RESPIRATORY SYSTEM DRUGS

NAME OF DRUG Diphenhydramine

CLASSIFICATION Pharmacologic class: Antihistamine
Therapeutic class: Antianaphylactic adjunct, antidyskinetic,
antiemetic, antihistamine, antitussive (syrup), antivertigo,
sedative-hypnotic
INDICATION This is used to treat hypersensitivity reactions. This includes
perennial and seasonal allergic rhinitis, allergic conjunctivitis, and
vasomotor rhinitis.
ACTION  Binds to central and peripheral H1 receptors, displacing
histamine from the action site by vying for these receptors.
 Diphenhydramine inhibits smooth muscle contraction in
the GI, respiratory, and vascular systems.
 It also decreases capillary permeability, which lessens
flare-ups, itching, and wheals, as well as lacrimal and
salivary gland secretions.
 Diphenhydramine has antidyskinetic effects that may be
caused by CNS acetylcholine inhibition.
 Directly inhibiting the cough center in the medulla
oblongata of the brain, it also has antitussive effects. Due
to its capacity to bind to CNS muscarinic receptors and
inhibit vestibular stimulation and labyrinthine activity.
ADVERSE REACTION  Diphenhydramine may cause drowsiness.
 Arrhythmias, tachycardia, and palpitations
 Diplopia and blurred vision
 Nausea and distress in epigastric
 Agranulocytosis ad thrombocytopenia
 Thickened bronchial secretions and photosensitivity
NURSING  This drug must be prevented from having contact with light
INTERVENTION so, keep the lid of container tightly close.
 Assess the patient if they are allergic to this drug.
 Inform the patient about the indications of drug.
 Assess the best administration method.

NAME OF DRUG Acetylcysteine

CLASSIFICATION Pharmacologic class: L-cysteine derivative
Therapeutic class: Antidote (for acetaminophen overdose),
mucolytic
INDICATION To thin out abnormally thick, viscid, or thick mucus discharges in
long-term lung conditions.
ACTION  Breaks the disulfide bonds that hold the glycoproteins in
mucus together, reducing the viscosity of pulmonary
secretions.
 Minimizes acetaminophen overdose-induced liver
damage. Normally, the liver's glutathione binds with the
harmful metabolites of acetaminophen to detoxify them.
 When liver cells are overexposed to acetaminophen and
 their glutathione levels drop, poisonous compounds bind
to the protein and destroy the cells.
 Glutathione levels are maintained, restored, or replaced by
acetylcysteine, which lessens liver damage from
acetaminophen overdose.
ADVERSE REACTION  Chills, headache, fever, and drowsiness
 Edema, hypotension, and tachycardia
 Rhinorrhea, stridor, and stomatitis
 Constipation, anorexia, and hepatotoxicity
 Bronchospasm, cough, and wheezing
 Erythema, pruritus, and rash
 Anaphylaxis and angioedema
NURSING  It's important to be aware that acetylcysteine should only
INTERVENTION be used with caution in people who have asthma or a
history of bronchospasm because it may negatively impact
respiratory function.
 Watch for signs of hepatotoxicity during treatment for
acetaminophen overdose.
 If the patient vomits after receiving a loading dosage or a
maintenance dose within an hour of administration, repeat
the dose as directed.
 Be aware that acetylcysteine may have a disagreeable
odor, which disappears as treatment progresses.

GASTROINTESTINAL TRACT DRUGS

NAME OF DRUG Lactulose
CLASSIFICATION Pharmacologic class: Disaccharide
Therapeutic class: Colonic acidifier
INDICATION This is used to treat constipation
ACTION  Arrives in the colon unmodified and disintegrates there,
acidifying the feces with lactic acid and trace amounts of
acetic and formic acids.
 Increased osmotic pressure in the colon brought on by
acidification raises the water content and softens the
feces.
 Lactulose also raises the acidity of intestinal contents over
that of blood. This stops the intestinal ammonia from
diffusing into the blood, which is what happens in hepatic
encephalopathy.
 Due to the cathartic properties of lactulose, the trapped
ammonia is changed into ammonia ions and released in
the feces together with other nitrogenous wastes.
ADVERSE REACTION  Hyperglycemia, Abdominal cramps, and hypovolemia
NURSING  Use a rectal tube with a balloon to help patient retain
INTERVENTION enema for 30 to 60 minutes. If not retained for at least 30
minutes, repeat dose. Be sure to deflate balloon and
remove rectal tube after completing administration.
  Monitor blood ammonia level in patient with hepatic
encephalopathy
 Watch for dehydration, hypernatremia, and hypokalemia
when giving higher lactulose doses to treat this condition.
 Plan to replace fluids if frequent bowel movements cause
hypovolemia.

NAME OF DRUG Omeprazole

CLASSIFICATION Pharmacologic class: Proton pump inhibitor
Therapeutic class: Antiulcer
INDICATION To treat symptomatic gastroesophageal reflux disease (GERD)
ACTION  Blocking the hydrogen potassium adenosine
triphosphatase (H+ K+ -ATPase) enzyme system, or
proton pump, in gastric parietal cells, omeprazole prevents
the release of stomach acid. Normally, the proton pump
drives hydrogen (H+) and chloride (Cl) out of parietal cells
and into the stomach lumen in exchange for potassium
(K+), which exits the stomach lumen and enters parietal
cells, using energy from the hydrolysis of adenosine
triphosphate.
 Omeprazole permanently prevents intracellular H+ and
extracellular K+ from exchanging, as seen in the
illustration to the right.
 Omeprazole prevents H+ from entering the stomach
lumen, preventing the production of more HCl.
ADVERSE REACTION  Agitation, asthenia, and drowsiness
 Hypertension and chest pain
 Hypoglycemia
 Agranulocytosis and anemia
 Neutropenia and thrombocytopenia
 Bronchospasm
 Anaphylaxis
NURSING  For a once-daily dose, administer omeprazole before
INTERVENTION meals, preferably in the morning. Give an antacid as
directed if necessary.
 Be aware that a medicine may interfere with a patient's
ability to absorb vitamin B12; keep an eye out for
macrocytic anemia.
 Omeprazole may cause acute interstitial nephritis,
therefore keep an eye on the patient's urine production. If
the patient's urine output drops or there is blood in their
pee, alert the prescriber.
 Know that proton pump inhibitors such as omeprazole
should not be prescribed longer than
 medically necessary