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DIPHENHYDRAMINE
1ST generation antihistamine.
CETIRIZINE
2ND generation antihistamine.
FEXOFENADINE
2ND generation antihistamine.
LORATADINE
2ND generation antihistamine.
OXYMETAZOLINE HYDROCHLORIDE
Nasal decongestant.
EPHEDRINE
Systemic decongestant.
PHENYLEPHRINE
Systemic decongestant.
PSEUDOEPHEDRINE
Systemic decongestant.
BUDESONIDE
Intranasal glucocorticoid.
FLUTICASONE
Intranasal glucocorticoid.
TRIAMCINOLONE
Intranasal glucocorticoid.
HYCODAN
Narcotic antitussive.
GUAIFENESIN & CODIENE
Expectorant antitussive combo.
BENZONATATE
Non-narcotic antitussive.
GUAIFENESIN
Expectorant.
ALBUTEROL
Short acting beta agonist (SABA).
LEVALBUTEROL
Short acting beta agonist (SABA), also known as Xopenex.
IPRATROPIUM
Short acting muscarinic antagonist (SAMA).
SALMETEROL
Long acting beta agonist (LABA), also known as Serevent.
FORMOTEROL
Long acting beta agonist (LABA), also known as Foradil.
TIOTROPIUM
Long acting muscarinic antagonist (LAMA), also known as Spiriva.
FLUTICASONE (Flovent)
Inhaled steroid.
BUDESONIDE (Pulmicort)
Inhaled steroid.
ALBUTEROL + IPRATROPIUM
Fixed combination (duoneb).
BUDESONIDE + FORMOTEROL
Fixed combination (Symbicort).
FLUTICASONE + SALMETEROL
Fixed combination (Advair).
FLUTICASONE + VILANTEROL + UMECLIDINIUM
Fixed combination (Trelegy).
THEOPHYLLINE
Methylxanthine.
MONTELUKAST
Leukotriene, also known as Singulair.
CROMOLYN NASAL
Mast cell stabilizer.
ACETYLCYSTEINE
Mucolytic, also known as Mucomyst.
RHINOVIRUS
Etiology of the common cold.
ACUTE RHINITIS
Inflammation of nasal mucous membranes, usually accompanies a cold.
ALLERGIC RHINITIS
Inflammation of mucous membranes of sinuses, also known as Hay Fever.
SINUSITIS
Inflammation of one of the sinuses, can be allergic, viral, or bacterial.
ACUTE PHARYNGITIS
Inflammation of the throat.
H1-BLOCKERS
Also known as H1 antagonists, used to block histamine release.
DIPHENHYDRAMINE (Benadryl)
First-generation H1-blocker that can cause drowsiness and anticholinergic side effects.
Second-generation antihistamines
Nonsedating antihistamines with fewer anticholinergic side effects.
Cetirizine
Brand name Zyrtec, a second-generation antihistamine.
Fexofenadine
Brand name Allegra, a second-generation antihistamine.
Loratadine
Brand name Claritin, a second-generation antihistamine.
Diphenhydramine
Brand name Benadryl, a first-generation antihistamine.
Nasal decongestants
Medications used to relieve nasal congestion.
Systemic decongestants
Examples include Ephedrine (Ephedrine), Pseudoephedrine (Sudafed), and Phenylephrine (Neo-Synephrine).
Allergic rhinitis
A condition treated primarily with decongestants, including hay fever and acute coryza (profuse nasal drainage).
Rebound congestion
A condition that may occur due to frequent use of nasal decongestants, requiring nasal corticosteroid treatment (rhinitis medicamentosa).
Intranasal glucocorticoids
Anti-inflammatory medications used to treat allergic rhinitis, with side effects including headache, epistaxis, and candidiasis.
Budesonide
Brand name Rhinocort, an intranasal glucocorticoid.
Fluticasone
Brand name Flonase, an intranasal glucocorticoid.
Triamcinolone
Brand name Nasacort, an intranasal glucocorticoid.
Guaifenesin
Brand name Mucinex, an expectorant that loosens tracheal secretions by reducing surface tension.
Expectorants
Medications used to treat dry, nonproductive cough by loosening mucus.
Antitussives
Medications that act on the cough-control center in the medulla to suppress the cough reflex.
Codeine derivatives
Examples include Hycodan (hydrocodone/homatropine) and guaifenesin and codeine (Robitussin AC).
