Upper Respiratory (Purple) & Lower Respiratory (Blue & White) Meds by Riana Ramos

Mechanism of Action

rianasomar — 2021-11-03 17:31:08 UTC

act directly on medullary cough center to suppress cough reflex

Indications

rianasomar — 2021-11-03 17:33:28 UTC

control nonproductive cough

Adverse Effects

rianasomar — 2021-11-03 17:42:06 UTC

drying of mucous membranes
GI upset
CNS effects
potential for abuse

Nursing Considerations

rianasomar — 2021-11-03 17:43:07 UTC

- 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

Prototype

rianasomar — 2021-11-03 17:43:16 UTC

dextromethorphan

Mechanism of Action

rianasomar — 2021-11-03 17:43:43 UTC

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

Indications

rianasomar — 2021-11-03 17:44:41 UTC

drainage of sinuses & improvement of airflow

Adverse Effects

rianasomar — 2021-11-03 17:47:12 UTC

rebound congestion
sympathetic effects (oral decongestants) *monitor for increased HR & BP

Nursing Considerations

rianasomar — 2021-11-03 17:48:15 UTC

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

Mechanism of Action

rianasomar — 2021-11-03 17:50:17 UTC

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

Indications

rianasomar — 2021-11-03 17:52:42 UTC

angioedema
seasonal allergies/rhinitis
uncomplicated urticaria
allergic conjunctivitis

Adverse Effects

rianasomar — 2021-11-03 17:53:13 UTC

drowsiness & sedation (more with first generation)
anticholinergic effects

Nursing Considerations

rianasomar — 2021-11-03 17:54:17 UTC

- contraindicated in renal or hepatic impairments & history of arrhythmias
- assess cardiac for prolonged QT interval
- assess kidney & liver functions
- monitor baseline skin & respiratory sounds

Prototype

rianasomar — 2021-11-03 17:55:02 UTC

psuedoephedrine

Prototype

rianasomar — 2021-11-03 17:55:33 UTC

first generation: diphenhydramine (Benadryl)
second generation: loratidine (Claritin)

Mechanism of Action

rianasomar — 2021-11-03 17:56:52 UTC

enhances output of upper respiratory tract fluids by decreasing adhesiveness & surface tension of secretions to enhance movement of less viscous secretions

Adverse Effects

rianasomar — 2021-11-03 17:57:20 UTC

GI symptoms, headaches, rash
prolonged use may mask underlying disorder

Indications

rianasomar — 2021-11-03 17:57:45 UTC

symptomatic relief of respiratory disorders associated with a dry, nonproductive cough

Nursing Considerations

rianasomar — 2021-11-03 17:58:45 UTC

- assess for persistent cough d/t smoking, emphysema, COPD, asthma (may be an underlying condition)
- obtain baseline breath sounds & monitor for adventitious sounds

Prototype

rianasomar — 2021-11-03 17:59:26 UTC

guaifenesin (Mucinex or Robitussin)

Mechanism of Action

rianasomar — 2021-11-03 17:59:58 UTC

liquify upper respiratory secretions to aid the clearing of the airway

Indications

rianasomar — 2021-11-03 18:00:43 UTC

patients who...
- have difficulty coughing up secretions
- have atelectasis
- are about to go into a bronchoscopy
- are post-op with tracheostomies

Adverse Effects

rianasomar — 2021-11-03 18:01:14 UTC

bronchospasm, GI upset, rhinorrhea, stomatitis, rash

Nursing Considerations

rianasomar — 2021-11-03 18:02:04 UTC

- use cautiously in patients with bronchospasm, esophageal varices, peptic ulcers, & asthma

Prototype

rianasomar — 2021-11-03 18:02:16 UTC

acetylcysteine

Mechanism of Action

rianasomar — 2021-11-03 18:33:48 UTC

direct effect on smooth muscles of the respiratory tract both in the bronchi & blood vessels

Indications

rianasomar — 2021-11-03 18:34:41 UTC

symptomatic relief/prevention of bronchial asthma & bronchospasm associated with COPD
Asthma
Chronic bronchitis
Emphysema

