[Exam 1] Module 4 - Drug Therapy for Upper Respiratory Disorders Flashcards by Kevin Avelino

What are the two types of antihistamines?

Those that cause sedation (first-generation) and those that do not (second-generation)

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines : Use antihistamines in the management of

mild allergic reactions, such as season allergic rhinitis, mild transfusions, and urticaria which is referred to as hives and appears as raised, itchy welts .

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines : You can use antihistamines during severe allergic reactions of anaphylactic nature that cause

hypotension, acute laryngeal edema, and bronchospasm and can be life-threathening.

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines : They are noted for their

sedative effects and often in drugs that treat insomnia

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines : Prototype and Other Drugs

Diphenhydramine (Benadryl)

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Expected Pharmacologic Action: These bind to what? And do what?

Bind to H1 Receptors, and block release of histamine. This make it effective in treatment of allergies.

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Expected Pharmacologic Action: Sedating antihistamines are also mild

cholinergic blockers, producing actions similar to anticholinergic drugs. Dry mouth , constipation, and urinary hesitancy

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Adverse Drug Reactions: Reactions are

mild and consist of drowsiness and dizziness, as well as anticholinergic effects

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Interventions: Because of sedating effects and potential for dizziness, monitor clients

when ambulating, and advice against operating machinery

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Interventions: If experiencing excesive sedation,

recommend swtiching to nonsedating antihistamine

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Interventions: To combat anticholinergic effects of dry mouth… encourage client to

sip on water or hard candy.

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Interventions: Given the drug with food will help decrease

GI discomfort

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Interventions: IF acute toxicity does develop, administer

activated charcoal to neutralize the drug and laxatives to facilitate elimination of absorbed drug.

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Interventions: What to do with fever?

Administer acetaminophen for fever, adn apply ice packs or give sponge baths to reduce fever

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Administration: How is this administered?

Enteric Coated Drug. Don’t chew or crush

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Administration: Make sure not to take with

alcohol or other CNS depressants because of risk of additional CNS depression

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Administration: If given for motion sickness, give…

30 minutes before activity, or 1-2 hours before activity

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Client Instructions: Instruct to take when?

At or just before bedtime. Also suck on hard candy and increase fiber.

With difficulty urinating, notify provider.

Abdominal discomofrt? Take drug with food

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Client Contraindications and PRecautions: Contraindicated in

newborns and children under age of 2.

Also those with narrow-angle glucoma , prostatic hypertrophy, or acute exacerbation of asthma.

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Client Contraindications and PRecautions: Those with narrow-angle glaucoma need to be told

avoid taking diphenhydramine because it can potentially cause sudden and painful increase in intraocular pressure

How well did you know this?

Not at all

Perfectly

First-Generation Antihistamines / Sedating Antihistamines - Indications: Interact with other

alcohol and CNS depressants because they increase the depressent effect of antihistamines

How well did you know this?

Not at all

Perfectly

Second-Generation/Nonsedating Antihistamines: Why are these better

Fewer side effects and currently available as OTC.

How well did you know this?

Not at all

Perfectly

Second-Generation/Nonsedating Antihistamines: Therapeutic use includes

Allergic Rhinitis

Treatment for Chronic Idiopathic Urticaria (which is rash and hives)

How well did you know this?

Not at all

Perfectly

Second-Generation/Nonsedating Antihistamines - Prototype:

Cetirizine (Zyrtec)

How well did you know this?

Not at all

Perfectly

Second-Generation/Nonsedating Antihistamines - Expected Pharmacologic Action: How does this work?

Antagonize histamine effects at H1, witout binding to or inactivating histamine . This is what makes allergic rhinitis and idiopathic urticaria effective

Second-Generation/Nonsedating Antihistamines - Expected Pharmacologic Action:Dosing happens how often?

Once daily

Second-Generation/Nonsedating Antihistamines - Adverse Drug Reactions: Some clients may experience what side effects?

