Upper Respiratory Meds

Antihistamines

• Compete with H1 to decrease nasopharyngeal secretions

• First and second generation

First generation Antihistamine Med

• Diphenhydramine(Benadryl)

Diphenhydramine(Benadryl) side effects

• Drowsiness

• dizzy, fatigue, blurred vision

• Disturbed coordination

• urinary retention

• Anticholinergic effects

• GI distress

Second Generation Antihistamine Meds

Loratadine(Claritin)

Loratadine(Claritin) side effects

• less drowsiness, anticholinergic

• Take in evening

• Better tolerated

Nursing care for Antihistamines

• Obtain history of exposure

• assess for urinary dysfunction

• assess cardiac and respiratory status

• Educate to take with food, causes anticholinergic effects

Decongestants

• Stimulate alpha-adrenergic receptors

• produces nasal vascular constriction(decreases blood flow), decreases nasal secretions

• Nasal spray, drops, tablet, capsule, liquid

Decongestant Meds

• oxymetazoline(Afrin): spray

• pseudoephedrine(Sudafed): oral

Decongestant Med side effects

• CNS excitation

• Cardiovascular: vasoconstriction

• rebound congestion if taking longer than 5 days

• Drowsiness

• Dizziness

Decongestant Med interactions

• Beta blockers: vasoconstriction vs vasodilation

• MAOIs: prevent breakdown of med causing vasoconstriction

• caffeine: CNS excitation

Intranasal Glucocorticoids

• treat allergies

• Decrease symptoms through anti-inflammatory action

Intranasal Glucocorticoids side effects

• headache

• nasal irritation

• pharyngitis

• fatigue, insomnia

Generally well tolerated

Intranasal Glucocorticoid Med

fluticasone(Flonase)

fluticasone(Flonase) instructions

• spray away from nasal septum

• sniff gently

• effects may take 1-3 weeks

Antitussives

• help make a non-productive cough into a productive cough

Antitussive Meds

• opioid: codeine

• non-opioid: dextromethorphan (robitussin)

Antitussives side effects

• dizziness

• drowsiness

• confusion

• fatigue

• n/v

• restlessness

Expectorants

• Loosens bronchial secretions

• allows for elimination by coughing

Expectorant Med

guaifenesin(Mucinex)

guaifenesin(Mucinex) side effects

• drowsiness

• dizziness

• HA

• nausea

Generally well tolerated

guaifenesin(Mucinex) patient teaching

• take with full glass of water and use a humidifier