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48 Cards in this Set

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antitussives -opioids
proto: codeine
other: hydrocodone
antitussive opioid MOA
supresses cough through its action on the central nervous system
antitussive opiod use (codeine)
chronic non-productive cough
antitussive opioid (codiene) adverse
CNS effects
GI distress
potential for abuse
antitussive contraindications (codeine)
pregancy risk C
acute asthma, head trauma, liver and renal disease, acute alcoholism
antitussive opioid interventions (codiene)
avoid CNS depressants while taking codeine
antitussive-nonopioid
proto: dextromethorphan
others: benzonatate (Tessalon), diphenhydramine (Benadryl)
antitussive non-opioid MOA
supresses cough through its action on the CNS. Although it is not an opioid, it is derived from opioids
antitussive non-opioid use
cough suppression
antitussive non-opioid adverse
few adverse effects
nausea, dizziness, sedation may occur
some potential for abuse
antitussive non-opioid contraindications
pregnancy risk c
antitussive non-opioid interactions
can cause high fever whe nused within 2 weeks of MAOI antidepressants
antitussive non-opioid interventions
may contain alcohol or sucrose
capsules, lozenges, liquids, and syrups
antitussive non-opioid effectiveness
absence or decreased episodes of coughing
expectorants
proto: guaifenesin (Mucinex)
guaifenesin MOA
promotes increased cough production through increasing mucous secretion, allows client to decrease chest congestion by coughing out secretions
guaifenesin uses
often combined with antitussives or a decongestant for treating symptoms of colds, allergies, or nonallergic rhinitis, or for cough caused by lower respiratory disorders
guaifenesin adverse
GI upset, drowsiness, dizziness, allergic reaction (rash)
guaifenesin contraindications
pregnancy category C
if breastfeeding, talk to provider
depending on formulation and med combinations- preparations containing guaifenesin may not be recommended for children
guaifenesin interventions
increase fluid intake to promote liquifying secretions
guaifenesin effectiveness
cough is more productive and mucous is easier to expectorate
chest congestion is decreased
mucolytics
proto: acetylcholine (Mucomyst, Acetadote)
other meds: hypertonic saline
mucolytics MOA
enhance the flow of secretions in the respiratory passages
mucolytics uses
acute and chronic pulmonary disorders exacerbated by large amounts of secretions
mucolytics are used in clients who have cystic fibrosis
acetylcysteine is the antidote for acetaminophen poisoning
mucolytics adverse
aspiration and bronchospasm when administered orally
mucolytics contraindications
pregnancy risk B
should not be used in clients at risk for GI hemorrhage
PUD, esophageal varices, and severe liver damage
due to potential for bronchospasm, acetylcysteine should be used cautiously in clients who have asthma
mucolytics admin
acetylcysteine has an odor like rotten eggs
acetylcyestine is adminstered by inhalation to liquify nasal and bronchial secretions and facilitate coughing
administered orally or IV for acetaminophen overdose
mucolytic effectiveness
improvement of manifestations as demonstrated by regular respiratory rate, clear lung sounds, and increased rate of expectoration
decongestants
phenylephrine (Neo-Synephrine)
Other: ephedrine
naphazoline (Privine)
pseudoephedrine (Sudafed)
decongestants MOA
sympathomimetic decongestants stimulate alpha1 adrenergic receptors, causing reduction in the inflammation of the nasal membranes
decongestants uses
treats allergic or non allergic rhinitis by relieving nasal stuffiness
acts as a decongestant for clients who have sinusitis and the common cold
decongestant adverse
rebound congestion secondary to prolonged use of topical agents
CNS stimulation
vasoconstriciton
decongestant contraindications
chronic rhinitis
coronary artery disease and hypertension
decongestant admin
when administering nasal drops- clients should be in lateral, head-low position to increase desired effect and to prevent swallowing the medication
topical- more effective, works faster, shorter duration
oral agents do not lead to rebound congestion
decongestant effectiveness
improvement of manifestations
antihistamines
1st gen H1 antagonists:
diphenyhydramine (Benadryl)
prmethazine (Phenergan)
dimenhydrinate (Dramamine)

2nd gen H1 antagonists
loratadine (Claritin)
cetirizine (Zyrtec)
fexofenadine (Allegra)
desloratadine (Clarinex)

Intranasal antihistamines
azelastine (Astelin, Astepro)
olopatdine (Patanase)
antihistamine MOA
action is on H1 receptors, which results in the blocking of histamine release in the small blood vessels, capillaries, and nerves during allergic reactions
when used for upper respiratory infections, antihistamines relieve manifestations by suppressing mucus secretion because of their anticholinergic effect
antihistamine use
mild allergic reaction
anaphylaxis (hypotension, acute laryngeal edema, bronchospasm)
motion sickness
insomnia
often used in combination with sympathomimetics to provide a nasal decongestive effect
antihistamine adverse
GI discomfort
acute toxicity (flushed face, high fever, tachycardia, dry mouth, urinary retention, pupil dilation)
excitation, hallucinations, incoordination, and seizures in children
antihistamine contraindications
third trimester of pregnancy
breastfeeding
newborns
promethazine -pregnancy category C, cardiac dysrhythmias, hepatic diseases, and those taking MAOI
children, older adults, asthma, urinary retention, open-angle glaucoma, hypertension and prostate hypertrophy
antihistamine interactions
CNS depressants
antihistamine interventions
be aware of sedating side effects
antihistamine effectiveness
improvement of allergic reaction
relief of symptoms
nasal glucocorticoids
mometasone (Nasonex)
others: fluticasone (Veramyst)
triamcinolone (Nasacort)
budesonide (Rhinocort aqua)
nasal glucocorticoids MOA
decrease inflammation associated with allergic rhinitis
first line of treatment for nasal congestion
nasal glucocorticoids use
reduce effects of allergic rhinitis including sneezing, nasal itching, runny nose
nasal glucocorticoids adverse
sore throat, nosebleed, headache, burning in the nose
nasal glucocorticoid contraindications
risk c