Drowsiness, as well as fatigue. Dry mouth, nose, adn throat may occur

Second-Generation/Nonsedating Antihistamines - Interventions: Asses patients during

ambulation to determine their degree of drowsiness and fatigue. Make sure water present too

Second-Generation/Nonsedating Antihistamines - Interventions: Maintain fluid

1500 - 2000 mL per day

Second-Generation/Nonsedating Antihistamines - Administration: Give with food?

Can give with or without food

Second-Generation/Nonsedating Antihistamines - Administration: Do not give this with what other drug?

Other OTC Antihistamines

Second-Generation/Nonsedating Antihistamines - Administration: Dosage for someone with compromised liver or kdiney function?

Decreased

Second-Generation/Nonsedating Antihistamines - Client Instructions:

Take once daily Avoid driving and activites that require mental alertness Frequent water sips adn hard candy sucking

Second-Generation/Nonsedating Antihistamines - Contraindications and Precautions: Don't go to who?

Those under 6 months or women breastfeeding

Second-Generation/Nonsedating Antihistamines - Client Instructions: Don't give for those to allergies with

H1 Antihistamine receptors or hydroxyzine.

Second-Generation/Nonsedating Antihistamines - Client Instructions: USe cautiosly for those with

impaired kidney or liver function because delay in metabolism

Second-Generation/Nonsedating Antihistamines - Interactions

Theo-24 can reduce clearance of nonsedating antihistamine from body and lead to toxicity. CNS Depression potentiate by sedative/hypnotics , opioid analgesics, or alcohol

Antitussives: What do they do?

Suppress chronic, nonproductive coughing, which commonly relates to allergies or upper respiratory infections. Known as cough suppressants

Antitussives (Opioid) - Prototype:

Codeine

Antitussives (Opioid) - Expected Pharmacologic Action: Work by

suppresing the cough reflex in the brain

Antitussives (Non-opioid) - Expected Pharmacologic Action:

suppresing the cough reflex in the brain

Antitussives (Non-Opioid) - Prototype:

Dextromethorphan (Delsym)

Antitussives (Opioid) - Adverse Drug Reactions: Common side effects are

Drowsiness and sedation. Dizziness and Lightheadedness with GI Distress , N/V. Constipation and Respiratory Depression because of depression of CNS

Antitussives (Opioid) - Adverse Drug Reactions: There is a potential for

abuse, so monitor them closely.

Antitussives (Non-opioid) - Adverse Drug Reactions: Drowsiness and Sedation are only present if

you give large doses, or give the doses concurrently with other CNS depressent drugs

Antitussives (Opioid) - Interventions: Monitor patients when they

change positions or ambulate because they could be dizzy or lightheaded.

Antitussives (Opioid) - Interventions: To prevent GI distress, administer

antitussive with either food o milk

Antitussives (Opioid) - Interventions: When should you give this?

Only when needed , because of its potential for abuse.

Antitussives (Opioid) - Interventions (Safety Alert): For clients taking opioid drugs they may experience respiratory depression. Monitor what?

RR. If below 12, stop drug. Give reversal drug like Naloxone (Narcan)

Antitussives (Opioid) - Administration: Only use antitussives on a how long basis?

Short-term basis and at lowest effective dose possible

Antitussives (Opioid) - Client Instructions: What to do if lightheadedness experienced?

Change positions gradually and to sit or lie down

Antitussives (Opioid) - Client Instructions: If GI distress occurs..

Take the drug with food or milk

Antitussives (Opioid) - Client Instructions: Increase their daily intake of

fluids and fiber.

Antitussives (Opioid) - Client Instructions: Clients taking these drugs should not participate in activites that

require mental alertness, drink alcohol, or take any other CNS depressent drugs

Antitussives (Opioid) - Contraindications and Precautions: Contraindicated in clients with known sensitivity to

Drug, and where concurrent use of MAO inhibitors and SSRIs is indicated

Antitussives (Opioid) - Contraindications and Precautions: With this causing respiratory depression, who must look out?

