Allergy, Cold, and Cough Flashcards
(26 cards)
How do antihistamines work?
Competes with histamine-1 for receptor sites, blocks histamine-1 release.
Note: 1st generation antihistamines have poor selectivity for H1 receptors – also bind cholinergic, alpha adrenergic, and serotonergic receptors
What drugs are 1st generation antihistamines?
Diphenhydramine (Benadryl)–> used for Allergic rhinitis
Meclizine (Antivert, Bonine, Dramamine) – used for nausea/vomiting/motion sickness
Hydroxyzine (Atarax, Vistaril) – used more for itching, sedation
What side effects of using 1st generation antihistamines?
Sedation, drowsiness, headache, dry mouth, Cognitive impairment, urinary retention, blurred vision (more likely with consistent use, elderly patients are more susceptible)
NOTE: Children can experience a paradoxical EXCITATION, rather than drowsiness
What are the counseling points for 1st generation antihistamines?
- Do not use while driving, operating heavy machinery until you know how this medication affects you
- Do not use with alcohol (additive CNS effects)
- Caution in elderly patients
What drugs are 2nd generation antihistamines?
Cetirizine (Zyrtec)
Fexofenadine (Allegra)
Levocetirizine (Xyzal)
Azelastine (Astepro, Astelin) – intranasal antihistamine
What are the side effects of 2nd generation antihistamines?
Drowsiness (cetirizine > others), headache
Azelastine (intranasal): also bitter taste, epistaxis (nose bleeds)
What are the counseling points for 2nd generation antihistamines?
Avoid activities involving mental alertness until you know how this medication affects you
What drugs are considered intranasal corticosteroids?
Fluticasone (Flonase, Xhance Nasal Spray)
Mometasone (Nasonex Nasal Spray)
Triamcinolone (Nasacort AQ Nasal Spray)
How do intranasal corticosteroids work?
Anti-inflammatory, antipruritic, vasoconstrictive properties lead to relief of allergic rhinitis symptoms of rhinorrhea, sneezing, itching (nose/palate/eyes), and congestion
What are the side effects of using intranasal corticosteroids?
Headache, nasal irritation, nasal burning, epistaxis (nosebleeds)
What are the counseling points for intranasal corticosteroids?
Proper administration technique will reduce risk of nosebleeds and irritation
Relief may be delayed several days, optimal effect may take 1-2 weeks
What drugs are considered decongestants?
Pseudoephedrine (Sudafed)
Oxymetazoline (Afrin)
How do decongestants work?
Stimulates alpha-1 adrenergic receptors= vasoconstriction, leads to less vessel engorgement
and mucosal edema
Stimulates beta-adrenergic receptor= some bronchial relaxation AND increased HR and contractility
What side effects of decongestants?
Headache, insomnia, restlessness, Heart palpitations, arrhythmias, increased blood pressure (caution in patients with uncontrolled cardiovascular disease, risk increases with consistent use)
For nasal spray local side effects are most common – stinging, sneezing, dry nose
What are the counseling points of decongestants?
Avoid pseudoephedrine near bedtime (restlessness, insomnia, jittery feeling)
For nasal spray – do not use for > 3 days due to risk of rebound congestion
What type of drug is Guaifenesin?
expectorant
When do you use Guaifenesin?
Cough (usually a cough with mucus)
How does Guaifenesin work?
Thins and loosens bronchial secretions (mucus), promoting lower respiratory tract drainage and
removal of mucus
What are the side effects of Guaifenesin?
Nausea, vomiting, constipation, drowsiness
What are the counseling points for Guaifenesin?
Adequate hydration is recommended while using this medication
What drugs are considered cough suppressants?
Dextromethorphan (Delsym)
Benzonatate (Tessalon Perles)
How does dextromethorphan work?
Depresses the cough center in the medulla
oblongata
What are the side effects of dextromethorphan?
Dizziness, nervousness
How does benzonatate work?
Anesthetizes stretch receptors in respiratory
passages, lungs, and pleura to reduce cough reflex
