Cough it up/Silence the cough
MOA of expectorants like guaifenesin.
What is increases respiratory tract fluid by reducing mucus viscosity, making coughs more productive?
Rationale: Thins secretions to help clear airway mucus.
MOA of H1 antihistamines.
What is block histamine from binding to H1 receptors, reducing allergic symptoms?
Rationale: Prevents histamine-mediated effects like swelling, itching, and bronchoconstriction.
MOA of hydroxychloroquine (Plaquenil).
What is inhibits antigen processing and presentation, decreasing immune activation?
Rationale: Reduces autoimmune inflammation, especially in lupus.
MOA of acetylcysteine (Mucomyst).
What is breaks disulfide bonds in mucus proteins, thinning secretions?
Rationale: Reduces viscosity of mucus for easier clearance.
A major infection-related risk when taking corticosteroids.
What is immunosuppression?
What should patients do to improve the effectiveness of expectorants?
What is drink plenty of fluids?
Rationale: Hydration helps thin mucus naturally, enhancing the drug’s effect.
Key difference between first- and second-generation antihistamines.
What is first-generation crosses the blood-brain barrier causing sedation; second-generation does not?
Rationale: CNS side effects are reduced in second-gen agents.
Common side effect requiring routine eye exams in hydroxychloroquine therapy.
What is retinal toxicity?
Rationale: Risk of irreversible vision loss with long-term use.
Common side effect of mucolytics that affects the lungs.
What is bronchospasm?
Rationale: Thinning mucus may irritate airways, triggering spasm.
Corticosteroids should be taken at this time of day.
What is in the morning?
Key risk associated with codeine as an antitussive.
What is respiratory depression and sedation?
Rationale: Opioid action depresses the brain’s respiratory centers.
Common side effects of first-generation antihistamines like diphenhydramine.
What is sedation, dry mouth, blurred vision, urinary retention (anticholinergic effects)?
Rationale: Anticholinergic blockade plus CNS depression.
MOA of methotrexate in lupus.
What is inhibits dihydrofolate reductase, blocking folate-dependent DNA synthesis in immune cells?
Rationale: Suppresses overactive immune responses.
MOA of nasal steroids like fluticasone.
What is locally inhibit inflammatory mediators, reducing nasal swelling and mucus?
Rationale: Decreases allergy-related nasal symptoms.
A common metabolic side effect of corticosteroids.
What is hyperglycemia?
Rationale: Steroids increase gluconeogenesis, raising blood sugar.
MOA of dextromethorphan.
What is suppresses the cough reflex by acting on the medullary cough center in the brain?
Rationale: Central nervous system suppressant for cough control.
Major nursing consideration with first-gen antihistamines.
What is advise against driving or using machinery due to sedation?
Rationale: Safety risk due to drowsiness.
Major adverse effect of azathioprine (Imuran).
What is bone marrow suppression (leukopenia, anemia, thrombocytopenia)?
Rationale: Risk for infection, bleeding, and fatigue.
Major nursing consideration when using nasal steroids long term.
What is monitor for nasal irritation, epistaxis (nosebleeds), and teach proper spray technique?
Rationale: Reduces mucosal side effects and enhances drug efficacy
Two bone-related complications of long-term steroid use.
What are osteoporosis and avascular necrosis?
Rationale: Steroids reduce bone formation and blood supply to bones.
Common side effects of dextromethorphan.
What is dizziness, nausea, drowsiness (mild CNS effects)?
Rationale: Although non-opioid, it affects the CNS.
Indications for antihistamines besides allergies.
What is motion sickness, insomnia (first-gen), urticaria, and adjunctive cold treatment?
Rationale: Their anticholinergic and sedating properties broaden uses.
MOA of belimumab (Benlysta).
What is monoclonal antibody that inhibits B-lymphocyte stimulator (BLyS), reducing B-cell survival?
Rationale: Targets B-cells to lower autoantibody production in lupus.
Indication for mucolytics beyond respiratory conditions.
What is acetaminophen overdose (acetylcysteine restores liver glutathione)?
Rationale: Dual-purpose drug—clears mucus and treats toxic overdoses.
Nursing teaching about infection risk with steroids.
What is monitor for fever, delayed wound healing, and avoid live vaccines?
Rationale: Corticosteroids suppress immune function, increasing infection risk.