Exam #2 Outline
1. What is the mechanism of action of the following in the treatment of respiratory problems?
● Antihistamines: compete with histamine H1 receptors for unoccupied histamine
receptors blocking the action of histamine which causes allergic symptoms and
decreases nasopharyngeal secretions.
● Decongestants: Stimulates alpha-adrenergic receptors in the sympathetic nervous
system. Relieves nasal stuffiness associated with common cold or allergies.
● Antitussives: dampen the cough reflex or raise the cough threshold in the CNS
● Bronchodilators: selectively binds to beta2 adrenergic receptors in bronchial smooth
muscle to cause bronchodilation
● Mucolytics/Expectorants: help loosen thick bronchial secretions so they can be
eliminated by coughing. Directly break down mucus molecule
2. What are some examples of these medications?
● Antihistamines: diphenhydramine (Benadryl), fexofenadine (Allegra), promethazine
(phenergan), loratadine (Claritin), dimenhydrinate (Dramamine)
● Antitussives:
○ Opioids: Hydrocodone (Hycodan), Codeine, Guaifenesin, Homatropine and
hydrocodone
○ Non opioid: Benzonatate (Tessalon Perles)
○ Expectorant: Dextromethorphan (Robitussin DM, Delsym)
● Bronchodilators: albuterol (Proventil, Ventolin, VoSpire), metaproterenol (Alupent)
● Mucolytics/Expectorants: acetylcysteine (mucomyst)
3. What are the contraindications?
● Antihistamines: in severe liver disease, narrow angle glaucoma, BPH, Urinary retention,
acute asthmatic attack
● Antitussives: take care when using in patients with asthma, bronchoconstriction may
occur. Hypersensitivity
● Bronchodilators: hypersensitivity, milk protein hypersensitivity
● Mucolytics/Expectorants: nonprescription cough and cold products (including those
containing guaifenesin) should not be used in children under 6 years of age.
4. What are the side effects?
● Antihistamines: drowsiness, paradoxical CNS stimulation and excitability, mild
hypotension. Anticholinergic effects: dry mouth, tachycardia, may cause photosensitivity
● Antitussives: overdose may cause respiratory depression. Drowsiness, dizziness,
euphoria, blurred vision, weakness, n/v/d, dependence, tolerance, withdrawal,
headache, hypotension, urinary retention, dry mouth, confusion, ocular irritation
● Bronchodilators: headaches, throat irritation, nervousness, restlessness, tachycardia,
chest pain, allergic reactions
● Mucolytics/Expectorants: drowsiness, dizziness, headache, confusion, irritability,
respiratory depression, fatigue, ataxia, n/v, restlessness
, 5. What are the teaching and nursing implications for the client being treated with this group of
medications?
● Antihistamines:
○ Give oral form of diphenhydramine with food to decrease gastric distress.
○ Warn the patient to avoid driving a motor vehicle and performing dangerous
activities until stabilized on the drug.
○ Advise the patient to avoid alcohol and other CNS depressants.
○ Suggest use of sugarless candy, gum, or ice chips for relief of mouth dryness.
● Antitussives:
○ Be careful with these because some of them have opioids. That’s why people
become addicted to them.
○ Overdose may cause respiratory depression
○ Take care when using in patients with asthma, bronchoconstriction may occur
● Bronchodilators:
○ Monitor vital signs.
○ Provide adequate hydration.
○ Observe for side effects.
○ Administer medication at regular intervals around the clock to have a sustained
therapeutic level.
○ Advise patients having asthmatic attacks to wear an identification bracelet or
Medic Alert tag.
● Mucolytics/Expectorants:
○ When taking an expectorant, patients should increase fluid intake to at least 8
glasses per day to help loosen mucus
6. What are the nursing implications for a client being treated with Beta2 adrenergic blockers
problems?
● Contraindications: hypersensitivity, milk protein hypersensitivity
● Patient education:
○ Monitor vital signs.
○ Provide adequate hydration.
○ Observe for side effects.
○ Administer medication at regular intervals around the clock to have a sustained
therapeutic level.
○ Advise patients having asthmatic attacks to wear an identification bracelet or
Medic Alert tag.
● Side effects: headaches, throat irritation, nervousness, restlessness, tachycardia, chest
pain, allergic reactions
7. What are the nursing implications for a client being treated with methylxanthines for
respiratory problems?
