Respiratory Meds

Acetylcysteine Mucomyst Classification

mucolytic → breaks up mucus into smaller pieces

Acetylcysteine Mucomyst Action

breaks up linkages of mucoprotein molecule secretions into smaller pieces

most effective at pH of 7-9

inhaled via nebulizer

Acetylcysteine Mucomyst ADR

few

some N/V due to odor from sulfur particles

stomatitis, rhinorrhea

bronchospasm may occur in asthmatics

Acetylcysteine Mucomyst Info

has unpleasant rotten odor due to sulfur

wash face after nebulizer to remove sticky coating left by drug

oral or IV given for acetaminophen overdose

Robitussin Classification

expectorant and bronchomucotropic (increases secretions)

aka: guaifenesin

Robitussin Action

direct irritation of gastric mucosa resulting in gastropulmonary reflex action

causes increased volume and viscosity (watery) respiratory secretions

Robitussin ADR

rare with occasional GI irritation

Robitussin Info

hydration is very important with an expectorant

Epinephrine Classification

sympathomimetic (non-selective), bronchodilator

Epinephrine Action

stimulates alpha, beta 1, and beta 2 receptors

alpha → mediates vasoconstriction to reduce mucosal edema (also raises BP)

beta 1 → increases HR and cardiac irritability

beta 2 → bronchodilator

Epinephrine ADR

nervousness, tremors, and fear

insomnia

tachycardia and palpitations 

headache and dyspnea 

Epinephrine Info

NEVER given orally

caution with CAD, HTN, or hyperthyroidism

if MAO inhibitors used it will worsen HTN

Isoproterenol Classification 

sympathomimetic non-selective beta stimulatory 

bronchodilator 

Isoproterenol Action

stimulates both beta 1 and 2 receptors (heart and lungs)

never given orally

Isoproterenol ADR

tachycardia and palpitations

headache, nausea, tremors, insomnia,

the more its used the less effective it is

Isoproterenol Info

one of the most powerful bronchodilators 

Albuterol Classification

bronchodilator

sympathomimetic selective beta 2

Albuterol Action

beta 2 stimulation causing relaxation of smooth muscles and bronchodilation

does have beta 1 action in high doses

Albuterol ADR

few 

peripheral dilation can cause hypotension causing tachycardia 

tinnitus at high doses 

Albuterol Info

inhaled short acting beta 2 agonist or SABA

lasts longer than epinephrine but onset is slower

use with caution with diabetes, HTN, or cardiac issues

a rescue inhaler

Atrovent Classification

anticholinergic bronchodilator

inhaled short acting muscarinic antagonist (SAAMA)

Atrovent Action

blocks cholinergic receptors and reduces bronchial tone 

used as maintenance therapy for prevention 

Atrovent ADR

few like dry mouth or pharyngeal irritation

Theophylline Classification

bronchodilator

methylated xanthine

Theophylline Action

relaxes smooth muscle, stimulates the heart, CNS, and renal excretion

stimulates medullary respiratory center

Theophylline ADR

GI → anorexia, N/V (vomiting center), abdominal pain

CNS → nervousness, insomnia, irritability, HA, convulsions, and coma

CV → tachycardia, hypotension, arrhythmias

renal → urinary frequency 

Theophylline Info

half life in smokers is shorter

take with food to reduce GI issues

Cromolyn Sodium Classification

antiallergic histamine inhibitor

Cromolyn Sodium Action

PREVENTS release of histamine

stabilizes membrane of mast cells that burst and release histamine

Cromolyn Sodium ADR

throat irritation 

Cromolyn Sodium Info

used for asthma prophylaxis and not used for acute attacks

comes in metered dose inhalers (MDI), powder driven, nasal spray, or eye drops

teach to rinse mouth after inhaled

effective in children

can prevent exercise induced asthma attack

Accolate Classification

leukotriene receptor antagonist

Accolate Action

competes for leukotriene receptors to block inflammatory response

don’t take with food because it prevents absorption

Accolate ADR

headache and elevated liver function tests (ALT, AST) 

Accolate Info

used as maintenance therapy for asthma and not for acute attacks

if given with warfarin caused elevated PT and given with aspirin elevates platelets

take before or after meals not during

Beclomethasone Classification

inhaled corticosteroid

Beclomethasone Action

suppresses antibody formation

blocks enzymes that produce inflammatory mediators in tissues

Beclomethasone ADR

hoarseness, dry mouth, thrush

Beclomethasone Info

can have some systemic absorption which produces steroid response in body 

most effective long term control treatment for COPD and asthma 

rinse mouth after use 

DM Classification

antitussive non-opioid

DM Action

central action to suppress cough center in brain

no analgesic or addictive properties

DM ADR 

infrequent

GI distress or drowsiness 

DM Info

synthetic opioid derivative totally devoid of analgesic or respiratory depressant effects

effectiveness is being questioned

Sudafed Classification

decongestant

Sudafed Action

stimulates both alpha and beta receptors directly and releases NE

alpha → vasoconstriction to reduce swelling (less than epi)

bronchodilator (less than epi)

Sudafed ADR

minimal like tachycardia and flushing and palpitations

Sudafed Info

avoid taking near bedtime due to stimulant effects

Benadryl Classification

antihistamine (H1 blocking drug)

Benadryl Action

competes with histamine for its receptor and prevent its action

prevents smooth muscle response 

inhibits vasoconstriction 

prevents edema 

doesn’t inhibit gastric secretions 

has sedative effects 

Benadryl ADR

rarely serious and often disappear with continued use

sedation and dizziness

loss of appetite, N/V

urinary frequency, palpitations, hypotension

tingling and weakness of hands

allergic manifestations may occur like dermatitis

Benadryl Info

don’t take with alcohol bc it enhances sedative

tolerance can occur

often used as a hypnotic for kids