Pharmacology Drug Cards.

RN Pharmacology Respiratory System

drugs

Adeline Samba DNP, MSN ed, RN

Common respiratory problem(upper airway)

Common cold, Allergy rhinitis, Pharyngitis, Influenza, Sinusitis,

Cough

Questions: Identify the common characteristics for the above

disorders.

Pathophysiology: •Exposure to pathogen or allergen •Immune system turned on •Chemical mediators released: Histamine, mast cell, leukotriene

•Chemical mediators line blood vessels in the airway causing vasodilation

•Blood vessels become permeable, and fluid leaks out

•Tissue swelling occurs •Increase mucous production

Signs and symptoms: •Running nose, Congestion, Itching, Cough

Drug therapy •Congestion(decongestant), itching(antihistamine),

•Cough(antitussives), Running nose(anticholinergics)

Upper respiratory system drugs: Chapter 38

Drug class Drugs Action and use Adverse effects Nursing implications

1st generation Antihistamines Indications___________ __ ______________________

Diphenhydramine Meclizine promethazine

Blocks histamine I receptor sites to stop vasodilation and capillary permeability

Dry mouth Difficulty urinating Constipation Changes in vision drowsiness

Teaching for dry mouth______________

Antihistamines (non-sedating)

loratadine, cetirizine, and fexofenadine

See above. Developed to eliminate unwanted a

See above. Less drowsiness

Teaching for dry mouth______________

Decongestants Adrenergic

pseudoephedrine (Sudafed) Oxymetazoline Phenylephrine  

Constrict small blood vessels, shrinking nasal tissue, and nasal secretions in the swollen mucous membranes are better able to drain.

Nervousness Insomnia Palpitations Tremors

Patient with HTN should use with caution.   Educate pt regarding rebound congestion

Decongestants Anticholinergics

ipratropium (Atrovent) Dry nasal secretion Dry mucous membrane, hypertension, tachycardia, urinary retention, constipation (With systemic absorption)

 

Decongestants Corticosteroids

inhaled fluticasone (Flonase), beclomethasone

Decreased inflammation results in decreased congestion Local mucosal dryness and irritation

Rinse mouth after each use to prevent fungi infection

Antitussives Opioids

Codeine Hydrocodone

Suppress the cough reflex Sedation, N, V lightheadedness, constipation Monitor resp. status

Antitussives Non opioids

Dextromethorphan Benzonatate (cause HA)

Suppress the cough reflex Dizziness, drowsiness, confusion, fatigue, ataxia, nausea, vomiting, restlessness

 

Expectorants guaifenesin Reduce the viscosity of secretions Nausea, vomiting, GI irritation Take with 8 oz fluid

Lower respiratory system drugs: Chapter 39

Drug class Drugs Action and use Adverse effects Nursing implications

Bronchodilators: Short acting Beta-Adrenergic Agonists

albuterol (Ventolin) levalbuterol (Xopenex) pirbuterol (Maxair)

Stimulate beta2 receptors! relaxes smooth muscle in the airway and results in bronchial dilation and increased airflow.

tremors, headaches, restlessness, increased pulse rate, and palpitations

Monitor BP and heart rate. Administer prn as rescue drug during an asthma attack

Bronchodilators: long-acting Beta-Adrenergic Agonists

salmeterol (Serevent) arformoterol (Brovana) formoterol (Foradil,

See above See above  

Anticholinergics Ipratropium (Atrovent), tiotropium (Spiriva),

Binds with ACH receptor to prevent bronchoconstriction

Dry mouth Nasal congestion Palpitations, GI distress Headache, Coughing Anxiety

Take measures to relief dry mouth and constipation

Xanthine Derivatives theophylline Increase levels of energy-producing cAMP Cause bronchodilation

Hyperglycemia tachycardia, Nausea, vomiting, anorexia

Major complications: dysrhythmias, seizures, and cardiac arrest Monitor levels: 10- 15mcg/ml. Warn pt against caffeine use

Leukotriene receptor antagonists

montelukast, zafirlukast, Blocks leukotriene and decrease inflammation

Headache, nausea, diarrhea  

Corticosteroids beclomethasone, dexamethasone, fluticasone

Turns off immune system and decrease inflammation

Pharyngeal irritation Coughing, Dry mouth Oral fungal infections Systemic effects rare with low doses for inhalation therapy.

Rinse mouth after each use

Reference

• Yeager, L.M.K.D.M.B.W. J. (2023). Pharmacology (11th ed.). Elsevier Health Sciences (US).  https://pageburstls.elsevier.com/books/9780323793179