respiratory tract drugs-pharm

Benefits equivalent to oral antihistamines metered

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Unformatted text preview: le – Benefits equivalent to oral antihistamines – Metered-spray device, leaves bitter taste 13 Actions of Histamine Actions Antihistamines are drugs that directly compete with histamine for specific receptor sites for this reason they are also called antagonists. Bronchoconstrictor Vasodilatation Increased Capillary Permeability Mucosal Edema 14 Histamine Antagonists Histamine Nonsedating- second generation Nonsedating“adine” desloratadine---Clarinex desloratadine---Clarinex fexofenadine---Allegra fexofenadine---Allegra loratadine---Claritin loratadine---Claritin Sedating- first generation Sedatingcetirizine---Zyrtec (mild) cetirizine---Zyrtec brompheniramine---Dimetane brompheniramine---Dimetane diphenhydramine---Benadryl diphenhydramine---Benadryl 15 Histamine Antagonists Histamine Mechanism of Action block H-1 receptors block action of histamine more effective in preventing the actions of histamine than reversing them once they have taken place 16 Histamine Antagonists Histamine Uses decrease discomfort in acute allergic reactions that involve the upper respiratory tract reduce swelling and itching relieve symptoms of a cold relieve allergic rhinitis allergic symptoms sleeping aids/insomnia prevent nausea and vomiting/motion sickness prevent tremors/PD 17 Histamine Antagonists Histamine Adverse Reactions (anticholinergic) dry mouth blurred vision urinary retention tachycardia constipation insomnia tremors Sedation/drowsiness most common Elderly are at greater risk 18 Histamine Antagonists Histamine Nursing Implications monitor vital signs avoid driving or using hazardous equipment take with meals or snacks to decrease GI distress increase fluids to decrease effects of dry mouth and constipation take regularly if being used to manage allergies avoid use of alcohol/additive effects can cause drowsiness instruct patient to read labels of OTC’s generally contraindicated in narrow-angle glaucoma, BPH, pregnancy, bladder neck obstruction, and peptic ulcer disease If using for motion sickness take 30-60 minutes before travel 19 Intranasal Glucocorticoids Intranasal Most effective for treatment and Most prevention of rhinitis prevention Mild adverse effects – Drying of nasal mucosa or sore throat – Rarely, systemic effects (adrenal suppression Rarely, and slowing of linear pediatric growth) and 20 21 21 Intranasal Cromolyn Intranasal Trade name: NasalCrom – Extremely safe, but only moderately effective – Suppresses release of histamines from mast Suppresses cells cells – Best used for prophylaxis, not for treatment – Response may take 1-2 weeks to develop 22 Sympathomimetics (Oral/Nasal) Sympathomimetics (AKA Decongestants) Reduce nasal congestion (do not reduce Reduce rhinorrhea, sneezing, or itching) rhinorrhea, Activate alpha1-adrenergic receptors on -adrenergic nasal blood vessels – Alpha 1 can become desensitized in the nose Adverse effects – Rebound congestion (after 3 days) – CNS stimulation – Cardiovascular effects and stroke – Abuse 23 Sympathomimetics (Oral/Nasal) Sympathomimetics (AKA Decongestants) Factors in topical administration – Should not use more than 5 consecutive days – Drops versus sprays Phenylephrine, ephedrine, Phenylephrine, pseudoephedrine (sudafed) pseudoephedrine Antihistamine-sympathetic combinations – Ipratropium bromide (Atrovent) – Montelukast (Singulair) – Omalizumab (Xolair) 24 25 25 Drugs for Cough Drugs Antitussives – Drugs that suppress cough...
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