-
intranasal glucocorticoids
prototype
mech of action
use
adverse effects
- flonase
- decreases inflammation in nasal passages reducing stuffiness
- used for allergic rhinintis
- adverse reaction: nasal irritation, epistaxis
-
who should not use intranasal glucocorticoids
worsens asthma and can lead to respiratory failure
-
patient teaching on flonase
- more effective if taken 2-3 weeks before seasons begin, know when their seasons begin.
- these are preventer drugs
- -report respiratory distress
- -wash nose piece with water after each use
- -return demonstration of technique
-
other types of intranasal glucocorticoids
- beconase
- vanconase
- rhinocort
- nasalike
- nasonex
- nasacort
-
flonase assessment
- old carts
- health history
- allergies
- current meds
- allergy history
- vital signs
-
flonase interventions
- monitor respiratory
- signs of infection
- irritation
- bleeding
-
alternative to flonase
nasocrom its a mast cell stabilizer- stops mast cells from releasing histamine
-
intranasal decongest
prototype
mech of action
adverse effects
- Afrin
- mech of action- causes arterioles in nose to constrict and dries membranes
- adverse effects- minor stinging and dryness in nose
-
patient teaching AFrin
- do not use more than 3-5 days due to rebound congestion
- take a break of two to three weeks in between
-
afrin assessment
- health history
- old carts
- allergy history
- past surgeries especially nasal
-
afrin interventions
- pupil size- for constriction
- respiratory status- depression
- diabetics- can raise blood sugar
- compliance- rebound congestion
- caution in patients with hyperthyroidism
-
other names for afrin
- oxymetazoline
- afrin 12 hour
- neo synephrine 12 hour
-
who should avoid oral decongestants
- patients with cardiac and HTN issues
- increased HR, Resp, BP
-
expectorants
acytocystine
- make secretions thinner thus easier to remove,
- acytocystine used in tylenol overdose
-
mucolytics
break down mucus molecule
-
antitussives
prototype
mech of action
use
adverse effects
- benylin (dextromethorphan)
- mech of action- in medulla to inhibit cough
- use- in most OTC cold and flu meds
- adverse effects dizziness, drowsiness, GI upset
-
opoid antitussives
contain codeine
-
when may the doctor want to suppress the cough reflex
- if patient had eye or ear surgery
- if cough is productive- may suppress only at nite so pt can sleep
- if cough is dry and non productive
- drug may worsen asthma attacks
-
what is the main thing you need to monitor for in anticholergic drugs (atrovent, comnivent)
- monitor vision changes
- use caution in patients with narrow angle glaucoma
-
what are other things to monitor with these drugs
- LOC becasue they can lower seizure threshold
- Renal toxicity- these drugs should be used cautiously in patients with kidney and urinary problems
- some of these can raise blood sugar
- GI- N/V, buring
- thyroid function in patients with hyperthyroid
-
what are the drugs for upper respiratory
- intranasal glucocorticoids- flonase
- mast cell stabilizers- comomlyn
- decongestants- afrin
- nasal decongestants anticholinergic- atrovent and combivent
- expectorants- acetocystine
- mucolytics
- antihistimines- benedryl 1st gen, allegra 2nd generation
- opoids cough meds containing codeine
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