Questions and Answers
What is the primary action of cromolyn in the treatment of allergies?
What is a common adverse effect of diphenhydramine?
What is the therapeutic use of fluticasone?
What is the primary action of oxymetazoline?
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What is the contraindication for the use of acetylcysteine?
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What is the mechanism of action of albuterol?
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What is the therapeutic use of ipratropium?
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What is the mechanism of action of phenylephrine?
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What is the therapeutic use of methylxanthines?
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What is a common adverse effect of oxymetazoline?
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What is the pharmacological action of Montelukast?
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What is a rare adverse effect of Montelukast?
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What is the therapeutic use of Cromolyn sodium?
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How often should Cromolyn sodium be inhaled?
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What is the mechanism of action of Reslizumab?
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What is a black box warning for Isoniazid?
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What is a side effect of Rifampin?
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What is the therapeutic use of Isoniazid?
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Study Notes
Mast Cell Receptor Stabilizers
- Cromolyn inhibits mast cell degranulation, preventing the release of histamine.
- Nursing interventions: instruct on proper inhaler or nasal spray technique and use prior to exposure.
H1 Receptor Antagonists
- Diphenhydramine (Benadryl) blocks the effects of histamine at H1 receptors, resulting in antihistamine effects.
- Adverse effects: photosensitivity, paradoxical excitement (especially in children), anticholinergic effects, dry mouth, tachycardia, and hypertension.
- Contraindications: hypersensitivity, narrow-angle glaucoma, BPH, and GI obstruction.
Intranasal Corticosteroids
- Fluticasone is used for allergic rhinitis and inhibits inflammatory pathways.
- Side effects: nasal irritation and epistaxis (nose bleeds).
- Adverse effects: systemic effects with prolonged use, especially with oral steroids.
- Contraindications: hypersensitivity and infection.
Decongestants
- Oxymetazoline stimulates alpha-adrenergic receptors, causing sympathomimetic vasoconstriction of nasal blood vessels.
- Side effects: rebound congestion with prolonged use, nasal irritation, minor stinging, and dryness.
- Nursing interventions: limit use to 3-4 consecutive days to prevent rebound congestion.
- Contraindications: hypertension, diabetes, thyroid disorder, and heart disease.
Antitussives
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Dextromethorphan suppresses the cough reflex in the CNS and provides analgesia.
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Side effects: dizziness, drowsiness, and nausea.
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Adverse effects: rare, but can cause slurred speech, ataxia, hyperexcitability, stupor, respiratory depression, seizures, coma, and toxic psychosis.
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Contraindications: concurrent use of MAOIs.
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Patient teaching: avoid alcohol use and be cautious with other CNS depressants.
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Codeine cough syrup suppresses the cough reflex via the CNS and provides analgesia.
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Side effects: sedation, constipation, and respiratory depression.
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Nursing interventions: monitor for respiratory depression and assess for pain relief.
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Contraindications: patients with asthma due to bronchoconstriction.
Expectorants
- Guaifenesin increases respiratory tract fluid, reducing mucus viscosity.
- Therapeutic use: productive cough and mucus clearance.
- Contraindications: hypersensitivity and children under six.
Mucolytics
- Acetylcysteine breaks disulfide bonds in mucus, reducing its viscosity.
- Therapeutic use: pulmonary disorders with thick, tenacious mucus, such as cystic fibrosis and chronic bronchitis.
- Note: has a rotten egg smell.
Beta-Adrenergic Agonists
- Albuterol is a selective beta-2 adrenergic agonist and bronchial dilator.
- Therapeutic use: acute bronchospasm.
- Adverse effects: palpitations, headaches, throat irritation, tremors, restlessness, nervousness, and tachycardia.
- Contraindications: hypersensitivity, cardiovascular effects, and concurrent use of beta blockers.
- Interactions: concurrent use of MAOIs within 14 days of beginning therapy.
Anticholinergics
- Ipratropium is an anticholinergic bronchial dilator.
- Therapeutic use: COPD, asthma, and exacerbations.
- Adverse effects: upper respiratory tract irritation, cough, dry nasal mucus, hoarseness, and contraindications: hypersensitivity to soybeans and peanuts.
Alpha-Adrenergic Agonists
- Phenylephrine stimulates alpha-1 receptors, constricting nasal blood vessels.
- Therapeutic use: nasal congestion.
- Adverse effects: increase in blood pressure, bradycardia, burning of the mucosa, and rebound congestion with prolonged use.
- Contraindications: acute pancreatitis, heart disease, hepatitis, or narrowing angle glaucoma.
Leukotriene Modifiers
- Montelukast is a leukotriene receptor antagonist.
- Side effects: headache and nausea, diarrhea.
- Adverse effects: neuropsychiatric events (rare), such as suicide ideations, hallucinations, aggressiveness, or depression.
- Nursing interventions: monitor ALT levels.
- Contraindications: hepatic impairment.
Monoclonal Antibodies
- Reslizumab (Cinqair) binds to interleukin-5 (IL-5).
- Omalizumab (Xolair) attaches to receptors on immunoglobulin E (IgE).
Anti-Tubercular Drugs
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Isoniazid inhibits microorganism cell wall synthesis.
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Therapeutic use: tuberculosis.
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Adverse effects: neurotoxicity, paresthesia of the feet and hands, compulsions, optical neuritis, dizziness, memory loss, and various psychoses.
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Black box warning: hepatotoxicity.
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Rifampin inhibits DNA-dependent RNA polymerase in mycobacteria.
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Mechanism of action: inhibits bacterial RNA synthesis.
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Side effects: orange discoloration of bodily fluids, gastrointestinal upset.
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Adverse effects: hepatotoxicity (rare but serious).
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Description
This quiz covers the pharmacological actions and nursing interventions of Cromolyn, a mast cell receptor stabilizer, and Diphenhydramine, an H1 Receptor Agonist. Learn about their effects on histamine release and blocking.