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

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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

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Review of Glossary TermsLilley pg. 527

• Antihistamines
• Expectorants
• Corticosteroids

• Adrenergic (smypathomimetic)
• Antagonist
• Anticholinergic (parasympatholytic)
• Histamine antagonist

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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)

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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

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Histamine Causes Stimulation of H2 Receptors

• Gastric Acid and Pepsin? Abdominal Pain
• Rate Force of Myocardial Contraction?
  tachycardia
• Vasodilation?Hypotension, Flushing, HA

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When Histamine is Stimulated How Does the Client
Look?

• Allergic Rhinitis
• Allergic Bronchitis
• Allergic Conjunctivitis
• Allergic Dermatitis
• Anaphylaxis

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

• Diphenhydramine (Benadryl)

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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 ?

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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

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Nasal DecongestantsClassifications

• Adrenergics (sympathomimetics)
• Anticholinergics (parasympatholytics)
• Corticosteroids (topical)

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Nasal Decongestant Classification1) Adrenergic
Agents

• Sympathomimetic Drugs
• Relieve Nasal Obstruction by constricting
  arterioles and blood flow
• Treatment of rhinitis

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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

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

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Prototype Drug Antitussive (Brand name in
parentheses) (Refer to Prototype List in
syllabus Also listed in Lilley, pg. 537)

• Codeine
• Dextromethorphan (Benylin DM)

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

• Guaifenesin (Robitussin)

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Mucolytics

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

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

• Acetylcysteine (Mucomyst)

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Nursing Considerations

• Relieve symptomsNOT a cure
• Nose drops for no more then 7 days
• Read the labels carefully
• Note if syrupsremember sugar!
• Report palpitations, dizziness, drowsiness

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Summary

• Rebound nasal congestion
• Side effects tachycardia, arrhythmias,
  hypertension (adrenergic effects)
• Many drugs alter the effects of OTC cold
  remediesBE CAREFUL..HTN, Arrhythmias!

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THE END