Scribd Logo
Upload

Welcome to Scribd!

  • 125 views

    Drugs Affecting The Respiratory System

    Uploaded by

    one_nd_onlyu
    This document discusses drugs that affect the respiratory system, including antihistamines, decongestants, antitussives, and expectorants. It provides information on the common cold, including that it is usually caused by a viral infection and results in excessive mucus production. Treatment involves using these drug classes together to treat symptoms like coughing and nasal congestion. Antihistamines work by blocking histamine receptors, decongestants constrict blood vessels to relieve nasal stuffiness, and antitussives suppress coughing. Nursing implications include monitoring for intended and adverse effects of these medications.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd

    Drugs Affecting The Respiratory System

    Uploaded by

    one_nd_onlyu
    125 views75 pages
    This document discusses drugs that affect the respiratory system, including antihistamines, decongestants, antitussives, and expectorants. It provides information on the common cold, including that it is usually caused by a viral infection and results in excessive mucus production. Treatment involves using these drug classes together to treat symptoms like coughing and nasal congestion. Antihistamines work by blocking histamine receptors, decongestants constrict blood vessels to relieve nasal stuffiness, and antitussives suppress coughing. Nursing implications include monitoring for intended and adverse effects of these medications.

    Original Title

    15 Antihistamines Upd

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses drugs that affect the respiratory system, including antihistamines, decongestants, antitussives, and expectorants. It provides information on the common cold, including that it is usually caused by a viral infection and results in excessive mucus production. Treatment involves using these drug classes together to treat symptoms like coughing and nasal congestion. Antihistamines work by blocking histamine receptors, decongestants constrict blood vessels to relieve nasal stuffiness, and antitussives suppress coughing. Nursing implications include monitoring for intended and adverse effects of these medications.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    125 views75 pages

    Drugs Affecting The Respiratory System

    Uploaded by

    one_nd_onlyu
    This document discusses drugs that affect the respiratory system, including antihistamines, decongestants, antitussives, and expectorants. It provides information on the common cold, including that it is usually caused by a viral infection and results in excessive mucus production. Treatment involves using these drug classes together to treat symptoms like coughing and nasal congestion. Antihistamines work by blocking histamine receptors, decongestants constrict blood vessels to relieve nasal stuffiness, and antitussives suppress coughing. Nursing implications include monitoring for intended and adverse effects of these medications.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 75

    Drugs Affecting the

    Respiratory System
    Antihistamines,
    Decongestants,
    Antitussives,
    and
    Expectorants
    Understanding the Common
    Cold
    Most caused by viral infection
    (rhinovirus or influenza virus—the
    “flu”)
    Understanding the Common
    Cold
    Virus invades tissues (mucosa) of upper
    respiratory tract, causing upper respiratory
    infection (URI).
    Excessive mucus production results from
    the inflammatory response to this
    invasion.
    Fluid drips down the pharynx into the
    esophagus and lower respiratory tract,
    causing cold symptoms: sore throat,
    coughing, upset stomach.
    Understanding the Common
    Cold
    Irritation of nasal mucosa often
    triggers the sneeze reflex.
    Mucosal irritation also causes release
    of several inflammatory and
    vasoactive substances, dilating small
    blood vessels in the nasal sinuses
    and causing nasal congestion.
    Common Colds
    initial acute stages:
    – the nasal mucosa is thickened
    – edematous, and red
    – the nasal cavities are narrowed
    – and the turbinates are enlarged
    Treatment of the Common Cold
    Involves combined use of
    antihistamines, nasal decongestants,
    antitussives, and expectorants.
    Treatment is SYMPTOMATIC only,
    not curative.
    Symptomatic treatment does not
    eliminate the causative pathogen.
    Treatment of the Common Cold
    Difficult to identify whether cause is
    viral or bacterial.
    Treatment is “empiric therapy,”
    treating the most likely cause.
    Antivirals and antibiotics may be
    used, but viral or bacterial cause
    may not be easily identified.
    Antihistamines
    Drugs that directly compete with
    histamine for specific receptor sites.
    Two histamine receptors:
    – H1 histamine-1
    – H2 histamine-2
    Antihistamines
    H2 Blockers or H2 Antagonists
    – Used to reduce gastric acid in PUD
    – Examples: cimetidine (Tagamet),
    ranitidine (Zantac), or
    famotidine (Pepcid)
    Antihistamines
    H1 antagonists are commonly referred
    to as antihistamines
    Antihistamines have several effects:
    – Antihistaminic
    – Anticholinergic
    – Sedative
    Antihistamines: Mechanism of
    Action
    BLOCK action of histamine at the
    receptor sites
    Compete with histamine for binding at
    unoccupied receptors.
    CANNOT push histamine off the
    receptor if already bound.
    Antihistamines: Mechanism of
    Action
    The binding of H1 blockers to the
    histamine receptors prevents the
    adverse consequences of histamine
    stimulation:
    – Vasodilation
    – Increased gastrointestinal and
    respiratory secretions
    – Increased capillary permeability
    Antihistamines: Mechanism of
    Action
    More effective in preventing the
    actions of histamine rather than
    reversing them
    Should be given early in treatment,
    before
    all the histamine binds to the
    receptors
    Histamine vs. Antihistamine
    Effects
    Cardiovascular (small blood vessels)
    Histamine effects:
    – Dilation and increased permeability
    (allowing substances to leak into
    tissues)
    Antihistamine effects:
    – Prevent dilation of blood vessels
    – Prevent increased permeability
    Histamine vs. Antihistamine
    Effects
    Smooth Muscle (on exocrine glands)
    Histamine effects:
    – Stimulate salivary, gastric, lacrimal, and

