Pharm Ch11: Allergy and Respiratory Medications

-Antihistamines: treat breathing problems caused by allergies
-Antitussives: control coughing
-Px and tx of asthma and COPD
-Decongestants and expectorants
-Nasal steroids

-Strictures (narrowed opening), obstruction (blockage) caused by mucous, collapse of the bronchioles, infectious masses or tumors, allergic reactions, or bacterial and viral infections

-A chemical the bod produces that cause the inflammatory process
-Mast cells (found near capillaries) and basophils (WBC's) contain large amounts of histamine the is released when the body is injures
-Causes smooth muscle and vascular system to increase blood flow by opening capillaries which leads to swelling, redness...

-Block the action of histamine by competing with it for the H1 receptor site on the "effector structure" (smooth muscle, salivary glands, mucosal glands)
-Blocking action limits the vasodilation and increased capillary permeability and reduces edema
-Antihistamines also limit the release of acetylcholine, producing an anticholinergic (drying) effect, esp in bronchioles and GI system

-Seasonal allergic rhinitis (SAR) (outdoor allergies), perennial allergic rhinitis (PAR) (indoor allergies), perennial nonallergic rinitis (PNAR) (caused by something other than allergies
-Used to relieve the symptoms of allergies: itchy eyes, sneezing, nasal stuffiness, post nasal drip, hives, angioneurotic edema, serum sickness, swollen nasal mucosa, clear watery discharge from nose

-HTN, hypotension, tachycardia, blurred vision, dizziness, drowsiness, excitation, insomnia, restlessness, sedation, tinnitus, anorexia, constipation, diarrhea, dry mouth, nausea, vomiting, difficult or painful urination, impotence, urinary retention, photosensitivity, rash, thickening of bronchial secretion

-A sedative effect is increased with other CNS depressants (hypnotics, sedative, alcohol, tranquilizers, analgesics

-Contradiction and percautions: thyroid disease (tachycardia), family history of sleep apnea or SIDS, children with symptoms of Reye's syndrome
-If giving IM may cause tissue irritation (z-track)

-May cause drowsiness so avoid task such as driving and heavy machinery
-If upset stomach take with meal or milk
-Do not take with alcohol or other sedative drugs
-Tolerance may develop, pt can switch to another antihistamine
-Stop using 48hrs before allergy test

-Alkylamines: brompheniramine, chlorpheniramine, dexchlorpheniramine
-Ethanolamines: Clemastine, dephenhydramine
-Ethylenediamine:
-Phenothiazine: promethazine
-Piperazine: Hydroxyzine
-Piperidines: azatadine, cetizine, cyorheptadine, fexofenadine, loratadine, phenindamine

-P-Tex
-Dimetapp
-Effective at low dosages, practical fro daytime use
-May cause both CNS depression and stimulation

-Chlor-Trimeton
-Low incidence of side effects
-Available OTC
-Effective at low dosages, practical fro daytime use
-May cause both CNS depression and stimulation

-Polaramine
-Effective at low dosages, practical fro daytime use
-May cause both CNS depression and stimulation

-Travist
-Highest incidence of drowsiness, but GI side effects are infrequent

-Benadryl
-Genahist
-Diphenhist
-Anticholinergic, antitussive, antiemetic, sedative properties; high incidence of CNS depressant effects; drowsiness increases with use

-Phenergan
-High incidence of side effects, including sever drowsiness, potent drug with prolonged action
-Strong CNS depressant, may suppress cough reflex,

-Vistaril
-For pruritus, sedation, adjunct to analgesia, antiemetic

-Astelin nasal spray

-Narcotic antitussive suppress the cough reflex by acting directly on the cough center in the medulla of the brain
-Nonnarcotic antitussives anesthetizing stretch receptors in the reparatory passage, lungs, and pleura and decreasing their activity

-Relief of overactive or nonproductive coughs

-Constipation, drowsiness, dry mouth, nausea, postural hypotension

-Additive effect on with other CNS depressants
-Increase the analgesic effect of aspirin, which may be helpful

-May cause drowsiness
-Overuse of the codeine-containing antitussives may cause constipation and addiction
-May cause nausea, lying down can help
-Take with milk or food if upset stomach occurs

-Codeine: codeine phosphate, codeine sulfate
-Hydrocodone: hycodan

-Benzonatate: Tessalon perles
-Dextromethorphan: Benylin DM, Robitussin DM, Vicks Formula 44
-Diphenhydramine: Tusstat