1 reactions to decrease allergic symp experiencing; antagonizing and blocking them so histamine cannot to reduce symp Have First gen and sec gen antihistamines
H1 receptor antagonists (aka anti-histamines)
45
First generation: sedation and short duration Second generation: non-drowsy and long duration
Antihistamines: H1 receptor antagonists
46
Diphenhydramine (Benadryl)
First generation: sedation and short duration
47
Intermediate level of antihistamine efficacy; high level of anticholinergic effects and sedation; occupy H1 receptor sites but also occupy muscarnic receptors part PSNS - also act anticholinergics; also passes blood brain barrier causing sedation Many uses (other than allergies): vertigo, motion sickness, Parkinson’s disease, insomnia, urticaria, allergies, sleep aid - makes people drowsy Crosses BBB: drowsiness High anticholinergic effect: increased HR, urinary retention, constipation, blurred vision, dry mouth Faster acting; shorter duration; more serious allergic rxn give this med since faster acting
Diphenhydramine (Benadryl)
48
Loratadine (Claritin), Fexofenadine (Allegra), Cetirizine (Zyrtec) High antihistamine; lower anticholinergic effects and lower risk for sedation Seasonal allergies - not in stupor because of first gen (Benadryl)
Second generation: non-drowsy and long duration
49
Block release of histamine from mast cells; compete for unoccupied histamine-1 receptor sites
MoA: - Antihistamine: H1 receptor antagonists: prototype: diphenhydramine (Benadryl)
50
allergic rhinitis (many others)
Indications: - Antihistamine: H1 receptor antagonists: prototype: diphenhydramine (Benadryl)
51
older adult, condition exacerbated by anticholinergic effects
Contraindication: - Antihistamine: H1 receptor antagonists: prototype: diphenhydramine (Benadryl)
52
drowsiness and sedation; high anticholinergic effects
AE: - Antihistamine: H1 receptor antagonists: prototype: diphenhydramine (Benadryl)
53
caution about driving/operating dangerous machinery
Nursing: - Antihistamine: H1 receptor antagonists: prototype: diphenhydramine (Benadryl)
54
Block release of histamine from mast cells; compete for unoccupied histamine-1 receptor sites
MoA: - Antihistamines: H1 receptor antagonists: Prototype: Loratadine (Claritin)
55
allergic rhinitis
Indications: - Antihistamines: H1 receptor antagonists: Prototype: Loratadine (Claritin)
56
condition exacerbated by anticholinergic effects
Contraindication: - Antihistamines: H1 receptor antagonists: Prototype: Loratadine (Claritin)
57
anticholinergic effects (less than first gen.)
AE: - Antihistamines: H1 receptor antagonists: Prototype: Loratadine (Claritin)
58
drowsiness may occur in some pts.
Nursing: - Antihistamines: H1 receptor antagonists: Prototype: Loratadine (Claritin)
59
"Blind as a bat" "Dry as a bone" "Red as a beet" "Mad as a hatter" "Hot as a hare" "Full as a flask" Blurred vision, dilated pupils Dry mucous membranes Flushing Confusion Hyperthermia Urinary retention
Anticholinergic effects mnemonic (toxicity/older adult)
60
Can’t see Can’t pee Can’t spit Can’t poop DUCT: Dry mouth; Urinary retention; Constipation; Tachycardia
Anticholinergic effects mnemonic (common)
61
liquefy lower respiratory tract secretions, reducing viscosity
Actions: - Expectorants: Prototype: Guaifenesin
62
symptomatic relief of respiratory conditions characterized by a productive cough
Indications: - Expectorants: Prototype: Guaifenesin
63
rare, well tolerated
AE: - Expectorants: Prototype: Guaifenesin
64
Pt must drink at least 2-3 L fluid daily
Nursing: - Expectorants: Prototype: Guaifenesin
65
The nurse is caring for a client prescribed oxymetazoline. Which assessment should the nurse perform prior to administration? A.Lung sounds B.Blood pressure C.Nasal mucosa D.Level of consciousness
Answer: C Rationale: Local sympathomimetic administered topical nasal route. Indicated for nasal congestion. Systemic effects are unlikely.

Pharm (30 decks)

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