    bronchial secretions
    Antihistamine effects:
    – Prevent salivary, gastric, lacrimal, and
    bronchial secretions
    Histamine vs. Antihistamine
    Effects
    Immune System
    (Release of substances commonly
    associated with allergic reactions)
    Histamine effects:
    – Mast cells release histamine and other
    substances, resulting in allergic reactions.
    Antihistamine effect:
    – Binds to histamine receptors, thus preventing
    histamine from causing a response.
    Antihistamines: Other Effects
    Skin:
    Block capillary permeability, wheal-and-
    flare formation, itching
    Anticholinergic:
    Drying effect that reduces nasal,
    salivary, and lacrimal gland secretions
    (runny nose, tearing, and itching eyes)
    Sedative:
    Some antihistamines cause drowsiness
    Antihistamines: Therapeutic
    Uses

    Management of:

    Nasal allergies

    Seasonal or perennial allergic rhinitis


    (hay fever)

    Allergic reactions

    Motion sickness

    Sleep disorders
    Antihistamines
    10 to 20% of general population is sensitive
    to various environmental allergies.
    Histamine-mediated disorders:
    – Allergic rhinitis
    (hay fever, mold and dust allergies)
    – Anaphylaxis
    – Angioneurotic edema
    – Drug fevers
    – Insect bite reactions
    – Urticaria (itching)
    Antihistamines: Therapeutic
    Uses

    Also used to relieve symptoms


    associated with the common
    cold:
    Sneezing, runny nose
    Palliative treatment, not curative
    Antihistamines: Side effects
    Anticholinergic (drying) effects,
    most common:
    – Dry mouth
    – Difficulty urinating
    – Constipation
    – Changes in vision
    Drowsiness
    – (Mild drowsiness to deep sleep)
    Antihistamines: Two Types

    Traditional
    or
    Nonsedating/Peripherally Acting
    Antihistamines:

    Traditional
    Older
    Work both peripherally and centrally
    Have anticholinergic effects, making them more
    effective than nonsedating agents in some
    cases
    Examples: diphenhydramine (Benadryl)
    chlorpheniramine (Chlor-Trimeton)
    Antihistamines:

    Nonsedating/Peripherally Acting
    Developed to eliminate unwanted side effects,
    mainly sedation
    Work peripherally to block the actions of
    histamine; thus, fewer CNS side effects
    Longer duration of action (increases
    compliance)
    Examples: fexofenadine (Allegra)
    loratadine (Claritin)
    Nursing Implications:
    Antihistamines
    Gather data about the condition or allergic
    reaction that required treatment; also, assess
    for drug allergies.
    Contraindicated in the presence of acute
    asthma attacks and lower respiratory diseases.
    Use with caution in increased intraocular
    pressure, cardiac or renal disease,
    hypertension, asthma, COPD, peptic ulcer
    disease, BPH, or pregnancy.
    Nursing Implications:
    Antihistamines

