by gringo


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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
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