Questions and Answers
Match the drug class with its anticipated action:
Mucolytics = Liquefies and loosens thick mucous secretions Decongestants = Relieves nasal congestion Antitussives = Suppress harmful or nonproductive cough Expectorants = Reduce viscosity of secretions to allow for ejection of mucus
By which mechanisms do expectorants loosen and thin respiratory secretions? (Select all that apply)
Which statements accurately describe the pharmacodynamics of dextromethorphan? (Select all that apply)
Which drug undergoes metabolism to form cysteine, disulfides, and conjugates?
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How long can a patient expect the effects of extended-release pseudoephedrine to last?
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Which explanation describes why the nurse would call the health care provider because of a safety concern for Mr. Clark?
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Which instructions would a nurse include when teaching a patient about the administration of guaifenesin? (Select all that apply)
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Which conditions would alert a nurse to potentially unsafe treatment with pseudoephedrine? (Select all that apply)
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Which nursing considerations about acetylcysteine are accurate? (Select all that apply)
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What time frame would the nurse share for when a patient would start to experience the effects of pseudoephedrine?
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Which statements describe the pharmacokinetics of guaifenesin? (Select all that apply)
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What counseling point regarding the pharmacokinetics and pharmacodynamics of dextromethorphan would a nurse include in patient teaching?
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Which patients would a nurse determine can safely receive inhaled acetylcysteine? (Select all that apply)
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Which clinical manifestation alerts a nurse to a possible drug-drug interaction in a patient with Parkinson's disease receiving selegiline and pseudoephedrine?
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Which counseling points would a nurse provide a patient who has been prescribed an antitussive containing codeine? (Select all that apply)
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Which drug causes a nurse to carefully consider the patient's drug list for potential drug-drug interactions due to its metabolism through CYP450 2D6?
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Study Notes
Drug Classes and Actions
- Expectorants reduce viscosity of secretions, facilitating mucus ejection.
- Antitussives suppress harmful or nonproductive cough.
- Mucolytics liquefy and loosen thick mucous secretions.
- Decongestants relieve nasal congestion.
Mechanisms of Expectorants
- Expectorants stimulate secretory glands in the respiratory tract directly.
- Some expectorants may also work by reflex stimulation from gastrointestinal irritation.
Dextromethorphan Pharmacodynamics
- Onset of action for dextromethorphan is 15 to 30 minutes.
- Time to peak concentration and duration of action is both approximately 2.5 hours.
- It suppresses the cough reflex by targeting stretch receptor cells in the respiratory tract.
Metabolism of Acetylcysteine
- Acetylcysteine metabolizes to form cysteine, disulfides, and conjugates.
Extended-Release Pseudoephedrine Effects
- Effects of extended-release pseudoephedrine can last 8 to 12 hours.
Safety Concerns with Dextromethorphan and Pseudoephedrine
- These medications can worsen glaucoma as they stimulate alpha1-adrenergic receptors.
- Patients should be cautious, especially if there's a history of the condition.
Patient Education for Guaifenesin
- Avoid alcohol while taking guaifenesin.
- Increase water intake to up to 3 liters daily to help liquefy secretions.
- Report fever above 100.4°F or symptoms persisting longer than 3-4 days.
Risk Factors for Pseudoephedrine
- Contraindicated for patients with glaucoma, hypertension, and hyperthyroidism due to exacerbation risks.
Nursing Considerations for Acetylcysteine
- Caution with inhaled acetylcysteine in patients with chronic obstructive pulmonary disease (COPD).
- Expect potential side effects like runny nose, nausea, and dizziness.
- Inhalation via nebulizer is the common route for respiratory conditions.
Onset of Pseudoephedrine Effects
- Patients may expect effects within 15 to 30 minutes post-administration.
Guaifenesin Pharmacokinetics
- Readily absorbed in the gastrointestinal tract and undergoes hydrolysis.
- Main elimination route is through urine.
Dextromethorphan Counseling
- Functions as an antitussive, suppressing the cough reflex in the cough center.
- Not classified as an opioid despite its effects; does not provide analgesia.
Safe Inhalation of Acetylcysteine
- Safe for patients with diabetes, benign prostatic hyperplasia, and a history of drug abuse.
- Caution necessary in elderly patients and those with hypertension.
Drug-Drug Interaction Alert
- Combining selegiline (an MAOI) with pseudoephedrine poses a risk for hypertension.
Counseling Points for Codeine Antitussives
- Avoid alcohol to mitigate risk for CNS depression.
- Educate patients on possible side effects including sedation and gastrointestinal disturbances.
- Advise reporting any abnormal sputum changes or breathing difficulties.
Dextromethorphan Drug Interactions
- Metabolized through CYP450 2D6; care needed with drugs like paroxetine and fluoxetine that share this metabolic pathway.
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Description
This flashcard quiz covers Chapter 35 of Pharmacology, focusing on expectorants, antitussives, mucolytics, and decongestants. Match each drug class with its corresponding action to test your understanding of these important therapeutic agents.