    Instruct patients to report excessive


    sedation, confusion, or hypotension.
    Avoid driving or operating heavy
    machinery, and do not consume alcohol
    or other CNS depressants.
    Do not take these medications with
    other prescribed or OTC medications
    without checking with prescriber.
    Nursing Implications:
    Antihistamines

    Best tolerated when taken with meals


    —reduces GI upset.
    If dry mouth occurs, teach patient to
    perform frequent mouth care, chew
    gum, or suck on hard candy
    (preferably sugarless) to ease
    discomfort.
    Monitor for intended therapeutic
    effects.
    Decongestants
    Nasal Congestion
    Excessive nasal secretions
    Inflamed and swollen nasal mucosa

    Primary causes:
    – Allergies
    – Upper respiratory infections (common cold)
    Decongestants

    Two main types are used:


    Adrenergics (largest group)
    Corticosteroids
    Decongestants

    Two dosage forms:


    Oral
    Inhaled/topically applied to the nasal
    membranes
    Oral Decongestants

    Prolonged decongestant effects,


    but delayed onset
    Effect less potent than topical
    No rebound congestion
    Exclusively adrenergics
    Examples: phenylephrine
    pseudoephedrine
    (Sudafed)
    Topical Nasal Decongestants

    Both adrenergics and steroids


    Prompt onset
    Potent
    Sustained use over several days
    causes rebound congestion,
    making the condition worse
    Topical Nasal Decongestants

    Adrenergics:
    ephedrine (Vicks) naphazoline (Privine)
    oxymetazoline (Afrin) phenylephrine
    (Neo Synephrine)
    Intranasal Steroids:
    beclomethasone dipropionate
    (Beconase, Vancenase)
    flunisolide (Nasalide)
    Nasal Decongestants:
    Mechanism of Action

    Site of action: blood vessels surrounding


    nasal sinuses
    Adrenergics
    – Constrict small blood vessels that supply
    URI structures
    – As a result, these tissues shrink and nasal
    secretions in the swollen mucous
    membranes are better able to drain
    – Nasal stuffiness is relieved
    Nasal Decongestants:
    Mechanism of Action

    Site of action: blood vessels surrounding


    nasal sinuses
    Nasal steroids
    – Anti-inflammatory effect
    – Work to turn off the immune system cells
    involved in the inflammatory response
    – Decreased inflammation results in decreased
    congestion
    – Nasal stuffiness is relieved
    Nasal Decongestants: Drug
    Effects

    Shrink engorged nasal mucous


    membranes
    Relieve nasal stuffiness
    Nasal Decongestants:
    Therapeutic Uses
    Relief of nasal congestion associated with:
    Acute or chronic rhinitis
    Common cold
    Sinusitis
    Hay fever
    Other allergies
    May also be used to reduce swelling of the nasal
    passage and facilitate visualization of the
    nasal/pharyngeal membranes before surgery or
    diagnostic procedures.
    Nasal Decongestants: Side
    Effects
    Adrenergics Steroids
    nervousness local mucosal
    dryness and irritation
    insomnia
    palpitations
    tremors
    (systemic effects due to adrenergic
    stimulation of the heart, blood
    vessels, and CNS)
    Nursing Implications:
    Nasal Decongestants

    Decongestants may cause


    hypertension, palpitations, and
    CNS stimulation—avoid in patients
    with these conditions.
    Assess for drug allergies.
    Nursing Implications:
    Decongestants

    Patients should avoid caffeine and


    caffeine-containing products.
    Report a fever, cough, or other
    symptoms lasting longer than a
    week.
    Monitor for intended therapeutic
    effects.
    Antitussives
    Cough Physiology

    Respiratory secretions and foreign


    objects are naturally removed by
    the
    cough reflex
    – Induces coughing and expectoration
    – Initiated by irritation of sensory
    receptors in the respiratory tract
    Two Basic Types of Cough

