Respiratory System Medications

hydrocodone drug class

opioid antitussives

hydrocodone therapeutic uses

chronic, nonproductive cough

hydrocodone complications

CNS: dizziness, drowsiness, respiratory depression

GI: NV, constipation

dependence

hydrocodone contraindications/precautions

contraindications: respiratory depression, acute asthma, acute EtOH use, liver/renal dx

cautions: children/older adults; hx SUD

hydrocodone interactions

CNS depressants

hydrocodone MoA

increased cough threshold; decreased frequency and intensity of cough

dextromethorphan drug class

non-opioid antitussive

dextromethorphan therapeutic uses

cough suppression

dextromethorphan complications

mild nausea, dizziness, sedation

potential for misuse

dextromethorphan contraindciations/precautions

generally safe

dextromethorphan interactions

MAOI: fever

dextromethorphan MoA

suppresses cough through altering cough center in CNS

guaifenesin drug class

expectorants

guaifenesin therapeutic uses

cough r/t cold, rhinitis, lower respiratory disorders

guaifenesin complications

GI upset

drowsiness, dizziness

allergic rash

guaifenesin contraindications/precautions

caution in asthma

guaifenesin interactions

generally safe

guaifenesin MoA

promoted increased cough production by increased and thinning mucous secretions

acetylcysteine drug class

mucolytic

acetylcysteine therapeutic uses

large secretions d/t acute and chronic respiratory dx, cystic fibrosis, antidote to acetaminophen

acetylcysteine complications

aspiration, bronchospasm

dizziness, drowsiness, hypotension, tachycardia

hepatotoxicity

smells like rotten eggs…

acetylcysteine contraindications/precautions

cautions: hypothyroidism, CNS depression, renal/liver dx, seizure dx, asthma

acetylcysteine interactions

acetaminophen

phenylephrine drug class

decongestant

phenylephrine therapeutic uses

rhinitis, sinusitis, common cold

phenylephrine compilations

rebound congestion: limit use to 3 - 5 days

CNS stimulation

vasoconstriction

misuse

phenylephrine contraindications/precaution

cautions: HTN, CAD, stroke, dysrhythmias

phenylephrine interactions

CNS stimulators

phenylephrine MoA

sympathomimetic decongestants stimulate alpha 1 adrenergic receptors → decreased inflammation of nasal membranes

diphenhydramine drug class

1st gen H₁ antagonist

diphenhydramine therapeutic uses

allergic rxn, anaphylaxis, motion sickness, insomnia

diphenhydramine complications

sedation

anticholinergic effects

GI upset

toxicity: excitation, hallucinations, incoordination, seizures

diphenhydramine contraindications/precautions

cautions: seizure dx, asthma; dx w/ anticholinergic concerns

diphenhydramine interactions

CNS depressants

anticholinergics

diphenhydramine MoA

inhibits histamine release in small blood vessels, capillaries, and nerves during allergic rxn

• relieve itching, sneezing, rhinorrhea

• does NOT relieve nasal congestion

• first gen causes anticholinergic effects and drowsiness

loratadine drug class

2nd gen H₁ antagonist

loratadine therapeutic uses

allergic rxn, anaphylaxis, motion sickness, insomnia

loratadine complications

mild anticholinergic effects

GI upset

toxicity: excitation, hallucinations, incoordination, seizures

loratadine contraindications/precautions

cautions: seizure dx, asthma; dx w/ anticholinergic concerns

loratadine interactions

anticholinergics

loratadine MoA

inhibits histamine release in small blood vessels, capillaries, and nerves during allergic rxn

• relieve itching, sneezing, rhinorrhea

• does NOT relieve nasal congestion

mometasone drug class

nasal glucocorticoid

mometasone therapeutic uses

allergic rhinitis, sinusitis

mometasone complications

sore throat

nosebleed

HA

burning in nose

mometasone contraindications/precautions

generally safe

mometasone interactions

generally safe

mometasone MoA

decreased inflammation d/t allergic rhinitis

• 1st line treatment for nasal congestion

albuterol drug class

B₂ adrenergic agonist

albuterol therapeutic uses

short-acting treatment of bronchospasm and asthma

albuterol complications

tachycardia, angina

tremors

albuterol contraindications/precautions

contraindications: tachydysrhythmias

cautions: DM, hyperthyroidism, heart disease, HTN, angina

albuterol interactions

B-adrenergic blockers

MAOIs, TCAs

albuterol nursing considerations

shake MDI and prime before use

if contains inhaled steroid, rinse mouth after use to avoid oral infection

theophylline drug class

methylxanthine

theophylline therapeutic uses

control and management of chronic asthma or COPD

theophylline complications

toxicity

• GI distress

• restlessness

• dysrhythmias

• seizures

theophylline contraindications/precautions

cautions: heart disease, seizure hx, HTN, DM, renal/hepatic dysfunction

theophylline interactions

caffeine

P450 inducers/inhibitors

• phenobarbital, phenytoin, rifampin

• ciprofloxacin

theophylline nursing considerations

not used very often d/t adverse effects

requires blood level monitoring for long-term control

theophylline MoA

relaxation of smooth muscles in bronchioles → bronchodilation

ipratropium drug class

inhaled anticholinergic

ipratropium therapeutic uses

bronchospasms d/t COPD

• off-label use for asthma

ipratropium complications

anticholinergic effects

• dry mouth, hoarseness

ipratropium contraindications/precautions

contraindications: allergy to soy or peanuts

cautions: disorders impacted by anticholinergics

ipratropium interactions

anticholinergics

ipratropium nursing MoA

blocks muscarinic receptors in the bronchi → bronchodilation

ipratropium nursing considerations

DO NOT SWALLOW CAPSULES…THEY ARE FOR INHALATION

dry mouth: chew sugarless gum/candy

prednisone drug class

glucocorticoid

prednisone therapeutic uses

short-term oral therapy for acute asthma exacerbation

• COPD

prednisone complications

adrenal gland suppression

bone loss, myopathy

hyperglycemia

infection

PUD

fluid and electrolyte imbalances

prednisone contraindications/precautions

cautions: DM, HTN, HF, PUD, osteoporosis, kidney dysfunction

prednisone interactions

K+-wasting diuretics

NSAIDs

hypoglycemic agents

prednisone nursing considerations

route of admin

• inhaled: beclomethasone, budesonide, fluticasone

• PO: prednisone, prednisolone

• IV: hydrocortisone, methylprednisolone

use of oral prednisone should not exceed 10 days…TAPER

hypokalemia

fluid retention and wt +

zafirlukast drug class

leukotriene modifier

zafirlukast therapeutic uses

long-term control of asthma

• exercise-induced asthma

zafirlukast complications

depression, SI

• montelukast

hepatic injury

zafirlukast contraindications/precautions

cautions: liver disease

zafirlukast interactions

warfarin

theophylline

zafirlukast MoA

suppress effects of leukotrienes → decreased inflammation, bronchoconstriction, airway edema, mucus production