the effectiveness of the stretch

FATHER SATURNINO URIOS UNIVERSITY

San Francisco St. Butuan City 8600, Region XIII Caraga, Philippines
Tel. Number 085-34130001 local 4853
Nursing Program
receptors that stimulate a cough reflex.
● For relief of moderate to moderately
PHARMACOLOGY N21 severe pain.
● For the treatment of dry cough, drug
Respiratory Agents
withdrawal syndrome, opioid type drug
Prepared by: Jovenice JC V. Alquizar, SN BSN2
dependence, and pain.

Adverse effects from the use of antitussives

RESPIRATORY AGENTS
include:
PDF by: Mrs. Daisy Carin
● CNS: Drowsiness and sedation.
OVERVIEW ● GI: Nausea, constipation, dry mouth, GI
● Recall the respiratory system upset.
● Respiratory dugs: Antihistamine
,Decongestant, Antitussives, Mucolytic, Interactions involved in the use of antitussives
Expectorant, Antiashtma are:
● Respiratory Disorders: nose/nostrils, nasal cavity, mouth, pharynx
(throat), and larynx above the vocal folds ● Monoamine oxidase inhibitors (MAOI).
○ Upper Respiratory Sysyem Dextromethorphan should not be used
○ Lower Respiratory System with MAOIs because hypotension, fever,
-tussive is related to cough larynx below the vocal folds, trachea, lungs, nausea, myoclonic jerks, and coma
ANTITUSSIVES
bronchi, bronchioles, alveoli, and diaphragm
could occur.
● Antitussive is a drug used to relieve
coughing , a medication often The following are contraindications and
recommended for the treatment of cautions for the use of antitussives:
cough and associated respiratory tract ● Patent airways
damaged alveoli
disorders. ● Asthma and emphysema
● Antitussives act on the cough-control ● Addiction
center in the medulla to suppress the ● Sedation
cough reflex; if the cough is ● Pregnancy
nonproductive and irritating,
anantitussive may be taken. Assessment and history taking in a patient
using antitussives include the following:
The desired actions of antitussives are as
follows: ● Assess for possible contraindications

➔ Acts directly on the medullary cough and cautions (e.g., history of allergy to

center of the brain to depress the the drug, cough for more than 1

cough reflex. week, and pregnancy and lactation).

➔ Because they are centrally acting, they ● Perform a physical examination to

are not the drugs of choice for anyone establish baseline data.

who has a head injury or could be ● Monitor the temperature to evaluate

impaired by central nervous system for possible underlying infection.

depression. ● Assess respirations and adventitious

sounds.

Antitussives are indicated for the following: ● Evaluate orientation and affect.

● Local anesthetic on the respiratory

passages, lungs, and pleurae, blocking
MUCOLYTIC Nursing interventions for patients
● Mucolytic is a drug that breaks down usingmucolyticsinclude:
thick, tenacious mucus in the lower
● Ensure drug effectiveness.
portions of the lungs. ● Prevent skin breakdown.
● Proper use of nebulizer.
Actions: a drug with mucolytic activity appears ● Proper storage.
to reduce the viscosity (thickness) of respiratory ● Provide health education.
secretions by direct action on the mucus. ● Provide support.

