Drugs for Upper Respiratory Tract

Drugs for Upper Respiratory Tract

• Antihistamines - Treat allergy symptoms like sneezing, runny nose, and itching.

  • Chlorpheniramine and Diphenhydramine - older generations with more side effects, like drowsiness
  • Claritin (Cetirizine) - newer generations, more selective, fewer side effects

• Drugs for Common Colds
  - Phenylephrine - nasal decongestant, relieves sinus pressure and congestion

Drugs for Upper Respiratory Tract - Cough

• Antitussives - Suppress cough - Dextromethorphan - Over-the-counter (OTC) cough suppressant - Codeine - Stronger cough suppressant, available by prescription - Butamirate - Prescription cough suppressant

• Expectorants - Thin mucus and make it easier to cough up - Guaifenesin - OTC expectorant

• Mucolytics - Break down thick mucus

  • Carbocysteine, Ambroxol, and Bromhexine - Prescription mucolytics

Drugs for Lower Respiratory Tract - Bronchodilators

• Bronchodilators - Open the airways to improve breathing

• Xanthine Derivatives (Methylxanthines) - Relax smooth muscles in the airway

  • Aminophylline (theophylline ethylenediamine) - Common example
    • Therapeutic level (N) : 10-20 mcg/mL
    • Toxicity:
      • >20 mcg/mL - Nausea (early sign)
      • >35 mcg/mL - Tremor (later sign)

• Sympathomimetic Bronchodilators - Stimulate the sympathetic nervous system (fight-or-flight response)

  • Short Acting - Quick relief
    • Albuterol - Lasts 4-6 hours
  • Long Acting - Extended relief
    • Terbutaline - Lasts 12 hours

• Anticholinergic Bronchodilators - Block the action of acetylcholine, a neurotransmitter that constricts the airways, leading to smooth muscle relaxation

  • Ipratropium Bromide - Inhaled bronchodilator

Drugs for Lower Respiratory Tract - Steroids

• Steroids - Reduce inflammation in the lungs, effectively managing chronic inflammatory lung diseases, like asthma.
  • Beclomethasone, Hydrocortisone, and Prednisone - Examples

Anti-Asthma Drugs

• Leukotriene Receptor Antagonists - Block leukotriene receptors, reducing inflammation in the airways.

  • Montelukast (Singulair) - Used for long-term asthma control

• Mast Cell Stabilizers - Prevent the release of histamine and other inflammatory chemicals from mast cells

  • Cromolyn Sodium - Used to prevent exercise-induced asthma

Nursing Considerations

• Breathing and Coughing Techniques - Help remove respiratory secretions and optimize oxygen exchange.
• Relaxation Techniques - Reduce anxiety and promote relaxation
• Evaluate Heart Rate and Blood Pressure - Assess for changes due to medication side effects
• Appropriate Positioning - Optimize lung expansion
• Tremors- Common side effect; observe and document
• Hydration - Encourage plenty of fluids to help thin respiratory secretions
• Smoking Cessation - Emphasize smoking cessation for respiratory health improvement
• Steroid Medications
  • Do not use during acute attacks - Use bronchodilator first
  • Use bronchodilator before corticosteroid aerosol - Open airways for better medication delivery
  • Hold the inhaled drug for a few seconds before exhaling - Ensure proper deposition in the airways
  • Allow 1-3 minutes to elapse between each inhalation - Allows for maximum absorption
  • Rinse mouth with water after - Prevents oral fungal infections
  • Notify provider if a sore throat or sore mouth occurs - May indicate fungal infection
  • Do not stop abruptly - Must taper off gradually under provider supervision