UPPER RESPIRATORY DRUGS Flashcards
What is the primary purpose of antitussives?
Controls a nonproductive cough
Benzonatate (antitussive)
Local anesthetic on the respiratory tract. Not centrally active. Works directly on the throat. Non opioid.
What is the mechanism of action of opioid antitussives?
They act on the medullary cough center of the brain to suppress cough reflex
Fill in the blank: Codeine and hydrocodone are ______ antitussives.
Opioid
Antitussives (Caution)
History of narcotic addiction, and if they need to be alert
What are the potential side effect of antitussives?
-drying effect on the mucus membranes
-G.I. upset
-possible respiratory depression
Antitussives (Interactions)
-MAOIs
-opioids/CNS depressants (like alcohol)
What is the recommended age for using antitussives?
Over 4 years old
Fill in the blank: Antitussives are contraindicated in patients who ______
Need to cough to maintain the airway
Antitussives (Contraindications)
-head injury
-impaired central nervous system
-serious, respiratory conditions like asthma and emphysema
Which antitussive is commonly used to treat cough associated with upper respiratory infections?
Dextromethorphan
True or False: Antitussives can be used to treat cough caused by asthma.
False
What is the primary goal of antitussive therapy?
To improve quality of life by reducing cough frequency and severity. However, do not take longer than prescribed or as needed.
Fill in the blank: Antitussives work by suppressing the _______ reflex.
Cough
What is the primary mechanism of action of topical nasal decongestants?
Vasoconstriction of blood vessels in the nasal mucosa.
Decreased edema and inflammation
True or False: Topical nasal decongestants are commonly used to treat nasal congestion and relieve middle ear pressure
True
Topical nasal decongestants (Drug names)
“Zoline”
-oxymetazoline
-tetrahydrozoline
-xylometazoline
Also phenylephrine
What is a common side effect of topical nasal decongestants if used for more than 3-5 days?
Rebound congestion
Fill in the blank: Topical nasal decongestants should not be used with ________.
Other sympathomimetic drugs
Which topical nasal decongestant is known for its longer duration of action compared to others?
Oxymetazoline
Topical nasal decongestions implementation
Don’t take drug longer than one week
True or False: Topical nasal decongestants are safe for use in pregnant women.
No established safety
topical nasal decongestions (Caution)
-lesion or erosion of the mucous membranes
-Condition that might be exacerbated by sympathetic activity
Which patient population should use caution when using topical nasal decongestants due to an increased risk of side effects?
Elderly individuals and children
Which topical nasal decongestant is commonly used in combination products for cold and flu relief?
Phenylephrine
What is the primary purpose of oral decongestants?
Shrink the nasal mucus membrane by stimulating the alpha-adrenergic receptors, and the nasal mucus membranes. Promotion of drainage in the sinuses and improving airflow.
True or False: Oral decongestants are commonly used to treat allergic rhinitis, common cold, sinusitis
True
Which class of medications do oral decongestants belong to?
Sympathomimetics
What is the common side effect of oral decongestants?
-rebound congestion
-sympathetic effects
Which population should use oral decongestants with caution due to the risk of adverse effects?
Patients with hypertension and or any condition that might be exacerbated by sympathetic activity
What is the common brand name for pseudoephedrine, a popular oral decongestant?
Sudafed
True or False: Oral decongestants are effective in treating viral infections such as the common cold.
False
Oral decongestants (Drug names)
“-rine”
-pseudoephedrine
-phenylephrine
Oral decongestants (Interactions)
Other over-the-counter products that contain these drugs.
What is the main difference between oral decongestants and nasal decongestants?
Oral decongestants work systemically to constrict blood vessels throughout the body, while nasal decongestants act locally to constrict blood vessels in the nasal passages.
Steroid nasal decongestants (drug names)
“-one” or “-ide”
-beclomethasone
-fluticasone
-triamcinolone
-budesonide
-flunisolide
Steroid nasal decongestants (therapeutic actions)
-blocks inflammatory response to relieve inflammation
-Minimal system absorption
-exact mechanism of action is not known
-takes one to three weeks to be effective
Steroid nasal decongestants (indications)
-seasonal allergic rhinitis
-Nasal congestion
-Inflammation after the removal of nasal polyps
steroid nasal decongestants (contraindications)
-acute infection
-Recent nasal surgery or trauma
Steroid nasal decongestants (caution)
Active infection
Common adverse effects in steroid nasal decongestants
-local burning, irritation, stinging and dryness of mucosa
-Headache
-Suppression of healing
Antihistamines (drug names)
“-amine” and “-ine”
-diphenhydramine
-hydroxyzine
-meclizine
-promethazine
-azelastine
-loraradine
Antihistamines (therapeutic action)
-blocks release or action of histamine at histamine -1 receptor sites
-decreases allergic response
-anticholinergic and antipruritic effects
-first generation: greater anticholinergic effects
-second generation: less sedating
Administer on an empty stomach to increase absorption. Most effective before onset of symptoms.
Antihistamines (indications)
-allergic rhinitis and conjunctivitis
-urticaria
-angioedema
Antihistamines (caution)
-Renal or hepatic impairment
-History of arrhythmias or prolonged QT interval
Antihistamines (interactions)
-vary based on the drug
-CNS depressants
-Any drug that increases QT intervals
Common adverse effects of antihistamines
-drowsiness, sedation
-anticholinergic: respiratory, skin, G.I./GU
Expectorants (drug names)
-Guaifenesin
expectorants (therapeutic actions)
-enhances the output of respiratory tract fluids by reducing the adhesiveness and surface tension of these fluids, allowing easier movement of less vicious secretions
Expectorants (indications)
-Increase productive cough to expel mucus to clear the airway, thereby relieving respiratory congestion
-infections include the common cold, bronchitis, and pneumonia
Expectorants (caution)
-persistent cough. Could be an underlying problem.
Common adverse effects of expectorants
-G.I. symptoms
-Headache, dizzy
-mild rash
-Prolonged use may mask serious underlying condition
Mucolytics (drug names)
-acetylcysteine
-dornase alfa
Mucolytics (therapeutic actions)
-work to break down mucus in order to aid the high-risk, respiratory patient and coughing up thick tenacious secretions.
Mucolytics (indications)
-patient who has difficulty coughing up secretions
-Patients who develop atelectasis
-postoperative patient
-Patient undergoing diagnostic bronchoscopy
-Patient with tracheostomies
-Illnesses, such as COPD, cystic fibrosis, pneumonia, and TB
Mucolytics (caution)
Asthma
Common adverse effects of mucolytics
-G.I. upset
-stomatitis
-rhinorrhea
-bronchospasm
-Rash
Implementation of mucolytics
-Do not combine a nebulizer for it prevents precipitation
-wipe face and mask with water after nebulizer to prevent skin breakdown
