upper respiratory infection mod 1

Question 1

antihistamines

First Generation
diphenhydramine (Benadryl)
Route: IM, IV, PO

Second Generation
Cetirizine (Zyrtec)
Loratadine (Claritin)
Fexofenadine (Allegra)
Route: PO

Answer 1

MOA: block histamine release from receptors

Indications: allergies, cold and flu symptoms, and others; edema, inflammation, itch, rash,red/watery eyes, runny nose, sneezing

First Generation
Indications: induce sleep, prevent motion sickness, reduce anxiety

Side effects: sedation, dry mouth, dizziness,low BP
Second Generation
Much less sedating (doesn’t affect receptors in CNS)

Nursing considerations: caution while driving, avoid alcohol

Question 2

Sympathomimetics (Decongestant)

phenylephrine
pseudoephedrine

Answer 2

Indications: reduce nasal congestion, allergic rhinitis, sinusitis, and the common cold

MOA: mimics the action of SNS, activates, alpha1-adrenergic receptors - causes vasoconstriction of blood vessels, causing nasal turbinates to shrink and opens nasal passages

SE: all r/t to CNS stimulation - agitation, insomnia, anxiety, tachycardia, heart palpitations

Patient Education: Do not use for more than 4 days - rebound nasal congestion occurs if drug is abruptly stopped after prolonged use
Tapering off recommended

Question 3

sympathomimetic

Pseudoephedrine

Answer 3

Potential for abuse
One of the active ingredients in methamphetamine (meth)
OTC, but must get at pharmaceutical counter, states have different requirements as far as age
Limits of how much people can get

Question 4

Antitussive

dextromethorphan
codeine
benzonatate (Tessalon Perles)

Answer 4

Indication: Cough suppressant, Acute or chronic coughs

MOA: directly suppresses the cough reflex in the brain

PO, syrups/sprays/lozenges

SE: CNS depressant
Do NOT take with other CNS depressants
Potential for abuse

Question 5

Expectorant

guaifenesin (Mucinex)

Answer 5

Indication: decrease mucus in colds, bronchitis, etc.

MOA: reduction in surface tension of secretion helping thin the mucus making it easier to expectorate

SE: Few, mild GI distress

ENCOURAGE fluid to help thin secretions as well
Be careful in patients with chronic cough/asthma