Ch. 40 & 41 - Upper & Lower Respiratory Flashcards Preview

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Flashcards in Ch. 40 & 41 - Upper & Lower Respiratory Deck (69)
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1

Antihistamines - Action:

blocks action of histamine at H1 histamine receptor site

Tx: Allergic Rhinitis

2

1st Generation Antihistamines:

Cause anticholinergic symptoms:
1.) Dry mouth
2.) Constipation
3.) Blurred vision
4.) Urinary retention

Ex: diphenhydramine (Benadryl)

3

diphenhydramine (Benadryl):

1.) PO, IM, IV

2.) Allergic rhinitis

3.) Prevents motion sickness

4.) Active ingredient in OTC sleep aids

4

diphenhydramine (Benadryl) - SE (anticholingeric effects):

**1.) Drowsiness
2.) dizziness, fatigue, urinary retention, constipation
3.) dry mouth, blurred vision

*Should NOT take with alcohol or other CNS depressants

5

diphenhydramine (Benadryl): contraindications (1):

Acute asthma:
-Drying effect on resp tract = may thicken secretions = more difficulty breathing

6

diphenhydramine (Benadryl): contraindications (2):

1.) Narrow-angle glaucoma
2.) BPH, urinary retention
3.) Pregnant/Nursing mothers

7

2nd Generation Antihistamines:

1.) Little to no effect on sedation

2.) More specific to H1 histamine receptor

3.) Fewer anticholingeric symptoms

8

2nd Generation Antihistamines - Examples:

1.) cetirizine (Zyrtec)
2.) fexofenadine (Allegra)
3.) loratadine (Claritin)

**Tolerance may develop over time

9

Nursing Diagnoses (1):

1.) Ineffective airway clearance r/t nasal congestion

2.)Sleep deprivation r/t frequent coughing

10

Nasal Decongestants (sympathomimetic amines):

Stimulate alpha-adrenergic receptors =vasoconstriction in nasal mucosa

Nasal mucous membranes shrink=decrease fluid secretion

11

Nasal Decongestants:

Adm:
-Nasal spray/drops

12

Nasal Decongestants With Frequent Use:

1.) Tolerance

2.) Rebound congestion
-Nasal vasodilation instead of vasoconstriction

3.) Shouldn't use more than 3-5 days

13

Examples (sprays/drops):

oxymetazoline HCl (Afrin)

14

Systemic Decongestants (alpha-adrenergic agonists):

1.) Po

2.) Tx: allergic rhinitis 
-Hay fever
-Acute coryza

15

Examples (systemic):

ephedrine (Ephedrine)
phenylephrine (Neo-synephrine)
pseudoephedrine (Sudafed)

16

Systemic Decongestants SE:

Jittery, nervous
-Disappear as tolerance develops

Alpha-adrenergic drug 
-Increase BP
-Increase glucose levels

17

Systemic Decongestants - Contraindications:

Hypertension
Cardiac disease
Hyperthyroidism
DM

18

Nasal / Systemic Decongestants -->

Not for:
-Infants
-Young children (

19

Drug Interactions (2):

Decongestants with MAO inhibitors: 
-Increased chance of hypertension & cardiac dysrhythmias

20

Avoid:

Large amts coffee / tea (caffeine) = increase restlessness & palpitations

21

Intranasal Glucocorticoids (steroids):

Antiinflammatory action decreases symptoms of:
1.) Rhinorrea
2.) Sneezing
3.) Congestion

22

Intranasal Glucocorticoids (steroids) - Ex:

dexamethasone (Decadron)

23

Intranasal Glucocorticoids - SE:

1.) Continuous use = dryness of nasal mucosa

2.) Usually no systemic side effects

3.) Should not use for > 30 days

24

Antitussives (1):

Act on cough control center in medulla =suppresses cough reflex

25

Antitussives (2):

Cough:
-Physiological mechanism
-Productive or nonproductive

26

Antitussives (3):

Involuntary cough should not be suppressed unless:
-Resp discomfort
-Cant sleep

27

3 Types of Antitussives:

1.) Narcotic
2.) Nonnarcotic
3.) Combination

28

Narcotic Antitussives:

codeine
hydrocodone
-Direct action on cough center in medulla

29

Major Problems With Narcotic Cough Suppressants:

1.) Risk for dependence
2.) Resp depression
3.) Bronchial constriction
4.) CNS depression
5.) Constipation

30

Nonnarcotic Antitussives:

Dextromethorphan HBr:
1.) Most common nonnarcotic cough suppressant
2.)Chemical derivative of opiates
3.) Acts on cough center