1. What is the mechanism of action of the following in the treatment of respiratory problems?
● Antihistamines: compete with histamine H1 receptors for unoccupied histamine
receptors blocking the action of histamine which causes allergic symptoms and
decreases nasopharyngeal secretions.
● Decongestants: Stimulates alpha-adrenergic receptors in the sympathetic nervous
system. Relieves nasal stuffiness associated with common cold or allergies.
● Antitussives: dampen the cough reflex or raise the cough threshold in the CNS
● Bronchodilators: selectively binds to beta2 adrenergic receptors in bronchial smooth
muscle to cause bronchodilation
● Mucolytics/Expectorants: help loosen thick bronchial secretions so they can be
eliminated by coughing. Directly break down mucus molecule
2. What are some examples of these medications?
● Antihistamines: diphenhydramine (Benadryl), fexofenadine (Allegra), promethazine
(phenergan), loratadine (Claritin), dimenhydrinate (Dramamine)
● Antitussives:
○ Opioids: Hydrocodone (Hycodan), Codeine, Guaifenesin, Homatropine and
hydrocodone
○ Non opioid: Benzonatate (Tessalon Perles)
○ Expectorant: Dextromethorphan (Robitussin DM, Delsym)
● Bronchodilators: albuterol (Proventil, Ventolin, VoSpire), metaproterenol (Alupent)
● Mucolytics/Expectorants: acetylcysteine (mucomyst)
3. What are the contraindications?
● Antihistamines: in severe liver disease, narrow angle glaucoma, BPH, Urinary retention,
acute asthmatic attack
● Antitussives: take care when using in patients with asthma, bronchoconstriction may
occur. Hypersensitivity
● Bronchodilators: hypersensitivity, milk protein hypersensitivity
● Mucolytics/Expectorants: nonprescription cough and cold products (including those
containing guaifenesin) should not be used in children under 6 years of age.
4. What are the side effects?
● Antihistamines: drowsiness, paradoxical CNS stimulation and excitability, mild
hypotension. Anticholinergic effects: dry mouth, tachycardia, may cause photosensitivity
● Antitussives: overdose may cause respiratory depression. Drowsiness, dizziness,
euphoria, blurred vision, weakness, n/v/d, dependence, tolerance, withdrawal,
headache, hypotension, urinary retention, dry mouth, confusion, ocular irritation
● Bronchodilators: headaches, throat irritation, nervousness, restlessness, tachycardia,
chest pain, allergic reactions
● Mucolytics/Expectorants: drowsiness, dizziness, headache, confusion, irritability,
respiratory depression, fatigue, ataxia, n/v, restlessness
, 5. What are the teaching and nursing implications for the client being treated with this group of
medications?
● Antihistamines:
○ Give oral form of diphenhydramine with food to decrease gastric distress.
○ Warn the patient to avoid driving a motor vehicle and performing dangerous
activities until stabilized on the drug.
○ Advise the patient to avoid alcohol and other CNS depressants.
○ Suggest use of sugarless candy, gum, or ice chips for relief of mouth dryness.
● Antitussives:
○ Be careful with these because some of them have opioids. That’s why people
become addicted to them.
○ Overdose may cause respiratory depression
○ Take care when using in patients with asthma, bronchoconstriction may occur
● Bronchodilators:
○ Monitor vital signs.
○ Provide adequate hydration.
○ Observe for side effects.
○ Administer medication at regular intervals around the clock to have a sustained
therapeutic level.
○ Advise patients having asthmatic attacks to wear an identification bracelet or
Medic Alert tag.
● Mucolytics/Expectorants:
○ When taking an expectorant, patients should increase fluid intake to at least 8
glasses per day to help loosen mucus
6. What are the nursing implications for a client being treated with Beta2 adrenergic blockers
problems?
● Contraindications: hypersensitivity, milk protein hypersensitivity
● Patient education:
○ Monitor vital signs.
○ Provide adequate hydration.
○ Observe for side effects.
○ Administer medication at regular intervals around the clock to have a sustained
therapeutic level.
○ Advise patients having asthmatic attacks to wear an identification bracelet or
Medic Alert tag.
● Side effects: headaches, throat irritation, nervousness, restlessness, tachycardia, chest
pain, allergic reactions
7. What are the nursing implications for a client being treated with methylxanthines for
respiratory problems?
