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
Adrenergic (smypathomimetic):
Antagonist:
Anticholinergic (parasympatholytic):
Histamine antagonist:
Antihistamines:
Expectorants:
Corticosteroids:
Antihistamines
(Antagonize the Action of Histamine)
Histamine found in tissues exposed to environment (eyes, nose, lungs, GI)
Histamine mainly found in Mast Cells
Histamine found in Basophils (RBC)
Histamine Causes:
Stimulation of H1 Receptors
Contraction of smooth muscleā Wheeze
Stimulation of Vagusā Cough
Permeability veinsā Edema
Vasodilationā Flushing
secretionsā Mucous
Stimulation of nerve endingsā Pruritus
Histamine Causes:
Stimulation of H2 Receptors
Gastric Acid and Pepsinā Abdominal Pain
Rate & Force of Myocardial Contractionā tachycardia
Vasodilationā Hypotension, Flushing, HA
When Histamine is Stimulated How Does the Client Look?
Allergic Rhinitis
Allergic Bronchitis
Allergic Conjunctivitis
Allergic Dermatitis
Anaphylaxis
Prototype Drug
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 531)
Diphenhydramine (Benadryl)
Nursing Assessment
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
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
Adrenergics (sympathomimetics)
Anticholinergics (parasympatholytics)
Corticosteroids (topical)
Nasal Decongestant
Classification:
1) Adrenergic Agents
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)
Antitussives
Suppress the cough center in the Medulla
Suppress the cough receptors in the throat, lungs
Narcotic, non-narcotic
Local anesthetics
Lozengers
Codeine
Dextromethorphan (Benylin DM)
Guaifenesin (Robitussin)
Mucolytics
Used to liquefy thick viscous mucous
Inhalation
Effective within 1 minuteā peaks in 5-10 minutes
Also used for Tylenol overdose... given orally
Acetylcysteine (Mucomyst)
Nursing Considerations
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
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