    Productive Cough
    – Congested, removes excessive
    secretions
    Nonproductive Cough
    – Dry cough
    Coughing

    Most of the time, coughing is


    beneficial
    Removes excessive secretions
    Removes potentially harmful foreign
    substances
    In some situations, coughing can be
    harmful, such as after hernia
    repair surgery
    Antitussives

    Drugs used to stop or reduce


    coughing
    Opioid and nonopioid
    (narcotic and non-narcotic)
    Used only for NONPRODUCTIVE
    coughs!
    Antitussives: Mechanism of
    Action

    Opioid
    Suppress the cough reflex by direct
    action on the cough center in the
    medulla.
    Examples: codeine (Robitussin A-C,
    Dimetane-DC) hydrocodone
    Antitussives: Mechanism of
    Action
    Nonopioid
    Suppress the cough reflex by numbing
    the stretch receptors in the respiratory
    tract and preventing the cough reflex
    from being stimulated.
    Examples: benzonatate (Tessalon)
    dextromethorphan (Vicks
    Formula 44,
    Robitussin-DM)
    Antitussives: Therapeutic Uses

    Used to stop the cough reflex


    when the cough is nonproductive
    and/or harmful
    Antitussives: Side Effects
    Benzonatate
    Dizziness, headache, sedation

    Dextromethorphan
    Dizziness, drowsiness, nausea

    Opioids
    Sedation, nausea, vomiting, lightheadedness,
    constipation
    Nursing Implications:
    Antitussive Agents

    Perform respiratory and cough


    assessment, and assess for allergies.
    Instruct patients to avoid driving or
    operating heavy equipment due to possible
    sedation, drowsiness, or dizziness.
    If taking chewable tablets or lozenges,
    do not drink liquids for 30 to 35 minutes
    afterward.
    Nursing Implications:
    Antitussive Agents
    Report any of the following symptoms
    to the caregiver:
    – Cough that lasts more than a week
    – A persistent headache
    – Fever
    – Rash
    Antitussive agents are for
    NONPRODUCTIVE coughs.
    Monitor for intended therapeutic
    effects.
    Expectorants
    Expectorants
    Drugs that aid in the
    expectoration
    (removal) of mucus
    Reduce the viscosity of secretions
    Disintegrate and thin secretions
    Expectorants: Mechanisms of
    Action

    Direct stimulation
    or
    Reflex stimulation

    Final result: thinner mucus that is easier


    to remove
    Expectorants: Mechanism of
    Action

    Direct stimulation:
    The secretory glands are stimulated
    directly to increase their production of
    respiratory tract fluids.
    Examples: terpin hydrate, iodine-
    containing products such as
    iodinated glycerol and potassium iodide
    (direct and indirect stimulation)
    Expectorants: Mechanism of
    Action

    Reflex stimulation:
    Agent causes irritation of the GI tract.
    Loosening and thinning of respiratory
    tract secretions occur in response to
    this irritation.
    Examples: guaifenesin, syrup of ipecac
    Expectorants: Drug Effects

    By loosening and thinning sputum


    and bronchial secretions, the
    tendency to cough is indirectly
    diminished.
    Expectorants: Therapeutic
    Uses

    Used for the relief of nonproductive


    coughs associated with:
    Common cold Pertussis
    Bronchitis Influenza
    Laryngitis Measles
    Pharyngitis
    Coughs caused by chronic paranasal
    sinusitis
    Expectorants: Common Side
    Effects

    guaifenesin terpin hydrate


    Nausea, vomiting Gastric upset
    Gastric irritation (Elixir has high alcohol
    content)
    Nursing Implications:
    Expectorants
    Expectorants should be used with caution
    in the elderly, or those with asthma or
    respiratory insufficiency.
    Patients taking expectorants should
    receive more fluids, if permitted, to help
    loosen and liquefy secretions.
    Report a fever, cough, or other
    symptoms lasting longer than a week.
    Monitor for intended therapeutic effects.
    THANK YOU FOR LISTENING

    TRUST IN THE LORD


    ROMEL Y. FELARCA,MD,DFM.

    You might also like