Pharmacology for Nursing Unit II - Chapter 9
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Questions and Answers

What is the primary action of expectorants?

  • To block the release of histamine
  • To depress cough reflex
  • To thin mucus for easier clearance (correct)
  • To reduce swelling in nasal passages

    • Which drug type is primarily used to relieve symptoms of allergies?

  • Antihistamines (correct)
  • Decongestants
  • Antitussives
  • Mucolytics

    • What is rebound congestion?

  • Occurring nasal swelling after stopping decongestants (correct)
  • Increase in mucus production during allergies
  • Swelling that occurs with antihistamine use
  • Return of symptoms after a viral infection

    • What physiological response is largely responsible for the symptoms of the common cold?

    <p>Inflammatory response to viral infection</p> Signup and view all the answers

    Which condition involves inflammation of the sinuses?

    <p>Sinusitis</p> Signup and view all the answers

    Which of the following describes the action of antitussives?

    <p>Depresses the cough reflex</p> Signup and view all the answers

    Cilia in the respiratory tract primarily serve what function?

    <p>Clear mucus and debris</p> Signup and view all the answers

    What triggers the sneeze reflex?

    <p>Irritation of the nasal mucosa</p> Signup and view all the answers

    Which of the following should be assessed before administering antihistamines?

    <p>Prolonged QT interval</p> Signup and view all the answers

    What is a potential adverse effect of topical nasal steroids?

    <p>Local ulceration</p> Signup and view all the answers

    Which patient condition is critical to evaluate before prescribing antihistamines?

    <p>Presence of renal or hepatic impairment</p> Signup and view all the answers

    In the case of iron toxicity, which medication would be prescribed?

    <p>Deferoxamine mesylate</p> Signup and view all the answers

    Which symptom should be monitored in a patient taking antihistamines?

    <p>Respiratory depression</p> Signup and view all the answers

    What is the primary action of oral decongestants?

    <p>Shrink the nasal mucous membrane</p> Signup and view all the answers

    Which condition is not an indication for the use of oral decongestants?

    <p>Anaphylactic shock</p> Signup and view all the answers

    What are the potential adverse effects of pseudoephedrine?

    <p>Nausea and vomiting</p> Signup and view all the answers

    How does pseudoephedrine work in the body?

    <p>Causes vasoconstriction in nasal passages</p> Signup and view all the answers

    Which of the following conditions contraindicates the use of oral decongestants?

    <p>Hypertension</p> Signup and view all the answers

    What should be assessed when considering the use of oral decongestants?

    <p>History of hypertension</p> Signup and view all the answers

    What is the onset time for the action of pseudoephedrine when taken orally?

    <p>30 minutes</p> Signup and view all the answers

    Which of the following is a common side effect of sympathomimetic decongestants like pseudoephedrine?

    <p>Anxiety and restlessness</p> Signup and view all the answers

    Which property is NOT associated with antihistamines?

    <p>Antibiotic</p> Signup and view all the answers

    What is the primary action of H1 antagonists?

    <p>Block the effects of histamine at H1 receptor sites</p> Signup and view all the answers

    Which of the following conditions is an indication for using antihistamines?

    <p>Seasonal allergic rhinitis</p> Signup and view all the answers

    What is a common adverse effect of first-generation antihistamines?

    <p>Drowsiness and sedation</p> Signup and view all the answers

    Which of the following is a second-generation antihistamine?

    <p>Loratadine</p> Signup and view all the answers

    What is a contraindication for antihistamine usage?

    <p>Pregnancy and lactation</p> Signup and view all the answers

    How does diphenhydramine primarily function?

    <p>As an H1 receptor blocker</p> Signup and view all the answers

    Which route of administration is NOT applicable for diphenhydramine?

    <p>Sublingual</p> Signup and view all the answers

    What is the main goal of treating upper respiratory infections as described?

    <p>To provide symptomatic relief</p> Signup and view all the answers

    Which group was advised against using over-the-counter cough and cold products in 2008?

    <p>Children younger than 4 years</p> Signup and view all the answers

    Which of the following is an effect of antitussives?

    <p>Blocking the cough reflex</p> Signup and view all the answers

    What potential risk is associated with older adults using OTC cold medications?

    <p>Higher likelihood of adverse effects</p> Signup and view all the answers

    What is the purpose of using mucolytics in upper respiratory infections?

    <p>To liquefy respiratory secretions</p> Signup and view all the answers

    What does empiric therapy refer to in the context of treating upper respiratory infections?

    <p>Treating based on the most likely cause without definitive identification</p> Signup and view all the answers

    What is one of the effects of antihistamines in treating upper respiratory conditions?

    <p>Block the action of histamine</p> Signup and view all the answers

    Why is it important to consult a pediatrician regarding cold medication for young children?

