Respiratory System Drugs

What is the mechanism of action of albuterol?

Stimulates beta-2 receptors in lungs → bronchodilation

What are the indications for albuterol?

Asthma (short & long-term), COPD

What are the routes of administration for albuterol?

Inhaled (MDI, DPI), nebulizer, oral (rare)

What are the common adverse drug reactions (ADRs) of albuterol?

Tachycardia, palpitations, tremors, angina

What nursing actions should be taken when administering albuterol?

Monitor HR, assess chest pain, teach inhaler use

What are the instructions for using albuterol?

Use before steroids, wait 5 min between puffs, report chest pain, limit caffeine

What is a contraindication for albuterol?

Allergy

What precautions should be taken when using albuterol?

Cardiac disease, HTN, hyperthyroidism, diabetes, seizure disorders

What is the mechanism of action (MOA) of Theophylline?

Relaxes bronchial smooth muscle and provides CNS stimulation.

What are the indications for Theophylline?

Long-term management of asthma and COPD.

What are the common routes of administration for Theophylline?

Oral and IV (rare, emergency use).

What are some adverse drug reactions (ADRs) of Theophylline?

Restlessness, insomnia, GI upset, seizures, dysrhythmias (toxic levels).

What should be monitored when a patient is on Theophylline?

Drug levels (5-15 mcg/mL) and heart rate/rhythm.

What instructions should be given to patients taking Theophylline?

Avoid caffeine, report palpitations/seizures, take at the same time daily.

What are the contraindications for Theophylline?

Cardiac disease and seizure disorder.

What precautions should be taken when using Theophylline?

Liver disease and smoking alters metabolism.

What is the mechanism of action of Ipratropium?

Blocks muscarinic receptors → prevents bronchoconstriction

What are the indications for Ipratropium?

COPD, sometimes asthma

What are the routes of administration for Ipratropium?

Inhaled (MDI, nebulizer)

What are common adverse drug reactions (ADRs) of Ipratropium?

Dry mouth, hoarseness, urinary retention, ↑ IOP in glaucoma

What nursing assessments are important for Ipratropium?

Assess lung sounds, teach spacer use, rinse mouth

What instructions should be given to patients using Ipratropium?

Use regularly (not rescue), rinse mouth, wait 5 min before other inhalers

What are the contraindications for Ipratropium?

Peanut/soy allergy (older forms), glaucoma, BPH

What precautions should be taken when using Ipratropium?

Elderly, urinary retention

What are examples of glucocorticoids?

Prednisone, beclomethasone, fluticasone, budesonide

What is the mechanism of action of glucocorticoids?

Suppresses airway inflammation & mucus production

What are the indications for glucocorticoids?

Asthma prophylaxis, COPD exacerbations

What are the routes of administration for glucocorticoids?

Oral, inhaled, IV

What are the adverse drug reactions (ADRs) of oral glucocorticoids?

Adrenal suppression, osteoporosis, hyperglycemia, infection risk

What are the adverse drug reactions (ADRs) of inhaled glucocorticoids?

Oral candidiasis, hoarseness

What nursing considerations are important for glucocorticoids?

Taper slowly if systemic, monitor blood sugar & bone density, rinse mouth (inhaled)

What instructions should be given to patients taking glucocorticoids?

Use after bronchodilator, rinse mouth, take with food (oral), report infection

What are the contraindications for glucocorticoids?

Systemic fungal infections, live vaccines (systemic)

What precautions should be taken when using glucocorticoids?

PUD, diabetes, osteoporosis, immunosuppression

What is the mechanism of action (MOA) of Montelukast (Leukotriene Modifier))?

Blocks leukotriene receptors → ↓ inflammation, bronchoconstriction, mucus

What are the indications for Montelukast (Leukotriene Modifier)?

Asthma prophylaxis, exercise-induced bronchospasm, allergic rhinitis

What is the route of administration for Montelukast (Leukotriene Modifier)?

Oral (daily)

What are the common adverse drug reactions (ADRs) of Montelukast (Leukotriene Modifier)?

Headache, depression, suicidal ideation, ↑ liver enzymes (rare)

What nursing considerations are important for Montelukast (Leukotriene Modifier)?

Monitor behavior, monitor liver function

When should Montelukast (Leukotriene Modifier) be taken?

Once daily in the evening, not for acute attack

What is a contraindication for Montelukast Leukotriene Modifier)?

