chapter 31, nasal congestion and cough PHARM

what is a common respiratory disorder?

the common cold, which usually effects the upper respiratory tract

what makes up the upper respiratory tract?

mouth, nose, pharynx, larynx, trachea

what kind of infection is the common cold?

viral infection, antibiotics don't work

How many occurrences of the common cold are typical in adults vs children per year?

~2 to 4 occurrences a year in adults

~ up to 10 occurrences a year for school children

how do viruses invade?

via mucous membranes

how long can viruses survive and where

can survive several hours on SKIN and HARD SURFACES

what is sinusitis

- inflammation of the paranasal sinuses

- fluid and microbe movement via cilia impeded because of nasal swelling

- impairment of movement results in infection

- Happens when the lining of the sinus cavities becomes inflamed or infected.

What is the most common cause of sinusitis?

Rhinitis aka runny nose

What are the common respiratory disorder signs and symptoms

- nasal congestion

-cough

-increased sections

what is a productive cough

cough with mucous

what is a nonproductive cough

non mucous, dry cough

Why is coughing and deep breathing important after surgery

To help mobilize secretions, even if the cough is non-productive

What meds are nasal decongestants

- pseudoephedrine

- oxymetazoline

what is the pharmacokinetics of pseudoephedrine

its an oral med that causes a lot of vasoconstriction

What is pharmacokinetics of oxymetazoline

-its a nasal spray

- less systemic effects

- only use for 3-5 days

- better for pts with HTN and CAD

what is the action of nasal decongestants (pseudoephedrine + oxymetazoline)

- relieve nasal obstruction and discharge by producing vasoconstriction

- helps decrease the size of nasal blood vessels to help you breathe

-stimulates the sympathetic nervous system

what are the contraindications of nasal decongestants (pseudoephedrine + oxymetazoline)

- severe HTN

- CAD

- narrow angle glaucoma

- antidepressants

What are the nursing considerations for nasal decongestants? (pseudoephedrine + oxymetazoline)

- may take with or without food

- monitor for cardiac side effects

- DO NOT crush extended release tablets

what is the patient teaching of nasal decongestants (pseudoephedrine + oxymetazoline)

- encourage adequate fluid intake

-humdiifcation

- do not take longer than package recommendation; can cause rebound congestion

- proper use of nasal spray

Which med is an antitussive

Dextromethorphan

What is the use of dextromethorphan (antitussive)

-suppresses dry cough

- hacking

-nonproductive cough

what are centrally acting antitussives

- include narcotic and nonnarcotics (codeine)

- acts on the whole body system

- ex: traditional cough syrup

What are locally acting antitussives?

-throat lozenges,

-cough drops

What are nursing considerations for antitussives?

- administration: NPO for 30 minutes after liquid

- drug to drug interactions with many antidepressants

patient teaching with antitussives

- encourage adequate fluid intake

- humidification

- do not take longer than 1 week without seeing a doctor

- avoid accidental overdose

which med is an expectorant

Guaifenesin

what is the use for expectorants ( Guaifenesin)

-liquefy respiratory secretions, allowing for easier removal

- use if you have a productive cough only

Nursing Considerations for Expectorants (Guaifenesin)

- do not crush or chew extended release tablets

- no major side effects besides allergies

Patient Teaching for Expectorants- guaifenesin:

- encourage adequate fluid intake

- humidification

- do not take longer than 1 week without seeing doctor

- avoid accidental overdose

- encourage coughing and deep breathing

which med is a mucolytic

acetylcysteine

what is the action of acetylcysteine (mucolytic)

-liquefy mucus in respiratory tract

- administered by inhalation

what is the use of acetylcysteine (mucolytic)

- used to clear airways in chronic lung disease

- ex: cystic fibrosis and severe asthma

- use with patients with productive cough only

- similar to expectorants; used in chronic respiratory issues

what are the nursing considerations for acetylcysteine

-can be given via different routes depending on drug use

-also an antidote to acetaminophen overdose

- monitor for airway clearance after administration

- have suction equipment available

- remove residue acetylcysteine off patient's face after treatment

patient teaching for acetylcysteine

-encourage adequate fluid intake

- encourage deep breathing and coughing

OTC cold remedies

- take within the first 24 hours

- many contain antihistamine, nasal decongestants, and analgesic

- some contain antitussives, expectorants, etc

-pseudoephedrine being replaced by phenylephrine; less potent, better for pts w/ cardiac issues and glaucoma