What four things make up the upper respiratory tract?

nose
nasal cavity
pharynx
sinuses

Mast cells release histamine which cause what reactions?

sneexing, watery eyes, itching nose, vasodilation, bronchoconstriction and increased secretion

The upper respiratory tract is richly supplied iwth vascular tissue which is under the control of what system?

Autonomic nervous system

What do you call inflammation of nasal mucosa due to allergens?

allergic rhinitis

What are the three drug classes for preventing (prophylaxis) allergic rhinitis?

- anti-hystamines
- nasal steroids
- mast cell stabilizers

Name a reliever of allergic rhinitis.

decongestants

What is the prototype 1st generation antihistamine?

Benadryl

What is the prototype second generation antihistamine?

Allegra

What is the MOA of Anti-histamines?

bind to histamine receptor to prevent response (does not prevent histamine release)

What is one contraindication of Antihistmines?

narrow angle glaucoma

What are sx of antihistamines?

2nd Gen - decreased drowsiness
1st Gen - dry mouth and mucus membranes, urinary retention, nausea, headache, dizziness, paradoxical CNS stimulation

What nursing implications are there for antihistamines?

-Assess symptoms: sneezing, runny nose, itching eyes, nose and throat
- Anti-cholinergic effects with 1st generation - dry mouth and urinary retention

What are six pt teachings for Antihistamines?

- should be taken before exposure to allergen
- avoid driving until response to med is known
- caution in using alcohol and other cns depressants (narcotics, sedatives)
- report eye pain, blurred vision, difficulty voiding
- 1st gen - paradoxical cns stimulation: nervousness, insomina, tremors
- 2nd gen - do not take with juices

Name five meds used to treat colds.

- antihistamines
- oral decongestants
- antitussives
- expectorants
- mucolytics

What is the drug of choice for perinneial allergic rhinitis?

Flonase (fluticasone propionate) (glucocorticoid)

What is the MOA of nasal steroid glucocorticoid Flonase (Fluticasone propionate)?

decrease inflammation

What sx are related to nasal steroid glucocorticoid Flonase (Fluticasone propionate)?

because it is topical and not systemic it has very few sx - dry nasal mucosa (epistaxis), burning sentation

List three nursing implications for nasal steroid glucocorticoid Flonase (Fluticasone propionate)?

- give nasal decongestants 15 min before nasal steroid
- pt to blow nose before administering
- assess mouth/throat for infection (thrush)

What is the prototype drug for nasal decongestants?

Afrin (oxymetazoline)

What is the pharmalogical classification for nasal decongestant Afrin (oxymetazoline)?

sympathomimetic

What is the MOA of nasal decongestant Afrin (oxymetazoline)?

bind to alpha1 receptors to vasoconstrict nasal mucosa 

What are sx of nasal decongestant Afrin (oxymetazoline)?

- nasal spray - not systemically absorbed
- oral - HTN, insomnia, anxiety (eg sudafed)

What nursing implication exists for nasal decongestant Afrin (oxymetazoline)?

can cause rebound congesting if used > 3-5 days

What meds are used to suppress dry, hacking, irritating, non-productive cough? 

Antitussives

What type of antitussive is dextromethorphan?

non-opioid

What type of antitussive is codeine?

opioid

What is the MOA of antitussive non-opioid dextromethorphan?

suppresses cough reflex in the medulla

What are two contraindicaions for antitussive non-opioid dextromethorphan?

- MAO inhibitors
- SSRI

What are four nursing implications for Antitussives?

- increase fluid intake
- assess respiratory status
- report cough lasting >1week
- do not drink immediately after taking