Week 7 Respiratory Medications Flashcards
Antihistamines examples
Diphenhydramine (Benadryl)
Loratadine (Claritin)
Cetirizine (Zyrtec)
Fexofenadine (Allegra) PO
Azelastine (Intranasal antihistamine)
Ranitidine (Zantac)
Famotidine (Pepcid)
antihistamine MOA
Selectively block the effects of histamine at the histamine-1 receptor sites, decreasing the allergic response
Indication:
of antihistamines
Benadryl: Allergies, symptoms of histamine release, motion sickness, insomnia.
All other meds: Seasonal and perennial allergic rhinitis
SEAE of antihistamines
Drowsiness and sedation, Anticholinergic effects –
-drying urinary blockage, constipation dry mucousa
antihistamines interactions
Alcohol, CNS depressants medication wise
Street drugs
=over sedative effect
antihistamines NSG Imp
Nursing Implications:
Properties include: Antihistaminic, Anticholinergic, & Sedative effects.
Avoid driving alcohol and other CNS depressants
Report excess sedation and confusion
Ranitidine (Zantac)
Famotidine (Pepcid)
indication
angioedema and reflex GI
Oral decongestant ex
Pseudoephedrine (Sudafed)
oral decongestant pseudoephedrine MOA and indication
MOA:
Shrink the nasal mucous membrane by stimulating the alpha-adrenergic receptors in the nasal mucous membranes
Indication: drains sinuses, improving air flow
oral decongestant pseudoephedrine SEAE
dizzy/headache, palpitations,
Rebound congestion-
If taken longer than 3-5 days the body gets used to the drug and congestion worsens
used long term
pseduephedrine contraindications
Very drying
-can be used to make meth
-hypertension, coronary artery disease, high exitability can cause palpitations that burden the heart
Nsg implications of pseudoephedrine
ID for pharmacy
Avoid caffeine or any stimulant products
Report fever and cough lasting longer than 1 week!!!!
Topical Nasal Decongestants
Oxymetazoline (Afrin)
Phenylephrine (Coricidin)
Oxymetazoline (Afrin)
Phenylephrine (Coricidin)
indication
Indication:
Relieve the discomfort of nasal congestion that accompanies the common cold,
sinusitis,
allergic rhinitis
Oxymetazoline (Afrin)
Phenylephrine (Coricidin)
SE AE
Vasoconstriction, Rebound congestion, Epistaxis, CNS Stimulation
Oxymetazoline (Afrin)
Phenylephrine (Coricidin)
contraindications
: lesions in the mucous membranes
Coronary artery disease
Hypertension
Cerebral artery disease
Blood flow issue
Any dysrhythmias
CNS stimulation like the Sudafed can cause agitation, nervousness, uneasiness
Potential interactions be aware!
oxymetazoline and phenylephrine nsg implications
Heart disease
rebound congestion
Topical Nasal Steroid* decongestants examples
Budesonide (Rhinocort)
fluticasone (Flonase),
triamcinolone (Nasacort),
ipratropium (Arovent)
Topical nasal steroid decongestants indications
Seasonal allergic rhinitis
SE AE ot topical nasal steroid decongestants?
nose irritation, burning, drying mucous membranes
headache
contra of topical nasal steroids decongestants
: Glaucoma, hypertension, BPH, acute infection, DM
topical nasal steroids decongestants pt edu
late onset
Antitussives examples
Benzonatate
Dextromethorphan (Robitussin)
Robitussin AC
-Codeine reduces cough
antitussive indication
Control nonproductive cough
antitussive SE AE
Drys mucous membranes
Non-opioid: CNS adverse effects-dizziness, lightheadedness, drowsiness.
Opioids:
GI upset N/V constipation dizziness and drowsy
Respiratory depression
contraindications of antitussives
alcoholics,
respiratory depression,
history of narcotic addiction (if on codeine)
antitussive pt edu
: avoid
Driving, drinking alcohol,
stool softener with codeine Plenty of water
Expectorants
Guaifenesin Mucinex
Guaifenesin Mucinex indication
non-productive cough when mucus or mucus plugs are present
Guaifenesin SE AE Nsg imp
SE/AE: GI symptoms, Dizziness, drowsiness
Nursing Implications: Pt ed: Increase fluid intake to 2L
Report symptoms lasting longer than 1 week.