Non-narcotic antitussives
Examples include Dextromethorphan (Delsym, Robitussin DM) and Benzonatate (Tessalon).
Nursing Process: Upper Respiratory Medications
A process to ensure patients understand how to utilize prescribed nasal decongestant spray.
Lower respiratory disorders
Disorders that lead to increased airway resistance.
Increased airway resistance
A condition that may be reversible depending on the underlying disease.
Chronic Obstructive Pulmonary Disease (COPD)
A progressive lung disease characterized by airway obstruction with increased airway resistance of airflow to lung tissues.
Major causes of COPD
Chronic bronchitis, emphysema, and asthma.
Structural diseases/lung damage in COPD
Decrease in total lung capacity due to fluid accumulation and loss of elasticity in the lungs.
Examples of structural diseases in COPD
Pulmonary fibrosis, pneumonitis, lung tumors, thoracic deformities (scoliosis), and myasthenia gravis.
Asthma
A condition associated with reversible lung tissue damage characterized by bronchoconstriction.
Early phase of asthma
IgE antibodies are produced after an exposure, leading to mast cell degranulation and inflammatory reaction.
Late phase of asthma
A new wave of inflammatory cells, including eosinophils and T-lymphocytes, leads to further reversible bronchoconstriction.
Asthma triggers
Factors contributing to bronchoconstriction.
Chronic Bronchitis
Defined as chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough have been excluded.
Symptoms of Chronic Bronchitis
Productive cough, hypoxemia, rhonchi, hypercapnia, and respiratory acidosis.
Emphysema
A progressive lung disease where increased mucous production and chronic inflammatory mediators lead to permanent damage to the airways.
Metered-Dose Inhaler (MDI)
A device used to deliver medication to the lungs, requiring specific steps for proper use.
Proper use of MDI
Insert the medication canister, shake well, place mouthpiece between teeth, seal lips, and take a slow deep breath while pressing the canister.
Self-administration of bronchodilator
Should be done first when taken at the same time as a steroid, waiting 5 minutes for optimal effect before using the steroid.
Reversible bronchoconstriction
Bronchoconstriction that can be alleviated with appropriate medications.
Inhalation technique with spacer
A spacer should be used to enhance medication delivery during inhalation.
Asthma exacerbation treatment
Medications used to reverse bronchoconstriction and decrease mucous production.
Inflammatory reaction in asthma
Histamine and prostaglandins are released leading to bronchoconstriction and increased mucosal production.
Chronic lung infections
One of the causes of chronic bronchitis.
Airway obstruction in COPD
Caused by bronchial inflammation and excessive mucus secretions.
Fluid accumulation in lungs
Contributes to the decrease in total lung capacity in COPD.
Bronchial inflammation
A key factor in the progression of both chronic bronchitis and emphysema.
Nebulizers
Devices that convert liquid medication into mist for inhalation.
Handihaler
A dry-powder capsule inhaler used for administering medication.
Bronchodilator
Medications that relax bronchial muscles to improve airflow.
Beta 2 Agonists
A class of bronchodilators that stimulate beta-2 adrenergic receptors.
SABA
Short Acting Beta Agonists used for treatment of acute symptoms.
LABA
Long Acting Beta Agonists used for prevention of symptoms.
Salmeterol (Serevent)
A long-acting beta agonist used to manage COPD and asthma.
Formoterol (Foradil)
A long-acting beta agonist used to manage COPD and asthma.
Albuterol (Proventil, Ventolin)
A short-acting beta agonist used to treat acute asthma symptoms.
Levalbuterol (Xopenex)
A short-acting beta agonist used for acute asthma exacerbation.
Anticholinergics
Bronchodilators that reduce bronchospasms and mucosal secretions.
Ipratropium (Atrovent)
A short-acting anticholinergic used for COPD management.
Tiotropium (Spiriva)
A long-acting anticholinergic used for maintenance treatment of COPD.
Methylxanthines
A class of bronchodilators that relax smooth muscle and increase cAMP.
Theophylline
A methylxanthine used for maintenance therapy in chronic asthma or COPD.
Therapeutic range for Theophylline
10 to 15 mcg/mL; toxicity greater than 20 mcg/mL.
Common side effects of bronchodilators
Dry mouth, pharyngitis, sinusitis, headache.
Fixed Combination Bronchodilators
Medications that combine different classes of bronchodilators.
Albuterol + Ipratropium
A fixed combination of a beta agonist and an anticholinergic.
