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26 Cards in this Set
- Front
- Back
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Antihistamines ( overview ) |
Drugs that compete with histamine for a specific receptor site.
Histamine1 Receptors : responsible for asthma Histamine2 Receptors
H1 Antagonists are commonly referred to as antihistamines |
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Antihistamines ( properties ) |
- Antihistaminic - Anthicholinergic : drying effect that reduces nasal, salivary and lacrimal gland secretions (e.g. runny nose, tearing and itching eyes) - Sedative : may cause drowsiness - Skin : reduces capillary permeability, wheal formation and itching
** Safety concern : don't drive and don't take with alcohol when using antihistamine (especially Benadryl) |
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Antihistamines ( mechanism of action ) |
Blocks the action of histamine at H1 receptor sites Prevents : vasodilation, i/c GI and respiratory secretions and i/c capillary permeability
It only competes with histamine-- it cannot push histamine off the receptor if already bound. ** This means that it is best preventative; it works best at early signs of allergies. It may not work if PT is already demonstrating symptoms. |
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Antihistamines ( indications ) |
Used for the management of : - nasal allergies - seasonal or perennial allergic rhinitis (hay fever) - allergic reactions - motion sickness - parkinson's disease - sleep disorders (sedative) - relief of cold symptoms (sneezing, runny nose) |
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Antihistamines ( adverse effects ) |
Most common -- Anticholinergic effects - Dry mouth - Difficulty urinating - Constipation - Changes in vision
Drowsiness (mild to deep sleep; hangover effect) |
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Antihistamines ( nonsedating / peripherally acting) |
Developed to eliminate unwanted adverse effects (mainly sedation)
Works peripherally to block the actions of histamine; thus, fewer CNS effects
Longer duration of action (increased compliance) Ex : fexofenadine, loratadine, cetirizine |
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Antihistamines ( traditional ) |
Works both peripherally and centrally.
Has anticholinergic effects, making them more effective than nonsedating drugs in some cases |
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Antihistamines ( contraindications ) |
- Acute asthma attacks
- Lower respiratory diseases (pneumonia) |
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Antihistamines ( nursing implications ) |
- Be aware of potential OTC interactions that will cause additional CNS depression (e.g. cough syrup) - Instruct PT to avoid driving or operating heavy machinery; advise against consuming alcohol or other CNS depressants - Best tolerated when taken with meals to reduce GI upset - For dry mouth, perform frequent mouth care, chew gum or suck on hard (sugarless) candy |
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Nasal Decongestants ( types used ) |
- Adrenergics : sympathomimetics. largest group.
- Anticholinergics : parasympatholytics. less commonly used.
- Corticosteroids : topical or intranasal steroids
Two dosage forms : oral or inhaled/topical |
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Oral Decongestants ( overview ) |
Prolonged decongestant effects, but delayed onset w/ less potent effect (compared to topical)
No rebound congestion
Only found in adrenergic decongestants ( ex: pseudoephedrine ) |
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Topical Decongestants ( overview ) |
Adrenergics : phenylephrine -- prompt onset, potent -- sustained use over several days causes rebound congestion
Intranasal steroids :
Intranasal anticholinergic : ipratropium |
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Nasal Decongestants ( mechanism of action ) |
Site of Action : the blood vessels surrounding nasal sinuses
Adrenergics : constricts vessels, causing tissues to shrink and secretions are better able to drain.
Steroids : anti-inflammatory. Turns off immune system cells, resulting in d/c congestion.
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Nasal Decongestants ( indications ) |
Relief of congestion associated with . . . - acute or chronic rhinitis - common cold - sinusitis - hay fever or other allergies
** may also be used to reduce swelling of nasal passage and facilitate visualization of nasal membranes before surgery/ dx procedures |
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Nasal Decongestants ( adverse effects - adrenergics ) |
Systemic effects caused by adrenergic stimulation of the heart, vessels and CNS : - Nervousness - Insomnia - Palpitations - Tremors
Drying of the mucosa and nose bleeds |
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Nasal Decongestants ( adverse effects - steroids ) |
- Local mucosal dryness - Irritations
(nose bleeds) |
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Nasal Decongestants ( nursing implications ) |
Whenever a PT is using ANY nasal spray, they must use a humidifier to prevent drying of the mucosa and nose bleeds.
- PT should avoid caffeine - PT should report a fever, cough or other symptoms lasting longer than a week |
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Antitussives ( overview + indications ) |
OTC cough medicines -- drugs used to stop or reduce coughing. Both opioid and non-opioid.
Used only for nonproductive coughs or in cases where coughing is harmful. |
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Antitussives ( mechanism of action ) |
Opioids : act in the CNS by elevating the cough threshold to suppress respirations. Works in the cough center in the medulla.
Non-opioid : Suppresses the cough reflex by numbing the stretch receptors in the respiratory tract and preventing stimulation of cough reflex |
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Antitussive ( adverse effects - opioids ) |
- Sedation - N/V - Lightheadedness - Constipation |
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Antitussive ( adverse effects - non-opioid ) |
Benzonatate : dizziness - headache - sedation - nausea
Dextromethorphan : dizziness - drowsiness - nausea |
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Antitussive ( nursing implications ) |
- Perform respiratory and cough assessment
- Instruct PTs to avoid driving or operating heavy equipment
- For nonproductive coughs!! |
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Expectorants ( overview ) |
Drugs that aid in the expectoration (removal) of mucus
Reduces the viscosity of secretions; disintegrates and thins secretions
Ex : guaifenesin |
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Expectorants ( mechanism of action ) |
Reflex stimulation : - Drug causes irritation of the GI tract - Loosening and thinning of respiratory tract secretions occur in response to this irritation
Direct stimulation : - Secretory glands are stimulated directly to increase their production of respiratory tract fluids
** By loosening and thinning sputum and bronchial secretions, the tendency to cough is directly diminished |
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Expectorants ( indications ) |
Used for the relief of productive coughs r/t : - common cold - bronchitis - laryngitis + pharyngitis - coughs caused by chronic paranasal sinusitis - pertussis - influenza - measles |
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Expectorants ( nursing implications ) |
- Should be used with caution in the elderly or those with asthma or respiratory insufficiency
- PTs taking expectorants should receive more fluids, if permitted, to help loosen and liquefy secretions
- Report a fever, cough or symptoms lasting longer than a week |