Herbal treatment and indication
Echinacea
boosts immune system
Indication: reduces symptoms of common cold
echinacea
: GI upset, dizziness, headache
Mucolytic ex
Acetylcysteine
acetylcysteine indication
Indication:
* Pts with acute and chronic pulmonary disorders exacerbated by large amts of secretions
* cystic fibrosis
* -treats acetaminophen toxicity
acetylcysteine SE AE
Bronchospasm and aspiration,
Dizziness, drowsiness,
Hypotension, tachycardia
contraindication of acetylcysteine
Contraindication:
Acute bronchospasms
nsg implications of acetylcysteine
Nursing Implications:
Smells like rotten eggs
Administered by inhalation
Can be administered orally or by IV for tyelenol OD
Anticholinergic examples
Ipratropium
Tiotropium
Ipratropium
Tiotropium
anticholinergic indications
bronchoconstriction is prevented, airways dilate
Indication: COPD, chronic bronchitis or emphysema bronchospasms
anticholinergic SE AE
Dizziness, headache, fatigue,
nervousness, palpitations, and
urinary retention,
anticholinergic effects most common:
Most common is dry mouth and sore throat
anitcholinergic contraindicated by
Glaucoma
what should nurse assess for pt on anticholinergic
Assess- P, BP, R, urinary output
anticholinergic pt edu
Rinse mouth after use
Do not swallow capsules they go in the inhaler
methylxanthine
Theophylline
theophylline Indication
bronchodilation for COPD,
chronic bronchitis,
emphysema,
asthma
Theophylline SE AE
CNS stimulation (seizures, irritability),
Cardiovascular stimulation -increases force of contractions
tachycardia
Hypotension, arrythmias
Increased blood flow to the kidney = diuretics
Theophylline interactions
Interaction:
Caffeine cipro fluoroquinolones
nicotine
-increases the drug metabolism
Food: charcoal-broiled, high-protein, low carb foods
Theophylline contraindications
Contraindication: GI problems, coronary disease, respiratory dysfunction, renal or hepatic disease, alcoholism, or hyperthyroidism
theophylline contraindications
Due to multiple AE its not often used
Must monitor for therapeutic range
5-15mcg/mL
Corticosteroids
(nonbronchodilating)
examples
Systemic corticosteroid:
Prednisone (PO)
Methylprednisolone (IV)
Inhaled steroids:
Beclomethasone
Budesonide (Pulmicort)
Fluticasone (Flovent)
nonbrochodilating corticosteroids
PO-short term burst for asthma flare up,
long-term for chronic/severe asthma/COPD.
Promote lung maturity in fetuses.
Will not abort asthma attack,
it will just decrease inflammation and prevent an asthma attack within a short time frame.
nonbrochodilating corticosteroids SE AE
SE/AE: PO-Suppression of adrenal gland function,
Hyperglycemia,
Infection Inhaled: coughing, dry mouth,
Oral fungal infections
nonbrochodilating corticosteroids interactions contra
Interactions: NSAID’s
Caution: diabetic patients
Corticosteroid nonbrocho nsg implications
Decrease their risk of infection
Monitor blood glucose
Checking insulin adjustments
Must be weaned off med
ALL inhalers
All Inhalers:
* Shake inhaler before use, put mouthpiece in mouth and close lips around it, push down on canister and inhale at the same time, hold breath for 5-10 sec. (after releasing med) Repeat per directions
* Use of spacer if needed: put mouthpiece in spacer (after shaking) put spacer in mouth, Push canister then inhale
* If 2 inhaled meds prescribed wait at least 5 min between meds
* Clean after use. At least weekly
corticosteroid inhaler
Corticosteroid inhaler:
Swish gargle and spit the water after each use
Reduces the risk of thrush
Do the albuterol first and then the steroid to promote bronchodilation in and get in more med
TE of inhaler
- Monitor for therapeutic effects:
-decreased dyspnea
Decreased wheezing, restlessness, anxiety
Improved resp patterns
Normal rate quality depth
Improved activity tolerance
Decreased symptoms
Better ease of breathing
other nonbrocho meds Leukotriene receptor atagonist
Leukotriene receptor antagonist:
Montelukast
Zarfirlukast
-lukast
sto leukotrine from triggering constriction
Luekotrine receptor agoanist SEAE and nsg
SE/AE: Headache, nausea, diarrhea
Nursing Implications:
-longer term, taken daily
-will not work for acute asthma attacks
Can take a week for improvement to be seen
Take med daily
