Drugs for upper respiratory infections

Question 1

What is the most prevalent URI:

Answer 1

Common cold affects adults 2-4 yr; children 4-12 yr

Question 2

What is the common cold caused by and what area of the body does it affect the most:

Answer 2

Rhinovirus affects the nasopharyngealtract

Question 3

An acute inflammation of the mucous membranes of the nose commonly accompanies the Rhinovirus is defined as:

Answer 3

acute rhinitis

Question 4

What is caused by pollen or foreign substance (animal dander) AKA hay fever:

Answer 4

Allergic rhinitis (NOT THE SAME AS ACUTE RHINITIS)

Question 5

What does acute rhinitis and allergic rhinitis have in common:

Answer 5

increased nasal secretions

Question 6

When is the common cold, caused by the rhinovirus, most contagious:

Answer 6

1-4 days before onset of symptoms (incubation period) and during the first 3 days of the cold (caught via touch)

Question 7

What are the common S/S of the common cold caused by the rhinovirus:

Answer 7

Rhinorrhea ( watery nasal discharge); nasal congestion; cough; increased mucosal secretions

Question 8

What does infected rhinitis look like and how should they be treated:

Answer 8

tenacious, mucoid that’s yellow-yellow/green; abx should be given

Question 9

What are some home remedies used to treat a cold:

Answer 9

rest; chix soup; hot toddy (sugar, EtOH, tea), vitamin C, megadoses of vitamines

Question 10

What are the 4 groups of drugs used to treat the common cold:

Answer 10

Antihistamines, antitussives, decongestants, expectorants

Question 11

What is the mechanism of antihistamines:

Answer 11

H1 antagonists (blockers) by competing with histamine for receptor sites thus preventing a histamine response.

Question 12

What are the types of histamine receptors:

Answer 12

H1 and H2

Question 13

What occurs when the H1 receptors are stimulated:

Answer 13

extravascular smooth muscles of the nasal cavity are constricted

Question 14

What occurs when the H2 receptors are stimulated:

Answer 14

increase of gastric secretions occur causing peptic ulcers

Question 15

This first generation antihistamine decreases nasal itchiness/tickling, but has anticholinergic properties. What is the type of drug and what is the anticholinergic property:

Answer 15

Diphenhydramine (Benadryl); causes drowsiness and decreased secretions (useful in treating acute rhinitis)

Question 16

These second-generation antihistamines are non-sedating and have fewer anticholinergic symptoms. What are some examples:

Answer 16

Allegra, claritin (loratadine), Zyrtec, optivar

Question 17

What is Diphenhydramine’s mechanism of action

Answer 17

Absorbed in GI; antagonist; antitussive; onset=15 min; can be used as a sleeping aid

Question 18

What are the common side effects of Diphenhydramine:

Answer 18

Drowsiness, fatigue, dizziness, anticholinergic, coordination; rashes

Question 19

DILATION of nasal blood vessels d/t infection, inflammation, or allergy is defined as:

Answer 19

nasal congestion

Question 20

What occurs when there’s DILATION of the nasal blood vessels:

Answer 20

transudation of fluid into the tissue spaces resulting in swelling of the nasal cavity

Question 21

What are sympathomimetic amines:

Answer 21

nasal decongestants

Question 22

What is sympathomimetic amines’ or nasal decongestant’s mechanism of action:

Answer 22

stimulates alpha-adrenergic receptors to produce vasoconstriction of capillaries w/in the nasal mucosa=SHRINKING reduced secretions (rhinitis)

Question 23

What could occur with frequent use of nasal decongestants or sympathomimetic amines:

Answer 23

tolerance and REBOUND NASAL CONGESTANTS (CAUSED BY IRRITATION OF NASAL MUCOSA)

Question 24

This category of decongestants is used primarily for allergic rhinitis (hay fever or acute coryza-profuse nasal discharge):

Answer 24

Systemic decongestants

Question 25

What is the main difference of nasal decongestants from systemic decongestants:

Answer 25

NASAL DECONGESTANTS ACT PROMPTLY W/FEWER SIDE EFFECTS THAN SYSTEMIC DECONGESTANTS

Question 26

What is the main difference of systemic decongestants from nasal decongestants:

Answer 26

RELIEVES NASAL CONGESTION FOR A LONGER PERIOD OF TIME THAN NASAL DECONGESTANTS

Question 27

What are some examples of systemic decongestants:

Answer 27

ephedrine, neo-synephrine, and Sudafed

Question 28

ephedrine, neo-synephrine, and sudafed is often combined with:

Answer 28

antihistamines, analgesics, antitussive

Question 29

What are the side effects of decongestants:

Answer 29

INCREASED BP/GLUCOSE; jittery/nervous/restless

Question 30

How long may rebound nasal congestion occur:

Answer 30

if a pt uses decongestants \>5 days ## Footnote

Question 31

What may occur if I take decongestants with beta-blockers:

Answer 31

effects of BBs are decreased

Question 32

What may occur if I take decongestants with MAO inhibitors:

Answer 32

increases risk of HTN /dysrhythmias

Question 33

What may occur if I take decongestants with lrg mounts of caffeine

Answer 33

palpations

Question 34

Steroids effective for treating allergic rhinitis is defined as:

Answer 34

intranasal glucocorticoids

Question 35

What is intranasal glucocorticoids mechanism of action:

Answer 35

antiinflammatory by decreasing allergic rhinitis s/s of rhinorrhea/sneezing/congestion

Question 36

What are some examples of intranasal glucocorticoids:

Answer 36

FLONASE and dexamethasone

Question 37

What could occur if a pt takes flonase or dexamethasone continuously:

Answer 37

dryness of nasal mucosa; DEXAMETHASONE SOULD NOT BE USED MORE THAN 30 DAYS

Question 38

This category of medications acts on the cough center in the medulla to suppress the cough reflex:

Answer 38

antitussive (effective for NON-PRODUCTIVE, IRRITATING COUGH)

Question 39

What are the 3 types of preparations of antitussives:

Answer 39

nonnarcotic, narcotic, combination

Question 40

What are some examples of antitussives:

Answer 40

dextromethorphan (nonnarcotic), codeine (narcotic)

Question 41

What type of medication is given to a pt that wants to loosen bronchial secretions:

Answer 41

expectorants

Question 42

What is a natural expectorant:

Answer 42

hydration

Question 43

what is a common example of an expectorant given:

Answer 43

guaifenesin (robitussin)

Question 44

What are the comfort measures of URIs:

Answer 44

rest, hydration, avoid dust/allergens/fumes, petroleum jelly for nares

Question 45

A pt has started taking antihistamine and diphenhydramine. What is most important to tell the pt when teaching: A) do not take this drug at bedtime to avoid insomnia, B) avoid driving until stabilized on the drug, C) Nightmares and nervousness are more likely in an adult, D) Limit use to 1-2 puffs/sprays 4-6 times per day to avoid rebound congestion:

Answer 45

B: avoid driving

Question 46

A pt is prescribed a decongestant nasal spray. What should the nurse teach the pt: A) take this drug at bedtime as a sleeping aid, B) directly spray away from the nasal sputum and sniff, C) this drug may be used in maintenance Tx of asthma, D) limit the drug to 5 days of use to prevent rebound nasal congestion:

Answer 46

D) less than 5 days of use to prevent rebound congestion

Question 47

Beclomethasone has been Rx to a pt w/allergic rhinitis. What is the most common side effect from continuous use: A)dizziness, B) rhinorrhea, C) hallucinations, D) dry nasal mucosa:

Answer 47

D) dry, nasal mucosa

Question 48

## Footnote The nurse is teaching a pt about diphenhydramine. What are the topics to include? Select all that applies: A) take med with food to decrease GI distress, B) Avoid EtOH and other CNS depressants, C) notify if confusion or hypotension occurs, D) take candy, gum, ice chips for temp relief of dry mouth, E) avoid handling dangerous equipment/activities until stabilized on drug:

Answer 48

B, C, D, E