respiratory meds part 2

Guaifenesin (Mucinex) mechanism of action

- Promotes increase in cough production by increasing and thinning secretions

- thin mucous secretion which dec chest congestion

- mucolytic properties

Guaifenesin routes of adminitstration

orally

Guaifenesin uses

- inc productive cough to clear airways

- typically combined w antitussives or decongestants

Guaifenesin adverse reactions

- Gi upset: nausea vomiting diarrhea

- dizziness

- drowsiness

Guaifenesin drug interactions

no known

Guaifenesin precaution/contraindications

- caution w breastfeeding & pregnancy

- caution w pt who have asthma

Guaifenesin nursing responsibilities

- administer w full glass of water

- can be given w food

Guaifenesin patient education

- do not use more than 1 week

- take w water

- w or w/o food

- inc fluid intake

- report cough lasting longer than week

- read otc labels

Guaifenesin drug class

expectorant

Acetylcysteine drug class

mucolytic

Acetylcysteine mechanism of action

thin and aid in the flow of secretions by breaking mucous membranes

Acetylcysteine routes of administration

- inhalation: to liquify secretion & facilitate coughing

- oral or IV: when used as antidote for acetaminophen poisoning

Acetylcysteine uses

- Acute and chronic pulmonary disorders with excessive secretions

- cystic fibrosis

- antidote for acetaminophen

- helps w atelectasis

Acetylcysteine adverse reactions

- bronchospasm/asthma

- dizzy + drowsy

- hypotension/tachycardia

- hepatotoxicity/liver disease

- hypothyroidism

- renal disease

- cns depression

- rotten egg smell = nausea

Acetylcysteine drug interactions

none

Acetylcysteine precautions/contraindications

- caution in pt with asthma

- safety during pregnancy hasn't been established

Acetylcysteine nursing responsibilities

- ensure suction is available to manage inc secretions

- assess pt ability to cough before admin

- smells like rotten eggs

-

Acetylcysteine patient education

- change positions slowly

- avoid activities requiring alertness

- discourage swallowing secretions

- rotten egg smell = nausea

Diphenhydramine drug class

- 1st Generation Antihistamine

- sedating

Diphenhydramine mechanism of action

- blocks H1 histamine release

- relieves itching and sneezing

- does not relieve congestion

Diphenhydramine routes of administration

- oral

- IV

- IM

Diphenhydramine uses

- seasonal and nonseasonal allergies

- mild allergic reactions

- seasonal allergic rhinitis, urticaria (hives)

- motion sickness

- anaphylaxis

- insomnia (sedating)

- w other meds, nasal decongestion

Diphenhydramine adverse reaction/complication

- sedative effect: dizziness, drowsiness

- anticholinergic effects: Dry mouth, constipation, urinary hesitancy

- GI distress: nausea vomiting constipation

- hallucinations in children

- respiratory depression

Anticholinergic effects

"can't see, can't pee, can't spit, can't poop"

Diphenhydramine drug interactions

- cns depressants

- alcohol

Diphenhydramine precautions/contraindications

- young and old

- asthma, seizure, cardiac, renal, glaucoma, HTN

- lactation & pregnancy

- enlarged prostate (urinary retention)

Diphenhydramine nursing responsibilities

- Monitor for signs of acute toxicity (especially in children).

- Treat symptoms of acute toxicity (e.g., activated charcoal, fever management).

- Safety precautions for dizziness/drowsiness: get up slowly, bed low, call light accessible

Diphenhydramine patient education

- take at bedtime (drowsy)

- suck on hard, sugarless candy

- inc fluid intake

- take w food

- inc fiber, fluids, and ambilation

Cetirizine drug class

- 2nd Generation Antihistamine

- nonsedating

Cetirizine mechanism of action

- blocks histamine release

- does NOT relieve congestion

- relieves itching + sneezing

Cetirizine route of administration

- PO

- IV

Cetirizine uses

- seasonal and nonseasonal allergies

- mild allergic reactions

- seasonal allergic rhinitis, urticaria (hives)

- motion sickness

- anaphylaxis

- insomnia

- w other meds, nasal decongestion

- less sedating, less side efefcts

Cetirizine adverse reactions

- Considered non-sedating or less sedating than first-generation antihistamines (though sedation can still occur and is patient-dependent).

- Anticholinergic effects are less common than with first-generation meds

- GI distress

Cetirizine Drug Interactions:

caution with other CNS depressants and alcohol

Cetirizine Precautions/Contraindications:

- Use caution with pregnancy and lactation.

- Use with caution in children and older adults.

- Caution with asthma, seizure disorder, cardiac disease, renal disease, open-angle glaucoma, hypertension.

Cetirizine Nursing Responsibilities:

No specific nursing responsibilities are detailed for cetirizine.

Cetirizine Patient Education Needs:

- typically lasts longer (dosing usually once daily).

- Can be given with or without food.

- Generally less sedating, but individual responses vary.

Phenylephrine drug class

decongestant

Phenylephrine mechanism of action

Stimulate alpha1-adrenergic receptors, leading to decrease in nasal inflammation

Phenylephrine routes of administration

- inhalation (sprays and drops)

- PO

- IM, SubQ, IV

Phenylephrine uses

- allergic + nonallergic rhinitis by relieving nasal stuffiness

- treats symptoms NOT cause

- common cold/sinitus

Phenylephrine adverse reactions/complications

- Rebound congestion with intranasal use if used longer than 3 to 5 days.

- CNS stimulation: Anxiety, restlessness, tremors

- Cardiovascular effects: Tachycardia, headache.

- Vasoconstriction.

- Increases blood pressure

Phenylephrine drug interactions

Not explicitly detailed, but generally, other stimulants should be used with caution.

Phenylephrine Precautions/Contraindications

- coronary artery disease

- hypertension

- closed-angle glaucoma

Phenylephrine • Nursing Responsibilities:

- Ensure use of correct measuring devices for liquids and syrups

- for drops, keep head low to avoid swallowing

Phenylephrine Patient Education Needs:

- read OTC meds (contain pseudoephedrine people use to make meth)

- Topical meds have a shorter duration

- Taking less than 5 days can cause rebound congestion

- not as good a decongestant