    <p>Because OTC medications may not be effective in small children</p> Signup and view all the answers

    Study Notes

    Pharmacology for Nursing - Unit II

    • Course Title: Pharmacology for Nursing
    • Unit: II
    • Chapter: 9 - Drugs Acting on the Respiratory Tract
    • Instructor: Dr. Hanan A. M. Youssef
    • Credentials: RN, MNS, DNS, Associate Professor- Emergency & Critical Care Nursing, Nursing Department – Taif University

    Learning Objectives

    • Define pharmacology key terms
    • Describe the physiological events in upper respiratory disorders
    • Detail therapeutic actions, indications, pharmacokinetics, contraindications, adverse reactions, and drug-drug interactions of drugs acting on the upper respiratory tract
    • Discuss drug use across the lifespan
    • Compare and contrast prototype drugs with other agents in their class and other drugs acting on the respiratory tract
    • Outline nursing considerations (teaching) for patients receiving these drugs

    Drugs Acting on the Respiratory Tract

    • Key Terms: Histamine, antihistamines, mucolytics, antitussives, cilia, common cold (URT), decongestants, expectorants, seasonal rhinitis, sinusitis, sneezing, ventilation, nasal spray, defense mechanisms.
    • Drugs Acting on the Upper Respiratory Tract: Includes nasal cavity, larynx, pharynx, trachea, bronchi, bronchioles, goblet cells, mucus, cilia, alveolar sacs.
    • Most common upper respiratory infections are caused primarily by viral infections (rhinovirus or influenza virus).
    • Excessive mucus production is a result of the inflammatory response.

    Treatment of Common Cold

    • Treatment involves combined use of antihistamines, nasal decongestants, antitussives, and expectorants.
    • Treatment is primarily symptomatic.
    • Difficult to definitively determine if the cause is viral or bacterial.
    • Treatment is often "empirical therapy"—treating the most likely cause.
    • Antivirals and antibiotics may be used, but a definitive viral or bacterial cause may not always be easily identified.

    Pediatric Concerns

    • In 2008, the FDA issued recommendations against giving over-the-counter (OTC) cough and cold medicine to children under 4-years-old. Extreme caution is advised for those 4-6 years old.
    • Evidence suggests that such medications are not effective in children and may be harmful, leading to adverse events like over-sedation, seizures, tachycardia, and even death.
    • Parents should consult pediatricians for the best ways to manage illnesses.

    Adults & Geriatric (Older Adults) Concerns

    • Adults may accidentally overdose on OTC medications, especially if taking multiple products.
    • The safety of these drugs during pregnancy and lactation is not always established.
    • Older adults are more prone to adverse effects such as sedation, confusion, and dizziness.
    • Renal and/or hepatic impairment can affect the metabolism and excretion of these drugs.

    Drugs Used to Treat Upper Respiratory Infections

    • Antitussives: Block the cough reflex (centrally) acting on the medulla.
    • Decongestants: Decrease blood flow to the upper respiratory tract, decreasing secretion production.
    • Antihistamines: Block the release or action of histamine, decreasing secretions and narrowing airways.
    • Expectorants: Increase productive cough.
    • Mucolytics: Increase or liquefy respiratory secretions which aid in clearing airways.

    Oral Decongestants

    • Actions: Decrease nasal congestion, shrink nasal mucosa by stimulating alpha-adrenergic receptors, and promote drainage.
    • Indications: Common cold, sinusitis, and allergic rhinitis.
    • Pharmacokinetics: Well-absorbed and widely distributed, metabolized in the liver, primarily excreted in urine.
    • Contraindications: Conditions exacerbated by sympathetic activity.
    • Adverse Effects: Rebound congestion and sympathetic effects.
    • Nursing Considerations: Assess for history of conditions such as pregnancy or lactation; hypertension; CAD; and history of allergies.

    Prototype Oral Decongestants (e.g., pseudoephedrine)

    • Indications: Temporary relief of nasal congestion.
    • Actions: Sympathomimetic effects, causing vasoconstriction in nasal passages to increase drainage and improve ventilation.
    • Route: Oral
    • Onset: 30 minutes
    • Duration: 4-6 hours

    Antihistamines and Histamine Antagonists

    • Histamine is a major inflammatory mediator in many allergic disorders, including allergic rhinitis, anaphylaxis, angioedema, drug fevers, and urticaria (itching).
    • Antihistamines have sedative, antihistaminic, and anticholinergic properties. H1 antagonists (e.g., diphenhydramine) block H1 histamine receptors, reducing allergic responses.
    • H2 blockers (e.g., cimetidine) reduce gastric acid in peptic ulcer disease.

    Prototype Antihistamines (e.g., diphenhydramine)

    • Indications: Symptomatic relief of allergic symptoms, seasonal and perennial allergic rhinitis, and for managing sleep and coughs.
    • Actions: Competitively blocks histamine at H1 receptors, resulting in sedation, anticholinergic effects.
    • Route: Oral, Intramuscular (IM), intravenous (IV).
    • Onset: Ranges from 15-30 minutes to rapid (IV)
    • Duration: Wide range, typically 4–8 hours.

    Nursing Considerations for Antihistamines

    • Assess for allergies and conditions like pregnancy, prolonged QT interval, renal or hepatic impairment, and skin, orientation, affect, and reflexes.
    • Monitor respiration rate, adventitious sounds, and appropriate laboratory values such as kidney function.

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    Upper Respiratory Tract Pharmacology (PDF)

    Description

    Explore the key concepts of pharmacology related to drugs acting on the respiratory tract in this quiz. Learn about therapeutic actions, indications, and nursing considerations for these medications. This assessment covers essential pharmacology terms and drug comparisons critical for nursing practice.

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