NSG 1721 Pharmacology: Upper Respiratory Drug Classes

Comprehensive review flashcards covering upper respiratory tract anatomy, conditions, and respiratory drug classes including antihistamines, antitussives, decongestants, expectorants, topical steroidal decongestants, and mucolytics.

What anatomical structures comprise the upper respiratory tract?

Nose and Nasal Cavity, Sinuses, Pharynx, Larynx, Trachea, and Bronchi.

What common upper respiratory tract conditions are listed in the lecture?

The Common Cold, Seasonal Rhinitis, Sinusitis, Pharyngitis, and Laryngitis.

What are example drugs in the antihistamine class?

Diphenhydramine (Benadryl) and hydroxyzine (Vistaril).

What is the pharmacodynamic action of antihistamines?

They block histamine at H1 receptors, inhibit smooth muscle constriction in blood vessels and the respiratory and GI tracts, and decrease capillary permeability, salivation, and tear formation.

What are the indications or clinical purposes for antihistamines?

Seasonal and perennial allergic rhinitis, allergic conjunctivitis, uncomplicated urticaria, and angioedema.

What adverse reactions are associated with antihistamines?

Sedation (first generation drugs), anticholinergic effects, gastrointestinal effects (nausea/vomiting), and a paradoxical effect of excitation in children.

What are the primary nursing considerations for antihistamines?

Take as directed, avoid allergens, and avoid alcohol or CNS depressants due to sedation.

What are example antitussive medications and what is their clinical purpose?

Codeine, hydrocodone, and dextromethorphan; their purpose is to control nonproductive cough.

What is the mechanism of action of antitussives?

They act directly on the medullary cough center of the brain to depress the cough reflex.

What adverse reactions and nursing considerations are associated with antitussives?

Reactions include CNS effects (sedation and dizziness) and mild gastrointestinal effects. Considerations include taking as directed, administering undiluted, avoiding alcohol due to CNS depression, and using with caution in patients with respiratory disease or those taking monoamine oxidase inhibitors (MAOIs).

What is an example of a decongestant and how does it work?

Pseudoephedrine; it shrinks the nasal mucous membrane by stimulating the alpha-adrenergic receptors in the nasal mucous membranes to promote sinus drainage and improve airflow.

What adverse reactions and nursing considerations are associated with decongestants?

Reactions include cardiovascular stimulation and rebound congestion with the nasal route. Nursing considerations include avoiding prolonged use $> 7\,\text{days}$, using cautiously with cardiovascular disease, and maintaining hydration ($2\text{--}3\,\text{liters/day}$).

What is an example of an expectorant and what are its actions and purposes?

Guaifenesin (Mucinex); it increases productive cough to clear airways, liquefies lower respiratory tract secretions, and reduces secretion viscosity for cough suppression and loosening respiratory tract mucus.

What reactions and nursing considerations are associated with expectorants?

Reactions include increased drowsiness in large doses and GI effects (nausea, vomiting, diarrhea). Considerations include no eating or drinking for $30\,\text{minutes}$ after syrup, encouraging coughing and deep breathing, and maintaining hydration ($2\text{--}3\,\text{liters/day}$).

What are example topical steroidal decongestants, their action, and their primary indication?

Beclomethasone (Beclovent), budesonide (Pulmicort), and fluticasone (Flovent); they suppress inflammatory and immune responses and are indicated for seasonal allergic rhinitis.

What adverse reactions and nursing teaching points are associated with topical steroidal decongestants?

Reactions include hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis. Nursing considerations focus on patient teaching regarding proper administration and mouth rinsing.

What is an example of a mucolytic, what is its action, and what are its clinical indications?

Acetylcysteine (Mucomyst); it breaks down thick mucous and aids in coughing up thick, tenacious secretions. Indications include difficulty coughing up secretions, development of atelectasis, and treatment as an antidote for acetaminophen overdose.