Anti cholinergic effects (dry mouth, constipation, urinary hesitancy)-Acute toxicity-*in adults: flushed face, high fever, tachycardia, dry mouth, urinary retention, pupil dilation-*in children: excitation, hallucination and seizures-Interventions-Monitor the patient when ambulating-Recommend a nonsedating antihistamine if sedation is excessive-Encourage sips of water or sucking on hard candy-Recommend selecting high fiber foods-Provide fiber supplement or laxative as needed-Monitor for urinary retention-Give with food-If acute toxicity develops:-Administer acetaminophen-Apply ice packs or give sponge baths-Anticipate the need for phenytoin IV if patient experience seizures-Administration-Do not crush or chew enteric-coated formulations-Do not take with alcohol or other CNS depressants-Take 30 min prior to activity for motion sickness-Patient instructions-Take the drug prior to or at bedtime-Suck on hard cany-Increase fluid and fiber intake and take laxative as needed-Report difficulty urinating-Take drug with food if experiencing abdominal discomfort-If symptoms of acute toxicity develop-Stop taking the drug
-Seek medical care-Contraindications-Newborns and children under 2 years-Breastfeeding women-Narrow-angle glaucoma-Prostatic hypertrophy-Acute asthma exacerbation-Precautions-Children and older adults-Patient with history of-*asthma-*urinary retention-*open-angle glaucoma-*Hypertension-*impaired kidney or liver function-Interactions-Alcohol and other CNS depressants increase depressant effects of antihistamine-Nonsedating antihistamines-Allergic rhinitis-Chronic idiopathic urticarial-Prototype drug: cetitizine (Zyrtec)-Other drugs:-Loratadine (Claritin)-Fexofenadine (Allegra)-Desloratadine (ClarineX)-Expected pharmacologic action-Bind to H1 receptors: block release of histamine-Side/Adverse effects-Drowsiness and fatigue-Mild anticholinergic effects (dry mouth, nose, throat)-Interventions-Monitor the patient when ambulating-Provide water, and encourage frequent sips-Provide hard candy to suck on-Administration-Give with or without food-Do not give with other over the counter antihistamines-Expect dose to be lower in patients who have compromised renal or liver function-Patient instructions-Take once-daily at time desired-Avoid driving and activities that requires mental alertness until the drug effects are known-Contraindication-Infants under 6 months
-Breastfeeding women-Precautions-Impaired kidney or liver function-Interactions-Theophylline can reduce clearance and lead to toxicity-Atropine may cause anticholinergic effects-Sympathomimetics-Reduction of nasal congestion-*allergic rhinitis-*sinusitits-*common cold-Prototype Drug : phenylephrine (Neo-Synephrine)-Other drugs-Pseudoephedrine (Sudafed)-Ephedrine-Expected Pharmacologic Action-Activate alpha1-adrenergic receptors in the nose (sympathomimetic)-Vasconstriction of blood vessels-Turbinates shrink, which opens nasal passages-Side/Adverse effects-CNS stimulation with oral agents (agitation, anxiety, insomnia)-
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Term
Spring
Professor
Fortes
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