Antihistamines Decongestants Antitussives and Expectorants Lilley Pharmacology Text

Antihistamines, Decongestants, Antitussives, and Expectorants Lilley Pharmacology Text: Chapter 34 Original Text modified by: Anita A. Kovalsky, R. N. , M. N. Ed. , Professor of Nursing Original PPT by: Professor Pat Woodbery, ARNP, CS

Review of Glossary Terms: Lilley pg. 527 n n Adrenergic (smypathomimetic): Antagonist: Anticholinergic (parasympatholytic): Histamine antagonist: n n n Antihistamines: Expectorants: Corticosteroids:

Antihistamines (Antagonize the Action of Histamine) n Histamine found in tissues exposed to environment (eyes, nose, lungs, GI) n Histamine mainly found in Mast Cells n Histamine found in Basophils (RBC)

Histamine Causes: Stimulation of H 1 Receptors n n n Contraction of smooth muscle Wheeze Stimulation of Vagus Cough Permeability veins Edema Vasodilation Flushing secretions Mucous Stimulation of nerve endings Pruritus

Histamine Causes: Stimulation of H 2 Receptors n n n Gastric Acid and Pepsin Abdominal Pain Rate & Force of Myocardial Contraction tachycardia Vasodilation Hypotension, Flushing, HA

n When Histamine is Stimulated How Does the Client Look? Allergic Rhinitis n Allergic Bronchitis n Allergic Conjunctivitis n Allergic Dermatitis n Anaphylaxis

Prototype Drug (Brand name in parentheses) (Refer to Prototype List in syllabus Also listed in Lilley, pg. 531) Diphenhydramine (Benadryl)

Nursing Assessment n n n Why is the client getting this drug? Is there any reason the client should not get an Antihistamine? Pregnancy, glaucoma, ulcer, medication interaction, allergy? ? ? Drowsiness ? Dry secretions ? ( Think of Asthma) Alcohol ?

Special Considerations n n Prevention of Allergic Reaction is the Best Care Paradoxical Excitement May Occur Use in Elder May Cause Confusion Consider Side Effects: Dryness, Drowsiness

Nasal Decongestants: Classifications 1) 2) 3) Adrenergics (sympathomimetics) Anticholinergics (parasympatholytics) Corticosteroids (topical)

Nasal Decongestant Classification: 1) Adrenergic Agents n n n Sympathomimetic Drugs Relieve Nasal Obstruction by constricting arterioles and blood flow Treatment of rhinitis

Prototype Drug: Adrenergic (Brand name in parentheses) (Refer to Prototype List in syllabus Also listed in Lilley, pg. 534) n Pseudoephedrine (Sudafed)

Antitussives n n n Suppress the cough center in the Medulla Suppress the cough receptors in the throat, lungs Narcotic, non-narcotic Local anesthetics Lozengers

Prototype Drug: Antitussive (Brand name in parentheses) (Refer to Prototype List in syllabus Also listed in Lilley, pg. 537) n n Codeine Dextromethorphan (Benylin DM)

Prototype Drug: Expectorants (Brand name in parentheses) (Refer to Prototype List in syllabus Also listed in Lilley, pg. 538) n Guaifenesin (Robitussin)

Mucolytics n n Used to liquefy thick viscous mucous Inhalation Effective within 1 minute peaks in 5 -10 minutes Also used for Tylenol overdose. . . given orally

Prototype Drug: Mucolytics (Brand name in parentheses) (Refer to Prototype List in syllabus Also listed in Lilley, pg. 132) n Acetylcysteine (Mucomyst)

Nursing Considerations n n n Relieve symptoms…NOT a cure Nose drops for no more then 7 days Read the labels carefully Note if syrups……remember sugar! Report palpitations, dizziness, drowsiness

Summary n n n Rebound nasal congestion Side effects: tachycardia, arrhythmias, hypertension (adrenergic effects) Many drugs alter the effects of OTC cold remedies……BE CAREFUL…. . HTN, Arrhythmias!

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