DRUGS FOR THE RESPIRATORY SYSTEM
DRUGS FOR THE UPPER RESPIRATORY TRACT Nursing Intervention:
I. SYMPATHOMIMETICS
MOA: stimulate the alpha adrenergic receptors of
the nasal mucosa, vasoconstriction, shrinking of
engorged nasal turbinates and nasal mucosa,
promotes sinus drainage and improves nasal air
passages
• **DOC for nasal congestion
• **available in P.O. & intranasal spray
Nursing Interventions:
1. Check history of HPN, DM, arrythmias,
hyperthyroidism, glaucoma, prostatic hyperplasia
2. Take vital signs
Side effects:
1. Nasal irritation- stinging or burning sensation
2. HPN – due to excessive use; monitor BP
II. ANTIHISTAMINES
MOA: compete for H1 receptors on the surface to
the arterioles, capilliaries and secretory glands of
the mucus membranes and prevents histamine
release
• **DOC for allergic rhinitis & allergic
conjunctivitis
Nursing Interventions:
1. Review history of glaucoma, prostatic
hyperplasia or asthma refer to MD
2. Assess patient’s work environment
Side effects:
1. Sedation and drowsiness most common side
effect; give during bedtime; provide personal
safety at work
2. Impaired expectoration dry mouth and throat
suck ice chips
3. Blurred vision, constipation, urinary retention
• ** increase fluid intake to 8-10 glasses of
water/day
III. INTRA-NASAL CORTICOSTEROIDS
MOA: inhibit generation of pro- inflammatory
cytokines
• ** for allergic rhinitis to control symptoms;
discontinue if no improvement within 3
weeks
Nursing Interventions:
1. Clear nose with decongestant
2. Blow nose thoroughly before spray
Side effects
1. Nasal burning
DRUGS FOR THE LOWER RESPIRATORY TRACT
I. ANTI-TUSSIVE AGENTS
MOA: suppress the cough center of the brain
• ** for severe, dry, hacking, non-
productive cough that wakes up the
patient at night
1. Assess the character of cough before therapy
Side effects:
1. Drowsiness alert patient if operating machines
2. Constipation increase in fiber intake
II. MUCOLYTICS
MOA: break disulphide bridges between the
macromolecules within the mucus, decreased
mucus viscosity, and easily removed by coughing,
bronchial clapping and postural drainage
• ** for emphysema, bronchitis, asthma,
pneumonia
Nursing Interventions:
1. Assess characteristics of cough
2. Monitor VS
3. Observe for GIT symptoms
4. Baseline assessment of mental status
Side effects:
1. Nausea & vomiting – due to pungent odor
(NAC); smell of rotten egg; have an emesis basin
ready
2. Bronchospasm – use a bronchodilating agent
III. EXPECTORANTS
Actions:
a) enhances output of respiratory tract fluid
b) decreases mucus viscosity
c) promotes cilliary action
• for dry productive cough; can be used in
combination of other cough agents
• do not give if cough lasts for a week
Nursing Intervetion:
1. Assess character of cough
Side effects:
** rare
The best expectorant is water
IV. BETA ADRENERGIC BRONCHODILATING AGENTS/
BETA 2 ADRENERGIC AGONISTS
MOA: stimulates beta 2 receptors thus open up the
airways
** mainstay treatment for asthma usually given as
nebulization for acute asthma attacks
Nursing Interventions:
1. Baseline VS
2. Assess palpitations and arrythmias
3. Baseline mental status (anxiety, nervousness,
alertness)
Side effects:
1. Tachycardia, palpitations increase of 20
beats/mins report to physician
2. Tremors adjust dose
3. Nervousness, restlessness, headache due to a) decrease bronchoconstriction
increase effect of the drug b) inflammatory responses
