[ATI Pharm Study Guide] Upper Respiratory & Airflow Disorders (copy)

Antitussives: Opioids Codeine (Upper Respiratory)

Ther use: nonproductive cough to decrease frequency and intensity

Complications: dizziness, lightheadedness (change positions slowly), drowsiness, resp depression, nausea, vomiting, constipation, opioid use disorder (advise of potential for abuse)

Expectorants Guaifenesin (Upper Respiratory)

Ther use: Thin mucous secretions

Complications: GI distress, drowsiness, allergic reaction (rash)

Nursing admin: increase fluid intake when taking guaifenesin, in order to promote liquifying secretions

Mucolytics Acetylcysteine (Upper Respiratory)

Ther use: chronic pulmonary disorders exacerbated by large amounts of secretions. CYSTIC FIBROSIS

Acetylcysteine is the antidote for acetaminophen poisoning

Complications: bronchospasm (use cautiously with asthma), nausea, vomiting, rash

Nursing admin: smells like rotten eggs

Decongestants Phenylephrine/Pseudoephedrine (Upper Respiratory)

Ther use: rhinitis, decongestant for clients with sinusitis or common cold

Complications: rebound congestion, agitation, nervousness, palpitations

Antihistamines Diphenhydramine/Loratadine (Upper Respiratory)

Ther use: mild allergic reactions, motion sickness

Complications: sedation, anticholinergic effects

Nasal Glucocorticoids Mometasone (Upper Respiratory)

Pharm action: decrease inflammation associated with allergic rhinitis

Ther use: Rhinitis

Complications: sore throat, h/a, burning in the nose

Beta-adrenergic agonists (Albuterol - Short acting, prevention of asthma episode/Salmeterol -Long acting, long term control of asthma) (Airflow Disorders)

Complications (for both): tachycardia, angina, tremors

Nursing admin: If has a script for both beta-adrenergic agonist and steroid inhale beta-adrenergic agonist FIRST. Beta-adrenergic agonist promotes bronchodilation and enhances absorption of the steroid. Ensure the clients know the dosage schedule if the med is to be taken on a fixed schedule or a PRN basis.

Methylxanthines Theophylline (Airflow Disorders)

Complications: GI distress, dysrhythmias, and seizures

Nursing admin: monitor serum levels

Inhaled anticholinergics (Airflow Disorders)

Ther use: COPD, Allergen-induced and exercise-induced bronchospasm

Complications: dry mouth, hoarseness

Nursing admin: rinse mouth after inhalation to decrease unpleasant taste, usually adult dose is 2 puffs, wait length prescribed amount of time between puffs, wait 5 min between medications.

Glucocorticoids Beclomethasone (inhalation) (Airflow Disorders)

Purpose: prevent inflammation, long-term prophylaxis of asthma

Complications: hoarseness, candidiasis – advise client to rinse mouth or gargle with water after use, monitor for redness, sores, or white patches and report to provider if they occur. Treat candidiasis with nystatin oral suspension.

Glucocorticoids Prednisone (oral) (Airflow Disorders)

Complications: suppression of adrenal gland function (taper dose), bone loss – perform wt. bearing exercises/consume efficient calcium and vit D, hyperglycemia – DM patients monitor BG/ may need to increase insulin dosage, myopathy – muscle weakness, peptic ulcer disease, infection, hypokalemia

IF CLIENT IS ON LONG-TERM ORAL THERAPY, ADDITIONAL DOSES OF ORAL STEROIDS ARE REQUIRED IN TIEMS OF STRESS, INFECTION, OR TRAUMA

Leukotriene Modifiers Montelukast/Zafirlukast (Airflow Disorders)

Ther use: long-term therapy of asthma in adults and children, and to prevent exercise induced bronchospasm

Complications: depression, suicidal ideation,

Nursing admin: take once daily at bedtime, take 2 hr before exercise.