Liver disease

What precautions should be taken when prescribing Montelukast (Leukotriene Modifier) to children and teens?

Neuropsychiatric effects

What is the mechanism of action (MOA) of Mast Cell Stabilizers (Cromolyn)?

Prevents mast cell degranulation → inhibits histamine release

What are the indications for Mast Cell Stabilizers (cromolyn)?

Asthma prophylaxis, exercise-induced bronchospasm, allergic rhinitis

What are the routes of administration for Mast Cell Stabilizers (Cromolyn)?

Inhaled (nebulizer, MDI), nasal spray

What are the common adverse drug reactions (ADRs) of Mast Cell Stabilizers (Cromolyn?

Throat irritation, cough, bronchospasm (rare)

What is the mechanism of action of Diphenhydramine (Benadryl)?

H1 receptor antagonist (blocks histamine-mediated effects); has anticholinergic activity.

What are the indications for Diphenhydramine (Benadryl)?

Mild allergic reactions, seasonal allergies, urticaria/hives, motion sickness, insomnia (short term).

What are the routes of administration for Diphenhydramine (Benadryl)?

Oral, IM, IV, topical.

What are the common adverse drug reactions (ADRs) of Diphenhydramine (Benadryl)?

Drowsiness, dizziness, dry mouth, fatigue, urinary retention, blurred vision.

What nursing considerations should be taken when administering Diphenhydramine (Benadryl)?

Monitor gait/ambulation safety; give with food if GI upset; provide hard candy for dry mouth; monitor urinary output/voiding.

What instructions should be given to patients taking Diphenhydramine (Benadryl)?

Take at bedtime if causing drowsiness; avoid driving or hazardous tasks while sedated; take with food; report urinary retention or vision changes.

What are the contraindications for Diphenhydramine (Benadryl)?

Newborns/children <2 y (per slide), breastfeeding (caution), known hypersensitivity.

What precautions should be considered when using Diphenhydramine (Benadryl)?

Children, older adults, urinary retention/BPH, narrow-angle glaucoma, HTN, impaired liver or kidney function, asthma.

What interactions should be noted with Diphenhydramine (Benadryl)?

Alcohol and other CNS depressants — additive sedation.

What is cetirizine commonly known as?

Zyrtec

What class of medication is cetirizine (Zyrtec)?

2nd Generation antihistamine

What is the mechanism of action of cetirizine (Zyrtec)?

H1 receptor antagonist — blocks histamine effects with less CNS penetration than 1st-gen.

What are the indications for cetirizine (Zyrtec)?

Allergic rhinitis, seasonal allergies, urticaria.

What is the route of administration for cetirizine (Zyrtec)?

Oral.

What are common adverse drug reactions (ADRs) of cetirizine (Zyrtec)?

Drowsiness (less than 1st-gen), dizziness, dry mouth, fatigue (larger doses).

What nursing considerations should be taken when administering cetirizine (Zyrtec)?

Give with or without food; counsel on fluids & oral care; monitor for sedation in sensitive patients.

What instructions should be given to patients taking cetirizine (Zyrtec)?

May take with or without food; avoid additional antihistamines; avoid driving if drowsy.

What are the contraindications for cetirizine (Zyrtec)?

Infants/newborns (under 6 months), breastfeeding (caution), known hypersensitivity.

What precautions should be taken when prescribing cetirizine (Zyrtec)?

Impaired liver or kidney function — dose adjust as needed.

What interactions should be monitored when taking cetirizine (Zyrtec)?

Alcohol/CNS depressants; theophylline may reduce clearance (monitor).

What is the mechanism of action (MOA) of sympathomimetics (Phenylephrine)?

Activates α-adrenergic receptors in nasal vasculature, leading to vasoconstriction of engorged nasal mucosa and reduced congestion.

What are the indications for sympathomimetics (Phenylephrine)?

Nasal congestion (allergic rhinitis, common cold), topical formulations for local decongestion, and IV formulation for hypotension in some settings.

What are the routes of administration for sympathomimetics (Phenylephrine)?

Topical nasal, oral, and IV in hospital settings.

What are the common adverse drug reactions (ADRs) of sympathomimetics (Phenylephrine)?

CNS stimulation (agitation), increased blood pressure, tachycardia, possible rebound congestion with topical overuse, and overdose effects.

What nursing considerations are important for patients taking sympathomimetics (Phenylephrine)?

Monitor CNS status and BP/HR in patients at risk, limit duration of topical use, and educate about dependence and rebound congestion.

