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Antihistamines, Decongestants, Antitussives, and Expectorants Lilley Pharmacology Text: Chapter 34

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. Adrenergic (smypathomimetic): Antagonist:

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Antihistamines, Decongestants, Antitussives, and Expectorants Lilley Pharmacology Text: Chapter 34

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  1. Antihistamines, Decongestants, Antitussives, and ExpectorantsLilley 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

  2. Adrenergic (smypathomimetic): Antagonist: Anticholinergic (parasympatholytic): Histamine antagonist: Antihistamines: Expectorants: Corticosteroids: Review of Glossary Terms:Lilley pg. 527

  3. 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)

  4. Histamine Causes: Stimulation of H1 Receptors • Contraction of smooth muscle Wheeze • Stimulation of Vagus Cough • Permeability veins Edema • Vasodilation Flushing • secretions Mucous • Stimulation of nerve endings Pruritus

  5. Histamine Causes: Stimulation of H2 Receptors • Gastric Acid and Pepsin Abdominal Pain • Rate & Force of Myocardial Contraction tachycardia • VasodilationHypotension, Flushing, HA

  6. Allergic Rhinitis Allergic Bronchitis Allergic Conjunctivitis Allergic Dermatitis Anaphylaxis When Histamine is Stimulated How Does the Client Look?

  7. Prototype Drug(Brand name in parentheses)(Refer to Prototype List in syllabus Also listed in Lilley, pg. 531) Diphenhydramine (Benadryl)

  8. 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 ?

  9. 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

  10. Nasal Decongestants:Classifications • Adrenergics (sympathomimetics) • Anticholinergics (parasympatholytics) • Corticosteroids (topical)

  11. Nasal Decongestant Classification:1) Adrenergic Agents • Sympathomimetic Drugs • Relieve Nasal Obstruction by constricting arterioles and blood flow • Treatment of rhinitis

  12. Prototype Drug: Adrenergic(Brand name in parentheses)(Refer to Prototype List in syllabus Also listed in Lilley, pg. 534) • Pseudoephedrine (Sudafed)

  13. Antitussives • Suppress the cough center in the Medulla • Suppress the cough receptors in the throat, lungs • Narcotic, non-narcotic • Local anesthetics • Lozengers

  14. Prototype Drug: Antitussive(Brand name in parentheses)(Refer to Prototype List in syllabus Also listed in Lilley, pg. 537) • Codeine • Dextromethorphan (Benylin DM)

  15. Prototype Drug: Expectorants(Brand name in parentheses)(Refer to Prototype List in syllabus Also listed in Lilley, pg. 538) • Guaifenesin (Robitussin)

  16. Mucolytics • Used to liquefy thick viscous mucous • Inhalation • Effective within 1 minute peaks in 5-10 minutes • Also used for Tylenol overdose... given orally

  17. Prototype Drug: Mucolytics(Brand name in parentheses)(Refer to Prototype List in syllabus Also listed in Lilley, pg. 132) • Acetylcysteine (Mucomyst)

  18. 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

  19. Summary • Rebound nasal congestion • Side effects: tachycardia, arrhythmias, hypertension (adrenergic effects) • Many drugs alter the effects of OTC cold remedies……BE CAREFUL…..HTN, Arrhythmias!

  20. THE END

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