Clients who have reduced respiratory reserve

Antitussives (Opioid) - Contraindications and Precautions: Inform men with prostatic hypertrophy that

antissives may cause urinary retention

Antitussives (Opioid) - Interactions: If combined with alcohol and other CNS depresents, will increase

CNS depressent efects

Antitussives (NonOpioid) - Interactions: Increase the analgesic effects of

opioids prescribed for pain

Antitussives (Opioid) - Interactions: Fever and hypotension may occur if

nonopoid antitussives taken with MAOI antidepressent. St John wart may increase sedation

Expectorants: What do they do?

Drugs to treat colds adn other upper respiratory infections that produce mucus as part of disease process Can also give them bronchitis to facilitate removal of secretions

Expectorants - Prototype:

Guaifensein (Mucinex)

Expectorants - Expected Pharmacologic Action: REaction is

reduction in the surface tension of secretions. Thins the thick mucus, making it easier to cough out.

Expectorants - Adverse Drug Reactions:

May experience dizziness, drowsiness, headache, GI Distress and allergic reaction

Expectorants - Interventions: Because of dizziness and drowsiness, monitor them as

they change positions or ambulate

Expectorants - Interventions: Avoid GI Distress by

giving the drug with food or 8 oz of water

Expectorants - Administration: When giving, make sure client...

increases their fluid intake to help the expectorant liquefy secretions

Expectorants - Administration: If worsening of cough or high fever, notify pprovider because

may be development of pneumonia

Expectorants - Administration: Give expectorants only when

needed and not with combination products for colds that also contain guaifenesin.

Expectorants - Administration: Available in

tablets and sustained-release formulations

Expectorants - Client Instructions: Avoid

driving or engaging in activities that require mental alertness.

Expectorants - Client Instructions: If experiecing GI Distress...

instruct them to take the drug with fofod or 8 oz of water.

Expectorants - Contraindication and Precautions: Contraindicated for clients with

known sensitivity and in clients with phenylketonura (aspartame content)

Expectorants - Contraindication and Precautions: USe incaution for those who have

cough lasting more than one week diabetes Clients receiving disulfiram

Expectorants - Interactions

No significant drug-drug interactions

Mucolytics: What are these?

inhalants drugs client need to decrease viscosity of mucous secretions.

Mucolytics: This can reverse what overdose?

Acetylcysteine (Acetadote) and can be administerd orally or intravenously

Mucolytics - Prototype:

Acetylcysteine (Acetadote)

Mucolytics - Expected Pharmacologic Action: Work by

breakign disulfide linkages of proteins in mucus, subsequently decreasing viscosity of mucus. Allows client to expectorate the mucus

Mucolytics - Adverse Drug Reactions: Side effect is

Bronchospasm and GI Distress.

Mucolytics - Adverse Drug Reactions: Drugs rotten-egg smell can precipitate

nausea in clients, along with ingestion of copious amounts of secretions

Mucolytics - Interventions: Closely monitor

clients respiratory status on a regular basis. Includes auscultation.

Mucolytics - Interventions: Clients may need bronchodilator along with

the mucolytic to enhance its effectiveness in removing secretions

Mucolytics - Interventions (Safety Alert): If trouble managing teh increase in secretions, give

suction equipment and have readily available

Mucolytics - Administration: For those with bronchopulmonary disease, you give by

inhalation throuhg a nebulizer or by direct instillation through a tracheotomy tube

Mucolytics - Administration: When giving acetylcysteine, its important to ensure

that the equipment you use does not contain metal or rubber parts

Mucolytics - Client Instructions: Tell them to report any

difficulty breathing or worsening cough. Encourage them to expectorate secretions

Mucolytics - Client Instructions (Safety Alert): Instruct clients on proper cleaning of

nebulizer equipment they use during respiratory treatments.

Mucolytics - Contraindications and Precautions: Dont use oral mucolytics in clients who have

risk of or have actual gastric bleeding

Mucolytics - Contraindications and Precautions: Use in caution in clients who have

asthma, history of bronchospasm, or severe respiratory insufficiency.

Mucolytics - Interactions: No

No known drug or food interactions

[Exam 1] Module 4 - Drug Therapy for Upper Respiratory Disorders Flashcards

(91 cards)