What instructions should be given to patients using sympathomimetics (Phenylephrine)?

Use only short term (usually ≤3-5 days for topical); report palpitations, chest pain, marked BP increase; follow dosing and taper instructions.

What are the contraindications for using sympathomimetics (Phenylephrine)?

Chronic rhinitis, narrow-angle glaucoma, and uncontrolled heart disease.

What precautions should be taken when using sympathomimetics (Phenylephrine)?

Caution in patients with coronary artery disease (CAD), hypertension (HTN), and older adults.

What drug interactions should be considered with sympathomimetics (Phenylephrine)?

MAOIs (risk of severe hypertension) and concomitant SABA/LABA may potentiate hypertension; monitor carefully.

What is the mechanism of action (MOA) of Codeine?

Codeine is an opioid agonist that suppresses the cough reflex centrally in the medulla.

What is the mechanism of action (MOA) of Dextromethorphan?

Dextromethorphan is a centrally acting antitussive related to NMDA.

What are the indications for Codeine and Dextromethorphan?

They are indicated for chronic nonproductive cough and sometimes for acute nonproductive cough.

What is the common route of administration for Codeine and Dextromethorphan?

Oral.

What are the adverse drug reactions (ADRs) associated with Codeine?

Drowsiness, dizziness, nausea, constipation, respiratory depression, and risk of misuse/abuse.

What are the adverse drug reactions (ADRs) associated with Dextromethorphan?

Drowsiness, dizziness, GI upset, and potential for misuse in high doses.

What nursing considerations are important when administering Codeine?

Monitor respiratory rate and depth; be ready to reverse opioid respiratory depression with naloxone; monitor for dizziness/falls; give with food if GI upset.

What instructions should be given to patients taking Codeine or Dextromethorphan?

Change positions slowly; take with food or milk if GI upset; remove environmental triggers; avoid driving while sedated; maintain hydration.

What are the contraindications for using Codeine and Dextromethorphan?

Known hypersensitivity, reduced respiratory reserve (severe COPD), and concurrent MAOI use.

What precautions should be taken when prescribing Codeine and Dextromethorphan?

Use with caution in children, older adults (increased sensitivity), and those with a history of substance misuse.

What are some significant drug interactions with Codeine?

MAOIs (serious), St. John's Wort (increased sedation risk), alcohol, and other CNS depressants (additive sedation).

What are some significant drug interactions with Dextromethorphan?

MAOIs (serious), alcohol, and other CNS depressants (additive sedation).

What is the mechanism of action (MOA) of Guaifenesin (Mucinex)?

Reduces surface tension of respiratory secretions → thins sputum so it is easier to expectorate.

What are the indications for using Guaifenesin (Mucinex)?

Productive cough to help mobilize secretions (upper respiratory infections).

What are the available routes of administration for Guaifenesin (Mucinex)?

Oral (tablets, liquids).

What are some common adverse drug reactions (ADRs) of Guaifenesin (Mucinex)?

Dizziness, drowsiness, headache, GI distress, allergic rash (rare).

What nursing considerations should be taken when administering Guaifenesin (Mucinex)?

Monitor for dizziness when changing positions; give with food and a full 8 oz of water; encourage fluids to help thin secretions; stop drug if rash occurs.

What instructions should be given to patients taking Guaifenesin (Mucinex)?

Do not drive if dizzy; sit/lie down if light-headed; take with 8 oz water; stop and report any rash.

What are the contraindications for using Guaifenesin (Mucinex)?

Known hypersensitivity; certain formulations contain aspartame (PKU), sugar (caution in DM), or alcohol (caution if on disulfiram) — check product label.

What precaution should be taken regarding cough duration when using Guaifenesin (Mucinex)?

Cough lasting >1 week — evaluate for underlying cause.

Are there any significant drug interactions with Guaifenesin (Mucinex)?

None significant (per slide).

What is the mechanism of action (MOA) of Acetylcysteine when inhaled?

It breaks disulfide bonds in mucoprotein, which thins secretions.

What is the mechanism of action (MOA) of Acetylcysteine when administered orally or IV?

It binds acetaminophen metabolites, serving as an antidote in overdose.

What are the indications for using Acetylcysteine?

Mucolytic therapy for thick secretions and acetaminophen overdose management.

What are the routes of administration for Acetylcysteine?

Inhaled nebulizer, oral, and IV.