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Pharmacology Respiratory Notes
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DRUGS AFFECTING RESPIRATORY SYSTEMYC DECONGESTANTSSYSTEM • Alpha adrenergic agonist: ephedrine,
Tuesday, 7 September 2021 phenylephrine and pseudoepherine
6:43 PM by Krizel Ayon • (phenylpropanolamine): stroke,
hypertension, renal failure and cardiac
ANTIHISTAMINES AND DECONGESTANTS dysrythmias
• Allergic rhinitis and common colds
ANTIHISTAMINES – medicines often used to • Relieve nasal congestion for longer period
relieve symptoms of allergies, such as hay fever,
hives, conjunctivitis and reactions to insect bites NASAL DECONGESTANTS
or stings. • Stimulate the alpha-adrenergic receptors
thus producing vasoconstriction of the
First Generation - with potent sedative effects. capillaries within the nasal mucosa
(can pass blood brain barrier. Helps improve • Shrinking of nasal mucous membranes
allergy symptoms, it usually makes patients and reduction in fluid secretion
sleepy. • Act promptly and fewer side effects
• Diphenhydramine (Benadryl) • By nasal spray, drops, tablet capsule or
liquid form
• Frequent use in tolerance called REBOUND
NASAL CONGESTION
NURSING IMPLICATIONS: Antihistamines
• Gather data about the condition or
allergic reaction that required treatment:
also, assess for drug allergies
• Contraindicated in the presence of acute
asthma attacks and lower respiratory
diseases.
Second-generation - these agents cannot pass • Use with caution in increased intraocular
through the blood-brain barrier and into the pressure, cardiac or renal disease,
central nervous system, which limits the degree hypertension, asthma, COPD, peptic ulcer
of drowsiness patients experience. disease, BPH, or pregnancy.
• Cetirizine (Zyrtec) • Instruct patients to report excessive
• Loratadine (Claritin) sedation, confusion, or hypotension.
• Avoid driving or operating heavy
machinery, and do not consume alcohol
or other CNS depressants.
• Do not take these medications with other
prescribed or OTC medications without
checking with prescriber.
• Best tolerated when taken with meals-
reduces GI upset
• If dry mouth occurs, teach patient to
perform frequent mouth care, chew gum,
or suck on hard candy (preferably
DECONGESTANT - Constrict blood vessels in the sugarless) to ease discomfort.
nose and sinuses, reducing the amount of mucus • Monitor for intended therapeutic effects.
that is formed, and can be found in combination
with antihistamines.
• Pseudoephedrine (Sudafed) II. ALLERGIC RHINITIS STEROID,
• Phenylephrine (NeoSynephrine) ANTITUSSIVE AND MUCOLYTICS
• Oxymetazoline (Afrin)
, • Allergic rhinitis is an inflammation (-itis) of Other medications:
the nose (rhin-) • Combination inhalers
Treatments: • Anticholinergics
• Local steroid - Triamcinolone (Nasacort • Leukotriene receptor antagonists and MC
Allergy 24HR) Stabilizers
• May take weeks of use for relief • IgE antagonists
OTC ALLERGIC RHINITIS STEROID NASAL SPRAY ORAL STEROIDS
• Triamcinolone (Nasacort Allergy 24HR) • Methylprednisolone (Medrol)
• Tapered dosing: a 6-day, 21-pill dose pack
OTC ANTITUSSIVE / MUCOLYTIC that gives patients 6 tablets on the first
• Guaifenesin / Dextromethorphan day, 5 on the 2nd, 4 on the 3rd, 3 on the
(Robitussin DM) 4th, 2 on the 5th, and 1 on the 6th.
• Should not be confused with pure • Prednisone (Deltasone)
Guaifenesin (Robitussin) • Many steroids have unofficial "-sone"
• Guaifenesin acts as a mucolytic to lyse ending
(break up) mucous and chest congestion
• DM (dextromethorphan) acts as the INHALED STEROID / BETA2-RECEPTOR AGONIST
antitussive LONG-ACTING
• Budesonide / Formoterol (Symbicort)
RX ANTITUSSIVE / MUCOLYTIC • "-terol" - beta 2 agonist bronchodilator
• Guaifenesin / Codeine (Cheratussin AC, • B2 agonist is Symbiotic (working with)
Rubitussine AC) Corticosteroid
• Used when DM may not be effective • Salmeterol / Fluticasone (Advair)
• Long acting bronchodilator +
NURSING IMPLICATIONS: Antitussive Agents corticosteroid
• Perform respiratory and cough • Added for air
assessment, and assess for allergies.
• Instruct patients to avoid driving or INHALED STEROID
operating heavy equipment due to • Fluticasone (Flovent HFA, Flovent Diskus,
possible sedation, drowsiness, or Flonase)
dizziness.
• If taking chewable tablets or lozenges, do BETA2 RECEPTOR AGONIST SHORT-ACTING
not drink liquids for 30 to 35 minutes • Albuterol [salbutamol] (Ventolin)
afterward. • Salbutamol starts with "S" -short acting.
• Report any of the following symptoms to
the caregiver. INHALERS: Patient Education
• Cough that lasts more than a week • For any inhaler prescribed, ensure that
• A persistent headache the patient is able to self-administer the
• Fever medicine.
• Rash • Provide demonstrations and return
• Antitussive agents are for demonstration
NONPRODUCTIVE coughs. • Ensure the patient knows the correct time
• Monitor for intended therapeutic effects. intervals for inhalers
• Provide a spacer if the patient has
III. ASTHMA difficulty coordinating breathing with
• A disease of bronchoconstriction and inhaler activation.
inflammation • Ensure that patient knows how to keep
Immediate relief: ALBUTEROL track of the number of doses in the
Reduce inflammation after severe attack: ORAL inhaler device.
STEROIDS
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