Antitussives
What does an antitussive do?
Suppress cough reflex
Second generation is less sedating
Drug of choice for acute asthma attack
Bronchodilator Albuterol
Expectorants work by
Thinning secretions for more productive cough and enhanced patency of airways
Cholesterol level goals for HDL, LDL
Higher “Happy” HDL
Lower “Lethal” LDL
How do decongestants exert their effect?
Decrease the overproduction of secretions by causing local vasoconstriction to the upper respiratory tract, shrink mucous membranes, open clogged nasal passages
When are antihistamines most effective
When used before the onset of symptoms
Oral complication of inhaled steroids that manifests with redness, sores, or white patches.
How to avoid
What is candidiasis. (Oral thrush)
Rinse mouth with water after using inhaler
Mucolytics work by
breaking apart the bonds in mucus, making it less thick and sticky and easier to cough up
Lifestyle changes to lower cholesterol
Dietary restrictions, Exercise, Weight loss, Decrease stress, Quitting smoking,
Using topical nasal congestants longer than 3-5 days can lead to this
Rebound congestion
Patient teaching for pediatric cold and cough medications
Do not give OTC cough and cold products to < 2 yo (unless directed by provider)
w/ opioids codeine and hydrocodone = not < 18 yo
Use children’s, infant’s, pediatric for child’s appropriate age and weight
Check active ingredients; overdose can occur using multiple
Use measuring spoon/cup that comes w/ medication
Child-proof caps
Nonpharmacological interventions – humidifier, fluids, bulb syringe, saline nasal spray or drops, analgesics, positioning
Commonly used stimulant that can increase theophylline levels and should be avoided.
Caffeine (coffee, sodas, energy drinks). - Increases CNS & cardiac adverse effects of theophylline.
This device prevents medication from depositing in the mouth and assures it reaches the lungs by slowing the delivery from pressurized MDIs.
A spacer
Food to avoid with HMG-CoA Reductase Inhibitors (Statins)
Grapefruit juice
Risk of taking oral decongestant pseudoephedrine with OTC medications
Overdose-read label carefully
Patient teaching for antihistamines
Increase fluids, change positions slowly, sugarless candy (for dry mouth), avoid driving/operating heavy machinery, avoid alcohol
Black box warning for montelukast (Singulair)
Behavior changes/Neuropsychiatric events- depression, suicide, hallucinations, aggressive behavior
Steroid medications may reduce this
immune function
Nursing assessment for bile acid sequestrants
Inspect skin for color, bruising, rash
How does dextromethorphan work?
Acts directly on the medullary cough center of the brain to depress cough reflex, centrally acting
A nurse is teaching a client with a new RX for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations? (Select all that apply).
A. Dry mouth
B. Nonproductive cough
C. Skin rash
D. Drowsiness
E. Urinary hesitation
A. Dry Mouth, D. Drowsiness, E. Urinary retention
Systemic effects to educate patient taking albuterol
Increased blood pressure, increased HR, decreased renal and GI blood flow, anxiety, restlessness, may disrupt sleep
Leukotriene receptor antagonists therapeutic indication
asthma maintenance.
Do not have immediate effect on airways, not indicated for treating acute asthma attack
Adverse effect and symptoms to educate patient on when taking HMG-CoA Reductase Inhibitors (Statins)
Rhabdomyolysis-break down of muscle tissue
S/S-muscle pain/aching, muscle weakness-contact provider