mucus thinners
● Mucolytics are medicines that thin EXPECTORANTS
mucus, making it less thick and sticky ● Expectorant is a drug that thins
and easier to cough up. respiratory secretions to remove them
● They are used to treat respiratory more easily from the respiratory system.
conditions characterized by excessive
or thickened mucus, such as a chesty Expectorants are indicated for the following:
(productive) cough. Symptomatic relief of respiratory conditions
● Its adverse effects include headache, characterized by a dry, nonproductive cough.
nausea, vomiting, gastric discomfort
and bleeding, diarrhea, and rash. It has, ● The most commonly used expectorant is
however, been shown to be an Guaifenesin, a common component of
effective mucolytic which is generally OTC for cold and flu medications.
well tolerated with few adverse effects. ● Guaifenesin is absorbed through the GI
tract, metabolized by the liver, and
Some of the more common types of excreted primarily by the kidneys.
mucolytics include: ● Guaifenesin helps make mucus easier to
● Mucinex (guaifenesin) cough up and is used for the relief of
● Carbocisteine symptoms caused by productive cough
● Pulmozyme (dornase alfa) from many disorders such as: colds,
● Erdosteine minor bronchial irritation, bronchitis,
● Mecysteine influenza, sinusitis, bronchial asthma and
● Bromhexine emphysema
● Hyperosmolar saline
● Mannitol powder The following are contraindications and
cautionswhenusingexpectorants:
The various types of mucolytic agents each ● Allergy.
have a different action: ● Pregnancy or lactation.
Expectorants clears mucus ● Cough.
- increase airway water to help with
mucus clearing. Adverse effects from the use of expectorants:
Mucoregulators coughing or movement of mucus increased ● GI: Nausea, vomiting, anorexia.
- increase the movement of mucus via ● CNS: Headache, dizziness.
cough. ● Underlying cough: The most important
Mucokinetics suppress mucus secretions
consideration in the use of these drugs is
- suppress the mechanisms causing discovering the cause of the underlying
excess mucus secretions. cough; prolonged use of the OTC
preparations could result in the masking
 of important symptoms of a serious ➔ Insomnia.
underlying disorder. ➔ Motion sickness.
● Respiratory: Rhinorrhea, bronchospasm. ➔ Anxiety.
● Skin: Rash.
● Guaifenesin isn't known to have specific H-2 antihistamines treat:
drug interactions. ➔ Heartburn.
● Adverse reactions include: vomiting , ➔ Gastroeophageal reflux disease (GERD).
diarrhea , drowsiness, nausea, ➔ Duodenal and gastric ulcers.
abdominal pain, headache, and hives ➔ Zollinger-Ellison syndrome. excess gastrin
or skin rash.
hormone causing
peptic ulcer & diarrhea
OTC antihistamines include:
Nursing Considerations for patients ● Brompheniramine (Dimetane)
undergoing treatment with an expectorant: ● Cetirizine (Zyrtec)
● Chlorpheniramine (Chlor-Trimeton)
● Proper administration
● Clemastine (Tavist)
● Prevent GI upset
● Diphenhydramine (Benadryl)
● Ensure safety
● Avoid overdosage ● Fexofenadine (Allegra)
● Provide health education ● Loratadine (Alavert, Claritin)
● Offer support nasal congestion is the blockage of nasal breathing

DECONGESTANTS
ANTIHISTAMINE ● Decongestants decrease the over
● Antihistamines are drugs which treat production of secretions by causing
allergic rhinitis and other allergies. local vasoconstriction to the upper
● Typically people take anti histamines as respiratory tract.
an inexpensive, generic, ● This vasoconstriction leads to a shrinking
over-the-counter drug that can provide of swollen mucous membranes and
relief from nasal congestion, sneezing, or tends to open clogged nasal passages,
hives caused by pollen, dust mites, or providing relief from the discomfort of a
animal allergy with few side effects. blocked nose and promoting drainage
● Antihistamines are divided into two of secretions and improved airflow.
major subtypes: ● Decongestants are a type of medicine
- H-1 receptor antagonists or H-1 that can provide short-term relief for a
blockers. blocked or stuffy nose (nasal
- H-2 receptor antagonists or H-2 congestion). They can help ease the
blockers symptoms of conditions such as colds
and flu, hay fever and other allergic
H-1 antihistamines treat: reactions, catarrh and sinusitis.
➔ Allergic rhinitis/hay fever. ● Topical nasal decongestants, oral
➔ Allergic conjunctivitis. decongestant, and topical steroid nasal
➔ Hives and other skin rashes. decongestants are classifications of
➔ Colds. decongestants.
➔ Food allergies.
➔ Hypersensitivity to certain drugs. Indications for decongestants include:
➔ Insect bites and stings. Topical nasal decongestants
● Relieves discomfort of nasal congestion
associated with the common cold,
First-generation H-1 antihistamines also treat: sinusitis, allergic rhinitis.
 inflammation of the middle ear

