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Mucolytic Drugs
     Drugs Affecting the                          Mucomyst (acetylecysteine)
Antihistamines                                 Antihistamines
Block action of histamine by occupying       Uses: Allergic ...
Xanthine Bronchodilators                           Antiinflammatory Asthma Drugs
Examples: Short acting - Aminophylline   ...
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Respiratory Drugs


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Respiratory Drugs

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  1. 1. Mucolytic Drugs Drugs Affecting the Mucomyst (acetylecysteine) MOA: Decreases viscosity of mucous by Respiratory System breaking specific bonds in the mucous molecule. Blocks formation of toxic metabolites in Acetaminophen overdose. Uses: Relief of abnormal viscous mucous that decrease airflow and gas exchange Review A&P and Know key terms (inhalation). Prevention of hepatotoxicity due to acetaminophen overdose (PO). Mucomyst Expectorants Adverse Effects: Anorexia, N&V – smells like Example: Robitussin (guaifenesin) rotten eggs. Bronchospasm. MOA: Nursing Measures: Warn about smell. Reduces adhesiveness and decreases Instruct to report N&V, dyspnea. Wash surface tension of mucous making it easier to nebulizer after use – causes a sticky coating. be expectorated. Be sure patient coughs and clears airway Uses: Expectorant prior to administering. Be sure patient is able to clear airway after dose or use suction. Nursing Measures: Instruct to take each dose with glass of water and increase intake of water. Decongestants Antitussives Examples: Neosynepherine, Afrin, (nasal Examples: Codeine (central acting narcotic) sprays. Sudafed (PO). Tessalon (local anesthesia of stretch MOA: Reduce congestion and edema by receptors in lungs) Swallow whole. constricting arterioles to reduce blood flow to MOA: Suppress cough by depression of the nasal mucosa. cough center in the medulla or the cough Uses: Rhinitis associated with respiratory receptors in the throat, trachea or lungs. infections and allergies. Contraindications: Hypertension, heart Contraindicated in supportive lung disease disease, glaucoma. where pus that needs to be expectorated. Caution re: rebound congestion with sprays. Uses: Dry cough that interferes with sleep. 1
  2. 2. Antihistamines Antihistamines Block action of histamine by occupying Uses: Allergic rhinitis, rash and pruitus in H1receptors, the same receptors as anaphylaxis. histamine. They prevent edema, itching and Adverse Effects: 1st generation – sedation, bronchoconstriction associated with the anticholinergic effects. 2nd generation – less action of histamine. sedation. Examples: 1st generation: Benadryl Contraindications: glaucoma, pregnancy, urinary obstruction. (diphenhydramine) (prototype), Tavist (clemastine) 2nd generation: Claritin Nursing Measures: Teach to avoid alcohol and other CNS depressants. D/C 72 hr. (loratadine), Allerga (fexofenadine) prior to allergy testing. Bronchodilator & Antiasthma Drugs Proventil (albuterol) Adernergic bronchodilators MOA: Short acting beta 2-adernergic agonist relaxes Examples: Epinephrine (SC or inhaled) bronchial smooth muscles to relieve bronchospasms and reduce airway resistance. MOA: Stimulates beta 2 receptors to relax Uses: Acute asthma attacks (reliever) – inhalation bronchospasms, constricts bronchial onset in 5 – 10 min. arterioles and blocks histamine to reduce congestion and edema and increase tidal Adverse Effects: tremors, nausea, palpatations. volume and vital capacity. Nursing Measures: Teach the short acting beta2 agonits lose their brochodilating effects with Most all OTC asthma inhalers contain overuse. Teach how to use inhaler. epinephrine. Uses: Asthma, anaphylaxis, cardiac arrest. Serevent (salmeterol) Anticholinergic Bronchodilators MOA: Long acting beta 2 agonist acts to Example: Atrovent (ipratropium) relax bronchospasms and reduce airway MOA: When given by inhalation, anticholinergics resistance. block the action of acetylcholine in bronchial smooth muscles and reduces intracellular GMP, a Uses: Prophylaxis (controller) of acute bronchoconstrictor. bronchoconstriction. Slower onset up to 20 Uses: Emphysema, chronic bronchitis, COPD, acts min., duration 12 hours or more. synergistically with beta 2 agonists to improve lung function up to 15% in asthma. Adverse Effects: Cough, nervousness, N, HA, dizziness. 2
  3. 3. Xanthine Bronchodilators Antiinflammatory Asthma Drugs Examples: Short acting - Aminophylline Leukotrine modifiers: (theophylline), Long acting – Theo-Dur Example: Singular (montelukast) MOA: Directly relax bronchial smooth muscles. Stimulate the respiratory center which strengthens MOA: Occupy receptors to prevent leukotrien diaphragmatic contractions and prevents fatigue in from acting on tissues and causing COPD. bronchoconstriction and mucous production. Uses: Asthma uncontrolled by other drugs, COPD. Uses: Prophylaxis and chronic treatment of Adverse Effects: tachycardia, N,V,D,GI bleed, asthma. (controller). May decrease need for restlessness. beta 2 agonists. Nursing Measures: Check levels (5-15 mcg/ml.) Adverse Effects: HA, N, infection. Corticosteroids Corticosteroids Examples: Prednisone (PO) Azmacort Uses: Acute, severe asthma given IV, PO if (triamcinolone), Pulmocort (budesonide), repeated inhalations are not effective. Flovent (fluticasone) Chronic asthma (inhalers), COPD. MOA: Suppress inflammation by inhibiting Adverse Effects: GI bleeding, edema. movement of fluids and protein into tissues, migration and function of neutrophils and May be given for 7-10 days for acute attacks. eosinophils, synthesis of histamine in mast Taper if over a week. cells, and production of inflammatory sub. such as prostaglandins, interleukins, leukotrienes. They also increase the number (4 hr) and sensitivity (2 hr) of beta2 receptors. Mast Cell Stablilzers Examples: Fivent (cromolyn) and Tilade (nedocromil) MOA: Antiinflammatory effect by inhibiting release of histamine and other mediators of inflammation. No effect on bronchodilation. Uses: Prophylaxis of acute asthma attacks. Not used much since leukotrine modifiers available. Adverse Effects: Generally well tolerated. 3
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