4. Nausea and vomiting
• inhibit trigger symptoms of asthma
V. METHYLXANTHINES • second line drugs
MOA: relaxes the smooth muscles of the bronchi • used if inhaled glucocorticoids does not
thus dilates the airways work
• for asthma and COPD
Nursing Interventions:
Nursing Interventions: 1. Baseline VS
1. Check history of angina, PUD, hyperthyroidism, 2. Pulmonary function test
glaucoma, DM
Side effects:
2. Baseline VS
no serious adverse reactions
3. Baseline mental status (anxiety, restlessness,
nervousness
Side effects: RESPIRATORY DRUGS
1. Nausea and vomiting; epigastric pain; A. DRUGS FOR UPPER RESPIRATORY DISEASES
abdominal cramps
2. Report palpitations
SYMPATHOMIMETIC DECONGESTANTS
3. Nervousness, alertness, anxiety due to
Phenylephrine (Dimetapp Reformulated)
the increased effects of the drugs report to the
physician Phenylpropanolamine ( Disudrin, Neozep,
Sinutab)
VI. ANTICHOLINERGIC AGENTS Ephidrine (Ephedrine)
MOA: blocks the muscarinic receptors of the Pseudoephedrine (Sudafed)
bronchi reducing bronchoconstriction Oxymetazoline (Drixine)
• for long term treatment of COPD
ANTI-HISTAMINES
Nursing Interventions: Diphenhydramine (Bendryl)
1. Baseline VS Chlorphenarmine maleate (Colvan, Ritemed)
2. Determine for any history of glaucoma Hydroxazine (Iterax)
Side effects: Loratadine (Claritin; Alerta; Loradex)
1. dry mouth suck ice chips or hard candy Desloratadine (Aerius, Deslogen)
2. throat irritation mouthwash of Cetirizine (Virlix; Zyrtec)
1 tbsp of hydrogen peroxide + 6-8 ounces of
Levocetirizine (Zyzal)
water; commercial mouthwashes are prohibited
Promethazine (Phenergan)
3. report tachycardia and urinary retention
Clemastine (Tavegyl)
Bilastine (Bilaxten)
VII. GLUCOCORTICOIDS (CORTICOSTERIODS)
MOA: suppressing inflammation thus INTRA-NASAL CORTICOSTEROIDS
a) reduce bronchial hyperactivity Mometasone fuorate (Mosaspray, Nasonex,
b) decrease airway mucus production Zymocort)
Fluticasone fuorate (Aramys)
• for long term airway inflammation
• prophylaxis for chronic asthma
B. DRUGS FOR LOWER RESPIRATORY DISEASES
• given only if unresponsive to previous drugs
mentioned
ANTI-TUSSIVE
Nursing Interventions: Dextromethorphan (Robitussin DM;Tuseran)
1. counseling and compliance Diphenhydramine (Benadryl)
2. preparation before administration Codeine (Robitussin AC)
3. mainating therapy Hydrocodone bitartarate (Hyocdan)
4. assess severe stress or acute asthma attack
Side effects: MUCOLYTIC
1. hoarseness and dry mouth Acetylcisteine (Fluimucil; Mucomyst)
2. oral thrush – advice mouthwash Carbocisteine (Solmux; Loviscol)

VIII. LEUKOTRIENE MODIFIERS/ ANTI

EXPECTORANT
LEUKOTRIENES
Guaifenesin (Robitussin)
MOA: suppress effects of leukotrienes thus Potassium iodide (SSKI)
BETA-ADRENERGIC BRONCHODILATING AGENTS
Salbutamol (Ventolin;Volmax)
Terbutaline (Bricanyl)
Salmeterol (Servent)
Isoproterenol (Isuprel)
Metaproterenol (Allupent)

XANTHINE DERIVATIVES
Aminophylline
Theophylline (Theodur; Nuelin; Asmasolon)

BRONCHODILATING AGENTS
Ipratropium bromide (Atrovent)
Iprsatropium bromide + salbutamol
(Pulmodual)
Ipratropium bromide + fenoterol (Berodual)
Ipratropium bromide + albuterol (Duavent)

CORTICOSTEROIDS
Prednisone (Organon; Pred)
Hydrocortisone (Solu-cortef)
Dexamethasone (Decadron)

ANTI-LEUKOTRIENE
Montelukast (Singulair; Montemax; Montiget)
Montelukast + levocetirizine (Zykast, Co-Altria;
Monte Plus)
Zafirlukast (Accolate)