# data[].attributes.body
act directly on medullary cough center to suppress cough reflex

# data[].attributes.body
control nonproductive cough

# data[].attributes.body
drying of mucous membranes
GI upset
CNS effects
potential for abuse

# data[].attributes.body
- drug-to-drug interactions with MAOIs
- contraindicated in patients that need to cough to maintain airway, head injuries, CNS impairments & used cautiously in patients with hx of narcotic addiction

# data[].attributes.body
dextromethorphan

# data[].attributes.body
topical nasal decongestants: decrease blood flow to upper respiratory tract, thus decreases overproduction of secretions through vasoconstriction (decreased inflammation & edema)

oral decongestants: shrink nasal mucous membranes by stimulating alpha-adrenergic receptors directly on nasal mucous membranes

# data[].attributes.body
drainage of sinuses & improvement of airflow

# data[].attributes.body
rebound congestion
sympathetic effects (oral decongestants) *monitor for increased HR & BP

# data[].attributes.body
topical nasal decongestants:
- limit use to 3-5 days to prevent rebound congestion
- contraindicated in pts with lesions or erosion in mucous membranes

oral decongestants:
- avoid OTC medications also containing psuedoephedrine
- exacerbate hyperthyroidism, diabetes mellitus, & BPH
- obtain baseline breath sounds, BP, & pulse

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selectively block histamine from binding to H1 receptors to decrease allergic response

# data[].attributes.body
angioedema
seasonal allergies/rhinitis
uncomplicated urticaria
allergic conjunctivitis

# data[].attributes.body
drowsiness & sedation (more with first generation)
anticholinergic effects

# data[].attributes.body
- contraindicated in renal or hepatic impairments & history of arrhythmias
- assess cardiac for prolonged QT interval
- assess kidney & liver functions
- monitor baseline skin & respiratory sounds

# data[].attributes.body
psuedoephedrine

# data[].attributes.body
first generation: diphenhydramine (Benadryl)
second generation: loratidine (Claritin)

# data[].attributes.body
enhances output of upper respiratory tract fluids by decreasing adhesiveness & surface tension of secretions to enhance movement of less viscous secretions

# data[].attributes.body
symptomatic relief of respiratory disorders associated with a dry, nonproductive cough

# data[].attributes.body
GI symptoms, headaches, rash
prolonged use may mask underlying disorder

# data[].attributes.body
- assess for persistent cough d/t smoking, emphysema, COPD, asthma (may be an underlying condition)
- obtain baseline breath sounds & monitor for adventitious sounds

# data[].attributes.body
guaifenesin (Mucinex or Robitussin)

# data[].attributes.body
liquify upper respiratory secretions to aid the clearing of the airway

# data[].attributes.body
patients who...
- have difficulty coughing up secretions
- have atelectasis
- are about to go into a bronchoscopy
- are post-op with tracheostomies

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bronchospasm, GI upset, rhinorrhea, stomatitis, rash

# data[].attributes.body
- use cautiously in patients with bronchospasm, esophageal varices, peptic ulcers, & asthma

# data[].attributes.body
acetylcysteine

# data[].attributes.body
direct effect on smooth muscles of the respiratory tract both in the bronchi & blood vessels

# data[].attributes.body
symptomatic relief/prevention of bronchial asthma & bronchospasm associated with COPD
Asthma
Chronic bronchitis
Emphysema

# data[].attributes.body
conditions exacerbated by xanthines:
CAD
respiratory dysfunction
renal or hepatic disease
alcoholism
hyperthyroidism

# data[].attributes.headline
Adverse Effects + Serum Levels of Theophylline

# data[].attributes.subject
Adverse Effects + Serum Levels of Theophylline

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<20: uncommon
<20-25: N/V, diarrhea, insomnia, headache, irritability
>30-35: hyperglycemia, hypotension, arrhythmias, tachycardia, seizures, brain damage, death

# data[].attributes.body
- monitor theophylline therapeutic levels (10-20 mcg/mL)
- can be used in children but usually used as a last resort d/t adverse reactions
- avoid caffeine (can increase theophylline levels & cardiac effects)
- monitor for neuro effects
- drug-to-drug interaction:
CYP1A2 inhibitors increase concentration of xanthines (decrease metabolism)
CYP1A2 inducers decrease concentrations of xanthines (increase metabolism)

# data[].attributes.body
aminophylline
theophylline

# data[].attributes.body
mimic effects of the sympathetic NS responsible for dilation of bronchi with increased rate & depth of respirations

# data[].attributes.body
1. short acting (SABA)
2. long acting (LABA)

# data[].attributes.body
acute asthma attack *rescue inhaler
bronchospasm
prevention of exercise-induced asthma

# data[].attributes.body
Tachycardia
Tremors
Terrible sleep/tossing
hypertension & bronchospasm with LABA

# data[].attributes.body
- contraindicated in severe cardiac or vascular disease, arrhythmias, diabetes, & hyperthyroidism
- SABA: drugs of choice for fast relief of symptoms in asthmatic patients
- LABA: black box warning with increased risk of asthma-related deaths *recommended to take inhaled corticosteroid to prevent bronchospasm adverse fx

# data[].attributes.body
SABA: albuterol & epinephrine
LABA: salmeterol (Serevent Diskus)

# data[].attributes.body
blocks vagally mediated reflexes by antagonizing action of acetylcholine so they inhibit muscarinic effects & result in bronchodilation

# data[].attributes.body
maintenance treatment of bronchospasm associated with COPD
patients who cannot tolerate sympathetic effects of beta-2 agonists

# data[].attributes.body
dizziness, fatigue, headache, blurred vision, urinary retention, dry mouth, palpitations

# data[].attributes.body
- assess for acute bronchospasm, BPH, urinary retention, narrow angle glaucoma
- contraindicated in BPH & narrow angle glaucoma
- know baseline pulse & BP

# data[].attributes.body
ipatropium

# data[].attributes.body
1. decrease inflammatory response in airway
2. promote beta adrenergic receptor activity

# data[].attributes.body
selectively antagonize receptors for the production of leukotrienes

# data[].attributes.body
prevention & treatment of asthma
maintenance therapy for chronic bronchial asthma

# data[].attributes.body
inhaled corticosteroids: sore throat, hoarseness, coughing, dry mouth, thrush

# data[].attributes.body
inhaled corticosteroids:
- NOT used for emergency during acute attack or status asthmaticus
- use cautiously if there is an active infection of the respiratory system

oral glucocorticoids:
Bone mineral density decreases, brings Ca down, elevates BP
Rinse mouth to decrease thrush
Edema, electrolytes onitor
Anti-inflammatory
Taper dose
Hypokalemia
Infection (increases WBCs & risk of infection)
Glucose will increase, GI effects

# data[].attributes.body
inhaled corticosteroid: budesonide

oral glucocorticoid: prednisone

# data[].attributes.body
prophylaxis & chronic treatment of bronchial asthma in adults & children < 5 y/o

# data[].attributes.body
headache, dizziness, myalgia, elevated liver enzymes, N/V

# data[].attributes.body
- drug-to-drug interactions with: propranolol, theophylline, & warfarin
- continue to take even when symptom free
- use cautiously in hepatic or renal impairment
- monitor liver function tests
- give before meals

# data[].attributes.body
lukast

# data[].attributes.body
works at cellular level to inhibit release of histamine & inflammatory mediators

# data[].attributes.body
treatment of chronic bronchial asthma
exercise induced asthma
allergic rhinitis

# data[].attributes.body
pharyngeal & tracheal irritations, cough, wheezing, bronchospasm, headache