Adverse Effects

rianasomar — 2021-11-03 18:35:21 UTC

conditions exacerbated by xanthines:
CAD
respiratory dysfunction
renal or hepatic disease
alcoholism
hyperthyroidism

Nursing Considerations

rianasomar — 2021-11-03 18:37:22 UTC

- 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)

Adverse Effects + Serum Levels of Theophylline

rianasomar — 2021-11-03 18:38:39 UTC

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

Prototype

rianasomar — 2021-11-03 18:39:03 UTC

aminophylline
theophylline

Mechanism of Action

rianasomar — 2021-11-03 18:39:28 UTC

mimic effects of the sympathetic NS responsible for dilation of bronchi with increased rate & depth of respirations

Types of Beta 2 Agonists

rianasomar — 2021-11-03 18:39:57 UTC

1. short acting (SABA)
2. long acting (LABA)

Indications

rianasomar — 2021-11-03 18:40:22 UTC

acute asthma attack *rescue inhaler
bronchospasm
prevention of exercise-induced asthma

Adverse Effects

rianasomar — 2021-11-03 18:41:06 UTC

Tachycardia
Tremors
Terrible sleep/tossing
hypertension & bronchospasm with LABA

Nursing Considerations

rianasomar — 2021-11-03 18:42:19 UTC

- 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

Prototype

rianasomar — 2021-11-03 18:43:33 UTC

SABA: albuterol & epinephrine
LABA: salmeterol (Serevent Diskus)

Mechanism of Action

rianasomar — 2021-11-03 18:44:07 UTC

blocks vagally mediated reflexes by antagonizing action of acetylcholine so they inhibit muscarinic effects & result in bronchodilation

Indications

rianasomar — 2021-11-03 18:44:39 UTC

maintenance treatment of bronchospasm associated with COPD
patients who cannot tolerate sympathetic effects of beta-2 agonists

Adverse Effects

rianasomar — 2021-11-03 18:45:08 UTC

dizziness, fatigue, headache, blurred vision, urinary retention, dry mouth, palpitations

Nursing Considerations

rianasomar — 2021-11-03 18:46:01 UTC

- assess for acute bronchospasm, BPH, urinary retention, narrow angle glaucoma
- contraindicated in BPH & narrow angle glaucoma
- know baseline pulse & BP

Prototype

rianasomar — 2021-11-03 18:46:25 UTC

ipatropium

Mechanism of Action

rianasomar — 2021-11-03 18:58:45 UTC

1. decrease inflammatory response in airway
2. promote beta adrenergic receptor activity

Mechanism of Action

rianasomar — 2021-11-03 18:58:51 UTC

selectively antagonize receptors for the production of leukotrienes

Indications

rianasomar — 2021-11-03 18:59:42 UTC

prevention & treatment of asthma
maintenance therapy for chronic bronchial asthma

Adverse Effects

rianasomar — 2021-11-03 19:00:31 UTC

inhaled corticosteroids: sore throat, hoarseness, coughing, dry mouth, thrush

Nursing Considerations

rianasomar — 2021-11-03 19:02:44 UTC

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

Prototype

rianasomar — 2021-11-03 19:03:21 UTC

inhaled corticosteroid: budesonide

oral glucocorticoid: prednisone

Indications

rianasomar — 2021-11-03 19:04:16 UTC

prophylaxis & chronic treatment of bronchial asthma in adults & children < 5 y/o

Adverse Effects

rianasomar — 2021-11-03 19:04:41 UTC

headache, dizziness, myalgia, elevated liver enzymes, N/V

Nursing Considerations

rianasomar — 2021-11-03 19:05:29 UTC

- 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

Prototype

rianasomar — 2021-11-03 19:06:03 UTC

lukast

Mechanism of Action

rianasomar — 2021-11-03 19:06:21 UTC

works at cellular level to inhibit release of histamine & inflammatory mediators

Indications

rianasomar — 2021-11-03 19:06:37 UTC

treatment of chronic bronchial asthma
exercise induced asthma
allergic rhinitis

Adverse Effects

rianasomar — 2021-11-03 19:07:04 UTC

pharyngeal & tracheal irritations, cough, wheezing, bronchospasm, headache