ANTIHISTAMINES
Name two first-generation H1 antihistamines.
Diphenhydramine and promethazine. Other examples include dimenhydrinate and meclizine.
What is the prototype short-acting beta2-adrenergic agonist?
Albuterol. Levalbuterol is another example.
Name the prototype inhaled glucocorticoid.
Beclomethasone.
What medication is the prototype expectorant?
Guaifenesin.
What is the primary therapeutic purpose of a bronchodilator such as albuterol?
Relieve bronchospasm and improve airflow.
Name two second-generation H1 antihistamines.
Loratadine and cetirizine. Fexofenadine and desloratadine are also examples.
How do beta2-adrenergic agonists work?
They activate beta2 receptors in bronchial smooth muscle, causing bronchodilation and relieving bronchospasm.
Are inhaled glucocorticoids used for immediate relief of an acute asthma attack?
No. They are used on a regular schedule for long-term prophylaxis and control.
How does guaifenesin help a client with chest congestion?
It thins mucus secretions, making them easier to cough out.
What should a client do to help prevent dry mouth while taking inhaled anticholinergics?
Sip fluids and suck on sugar-free hard candies.
What major effect is associated with first-generation antihistamines?
Drowsiness/sedation and anticholinergic effects.
What are common adverse effects of albuterol?
Tachycardia, angina, and tremors.
What should a client do if prescribed both an inhaled beta2 agonist and an inhaled glucocorticoid?
Use the beta2 agonist first, then the glucocorticoid.
What is the prototype mucolytic?
Acetylcysteine.
A client is prescribed two inhaled medications. How long should the client wait between the medications?
At least 5 minutes.
Why should clients taking antihistamines avoid alcohol and other CNS depressants?
They can cause additive CNS depression and increased sedation.
Which medication relaxes bronchial smooth muscle but is used infrequently because newer medications are safer and more effective?
Theophylline.
What adverse effects can occur with inhaled beclomethasone?
Hoarseness and candidiasis.
How long should topical decongestants generally be used to prevent rebound congestion?
No longer than 3–5 days.
Which medication should be taken once daily at bedtime for long-term asthma control and can also be used for allergic rhinitis?
Montelukast.
A client taking a first-generation antihistamine develops dry mouth, urinary retention, and pupil dilation. What type of effects are these?
Anticholinergic effects.
Why does theophylline require careful monitoring?
It has a narrow therapeutic index of 8–20 mcg/mL and can cause adverse effects such as GI distress and restlessness. Caffeine and other medications can also interact with it.
A client has been prescribed oral prednisone following an acute asthma exacerbation. Why should the client not stop the medication abruptly?
The slides specifically state that short-term oral/IV glucocorticoids are used following an acute exacerbation and cannot be stopped abruptly.
A client taking codeine for a cough reports dizziness and drowsiness. What additional instruction is important?
The client should avoid driving or operating heavy machinery and avoid alcohol/CNS depressants because codeine can cause CNS and respiratory depression.
A client taking montelukast reports depression or suicidal thoughts. What should the nurse recognize?
Depression and suicidal ideation are listed adverse effects requiring attention.