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Antihistamines,
Decongestants,
Antitussives, and
Expectorants
Lilley Pharmacology Text: Chapter 34
Original Text modified by:
Anita A. Kovalsky, R.N., M.N.Ed.,
Professor of Nursing
Original PPT by:
Professor Pat Woodbery, ARNP, CS
Review of Glossary Terms:
Lilley pg. 527
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Adrenergic
(smypathomimetic):
Antagonist:
Anticholinergic
(parasympatholytic):
Histamine antagonist:
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Antihistamines:
Expectorants:
Corticosteroids:
Antihistamines
(Antagonize the Action of Histamine)
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Histamine found in tissues exposed to
environment (eyes, nose, lungs, GI)
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Histamine mainly found in Mast Cells
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Histamine found in Basophils (RBC)
Histamine Causes:
Stimulation of H1
Receptors
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Contraction of smooth muscle Wheeze
Stimulation of Vagus Cough
Permeability veins Edema
Vasodilation Flushing
secretions Mucous
Stimulation of nerve endings Pruritus
Histamine Causes:
Stimulation of H2 Receptors
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Gastric Acid and Pepsin Abdominal Pain
Rate & Force of Myocardial Contraction
tachycardia
VasodilationHypotension, Flushing, HA
When Histamine is
Stimulated How Does
the Client Look?
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Allergic Rhinitis
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Allergic Bronchitis
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Allergic Conjunctivitis
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Allergic Dermatitis
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Anaphylaxis
Prototype Drug
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 531)
Diphenhydramine (Benadryl)
Nursing Assessment
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Why is the client getting this drug?
Is there any reason the client
should not get an Antihistamine?
Pregnancy, glaucoma, ulcer,
medication interaction, allergy???
Drowsiness ?
Dry secretions ? ( Think of Asthma)
Alcohol ?
Special Considerations
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Prevention of Allergic Reaction is the Best
Care
Paradoxical Excitement May Occur
Use in Elder May Cause Confusion
Consider Side Effects: Dryness, Drowsiness
Nasal Decongestants:
Classifications
1)
2)
3)
Adrenergics
(sympathomimetics)
Anticholinergics
(parasympatholytics)
Corticosteroids
(topical)
Nasal Decongestant Classification:
1) Adrenergic Agents
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Sympathomimetic Drugs
Relieve Nasal Obstruction by constricting
arterioles and
blood flow
Treatment of rhinitis
Prototype Drug: Adrenergic
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 534)
Pseudoephedrine (Sudafed)
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Antitussives
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Suppress the cough center in the Medulla
Suppress the cough receptors in the throat, lungs
Narcotic, non-narcotic
Local anesthetics
Lozengers
Prototype Drug: Antitussive
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 537)
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Codeine
Dextromethorphan (Benylin DM)
Prototype Drug: Expectorants
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 538)
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Guaifenesin (Robitussin)
Mucolytics
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Used to liquefy thick viscous mucous
Inhalation
Effective within 1 minute peaks in 5-10
minutes
Also used for Tylenol overdose... given orally
Prototype Drug: Mucolytics
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 132)
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Acetylcysteine (Mucomyst)
Nursing Considerations
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Relieve symptoms…NOT a cure
Nose drops for no more then 7 days
Read the labels carefully
Note if syrups……remember sugar!
Report palpitations, dizziness, drowsiness
Summary
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Rebound nasal congestion
Side effects: tachycardia, arrhythmias, hypertension
(adrenergic effects)
Many drugs alter the effects of OTC cold
remedies……BE CAREFUL…..HTN, Arrhythmias!
THE END