Antihistamine
1st Generation H1 Antagonist
Diphenhydramine (Benadryl)
*can cause anticholinergic effects (dry mouth, drink 2-3L of h20/day) and drowsiness
*Sedating Effects
Phenylephrine
Neo-synephrine
Codeine
Opiod - codeine suppresses cough through its action on the CNS to increase cough threshold
*opiods have a potential for abuse
Guaifenesin
Mucinex
Acetylcysteine
Thin and enhance the flow of secretions in the respiratory passages
2nd Generation H1 Antagonist
Cetirizine (Zyrtec)
Pseudoephedrine
Sudafed
Dextromethorphan
Non-opioid - Also suppresses cough through its action on the CNS
*cough suppression
*can reduce pain when combined with an opioid
Guaifenesin Pharmacologic Action
Thinning of mucous secretions allowing clients to decrease chest congestion by coughing out secretions
Acetylcysteine Therapeutic Uses
Mucolytics are used in clients who have cystic fibrosis
Acetylcysteine is the antidote for acetaminophen poisoning
Used in clients who have acute and chronic pulmonary disorders exacerbated by large amounts of secretions
Pharmacological Action
These medication relieve itching, sneezing, and rhinorrhea (nasal discharge)
*mild allergic reactions
*Anaphylaxis
Pharmacological Action
Stimulate alpha1-adrenergic receptors, causing reduction in the inflammation of the nasal membranes
*treat allergic or nonallergic rhinitis by relieving nasal stuffiness
*Acts as a decongestant for clients who have sinusitis and the common cold
Codeine Complications
CNS effects: dizziness, lightheadedness, drowsiness, respiratory depression
Nursing Action: obtain baseline vitals, observe for manifestations of respiratory depression (RR<12)
Therapeutic Uses
often combined with antitussives (either opioid or non-opioid) or a decongestant for treating manifestations of colds, rhinitis, or cough caused by lower respiratory disorders
Acetylcysteine Complications
Aspiration, Bronchospasm, Dizziness, Drowsiness, Hypotension, Tachycardia, Hepatotoxicity
Complications
Sedation - common with diphenhydramine, take this med at night, avoid driving/operating heavy machinery.
GI Discomfort - N/V/C , take antihistamines with meals
Complications
Rebound Congestion - Secondary to prolonged use, taper and D/C one nostril at a time. Use for short-term therapy, no more than 3 to 5 days
Dextromethorphan Complications
some mild nausea, dizziness, and sedation can occur.
there is some potential for abuse as the medication can instill euphoria in high doses
Guaifenesin Complications
Gi Upset - take with food
Drowsiness, Dizziness
Acetylcysteine Nursing Administration
Be prepared to suction clients if aspiration occurs with oral administration
This medication has an odor that smell like rotten eggs
Contraindications/Precautions
Use cautiously in clients with coronary artery disease, hypertension, and dysrhythmias because these can cause vasoconstriction
Asthma, because guaifenesin can cause bronchospasms