Pulmonary Med Charts, part 2 Antitussives - Opioids

Mechanism of action Therapeutic Uses Side Effects/Precautions Interactions Nursing/Patient Teaching Common Drugs suppresses cough through action on CNS used for chronic non-productive cough CNS effects (dizziness, drowsiness, respiratory depression), GI upset, potential for abuse contraindicated in clients with acute asthma, head trauma, acute alcoholism no driving, no alcohol, avoid other CNS depressants codeine, hydrocodone

Antitussives - Non-Opioids
Mechanism of action Therapeutic Uses Side Effects/Precautions Interactions Nursing/Patient Teaching Common Drugs suppresses cough through action on CNS cough supression few adverse effects, mild nausea, sedation high fever if used with MAOIs some formulations may contain alcohol or sucrose dextromethorphan (Robitussin), Benadryl

Expectorants
Mechanism of action Therapeutic Uses Side Effects/Precautions Interactions Nursing/Patient Teaching Common Drugs increase fluid intake to promote liquefying secretions guaifenesin (Mucinex) increases cough production through increasing mucous secretion often used in combination with antitussives, or a decongestant GI upset, drowsiness, dizziness

Mucolytics
Mechanism of action Therapeutic Uses enhance flow of secretion in respiratory passages used in patients with acute and chronic pulmonary disorders exacerbated by large amounts of secretions, can be used as antidote for acetaminophen poisoning risk of aspiration and bronchospasm when administered orally

Side Effects/Precautions Interactions Nursing/Patient Teaching Common Drugs

acetylcysteine smells like rotten eggs, administered by inhalation (for pulmonary) or IV (for acetaminophen overdose) acetylcysteine (Mucomyst, Acetadote)

Decongestants
Mechanism of action Therapeutic Uses Side Effects/Precautions Interactions Nursing/Patient Teaching Common Drugs topical agents typically are more effective and work faster and have shorter duration, vasoconstriction and CNS stimulation are less common with topical agents, use no longer than 3 to 5 days (due to rebound congestion) phenylephrine, Ephedrine, sympathomimetic decongestants stimulate alpha adrenergic receptors causing reduction in inflammation of nasal membranes can be used to treat allergic rhinitis by relieving nasal stuffiness, acts as decongestant rebound congestion if used for more than 3 to 5 days, CNS stimulation, vasoconstriction

Antihistamines
Mechanism of action blockage of histamine release in small blood vessels, capillaries and nerves during allergic reactions, also relieve mucous secretion due to anticholinergic effects mild allergic reaction, anaphylaxis, motion sickness, insomnia sedation (with 1st generation), anticholinergic effects (dry mouth, constipation), GI upset, CNS depressants have additive CNS depressant effects caution with sedation effect with 1st generation 1st generation histamine antagonists: Benadryl Phenergan Dramamine 2nd generation histamine antagonists: Loratadine (Claritin) Zyrtec Allegra Clarinex

Therapeutic Uses Side Effects/Precautions Interactions Nursing/Patient Teaching Common Drugs