● Relieves pressure of otitis media. 5. Monitor pulse, blood pressure, and

Oral decongestants cardiac auscultation
● Decreases nasal congestion associated 6. Evaluate respirations and adventitious
with the common cold, allergic rhinitis. breathsounds
● Relief of pain and congestion of otitis 7. Evaluate nasal mucous membrane
media. 8. Monitor urinary output
Topical nasal steroid decongestants 9. Monitor temperature
● Treatment of seasonal allergic rhinitis in
patients who are not obtaining a
Nursing interventions for clients using
response with other decongestants or decongestants are:
preparations.
● Proper administration
● Relieves inflammation following removal
● Proper technique
of nasal polyps.
● Duration of intake
● Avoid overdosage Safety measures
Adverse Effects from the use of decongestants ● Comfort measures
include: ● Patient teaching
➔ Rebound congestion ● Provide support
➔ Topical nasal decongestants ● Ensure compliance
● Monitor for infection
➔ Oral decongestants
➔ Topical nasal steroids decongestants

The following are contraindications and BRONCHODILATORS

cautions for the use of decongestants: ● Bronchodilators are a type of
● Caution must be used when there is medication that make breathing easier
lesion or erosion in the mucous by relaxing the muscles in the lungs and
membrane that could lead to systemic widening the airways (bronchi).
absorption. ● They're often used to treat long-term
● Caution should also be used in patients conditions where the airways may
with any condition that might be become narrow and inflamed, suchas:
exacerbated by sympathetic activity. asthma
● If used during pregnancy or lactation, - a common lung condition
caution is advised. caused by inflammation of the
● Caution should be used in any patient airways.
who has an active infection, including ● Bronchodilators may be either:
tuberculosis because systemic - short-acting
absorption would interfere with the - Long-acting
inflammatory and immune response.
Types of Bronchodilator
History taking and examination of a client The 3 most widely used bronchodilators are:
usingdecongestants should include the 1. Beta-2 agonists, such as salbutamol,
following: salmeterol, formoterol and vilanterol
1. Assess for possible cautions and 2. Anticholinergics, such as ipratropium,
contraindications tiotropium, aclidinium and
2. Perform a physical examination glycopyrronium
3. Assess skin color and temperature 3. Theophylline
4. Evaluate orientation and reflexes
ANTIASTHMA DRUGS ● Evaluate orientation, affect, and

● Antiasthmatic drugs are medicines that reflexes

treat or prevent asthma attacks.

● Three types of drugs are used in treating
and preventing asthma attacks:
- Bronchodilators relax the smooth
muscles that line the airway.
- Corticosteroids block the
inflammation that narrows the
airways.
- Cromolyn also is taken regularly
to prevent asthma attacks and
may be used alone or with other
asthma medicines.
Precautions:
➔ Using antiasthmatic drugs properly is
important.
The nursing interventions for patients using
bronchodilators or antiasthmatics include:
● Relieve GI upset
● Monitor drug response
● Provide comfort
● Provide follow-ups
● Individual drug response
● Proper administration and dosage
● Proper use of sympathomimetics
● Use of adrenergic blockers
● Increase oral fluid intake
● Encourage voiding
● Small, frequent meals
● Use of inhalator
● Educate the patient
● Provide patient support

➔ Parents whose children are using their

antiasthmatic drugs correctly but feel
their asthma is not under control should
see consult their child's physicians.
➔ Corticosteroids are powerful drugs that
may cause serious side effects when
used over the long term.
➔ When used to prevent asthma attacks,
cromolyn must be taken as directed
everyday.

History taking and physical examination of

patients taking bronchodilators or
antiasthmatics:
● Assess for possible contraindications or
cautions
● Perform a physical examination
● Perform a skin examination, including
color and the presence of lesions
● Monitor blood pressure, pulse, cardiac
auscultation, peripheral perfusion, and
baseline electrocardiogram
● Assess bowel sounds and do a liver
evaluation and monitor liver and renal
function tests
● Evaluate serum theophylline levels
● Evaluate urinary output and prostate
palpation as appropriate