Postpartum

Respiratory Drug Chart
DrugMechanismUseSide/Adverse EffectsNursing Implications
Antihistamines
diphenhydramine hydrochloride-BENADRYL
ALLEGRA, CLARITIN, ZYRTEC -competes for H1 receptors -prevent & treat allergic responses
-hypnotic—safe, non- narcotic
-anticholinergic
-anti-emetic Central nervous system side effect are: drowsiness, sedation, vertigo.
Cardiovascular side effect are: hypotension, palpitations, arrhythmias
Respiratory side effects are: dryness of mouth, thicken bronchial secretion
Gastrointestinal : anorexia, diarrhea or constipation
Genitial urinary: urinary rentention, dysuraiAvoid pregnancy, and lactation
Take anticholingeric caution with glaucoma, hyperthyroidism
Be caution about driving
Take meds at bedtime to avoid sedation
Bronchodilators Beta Agonists
Nonselective: Isoproterenol, Epinephrine, Ephedrine
Selective: albuterol, metaproterenol, terbutaline, salmeterol-stimulate beta-2 adrenoreceptors-bronchial smooth muscle relaxation
-stimulate mucocillary clearance -“rescue therapy” during acute asthma attacks
-prophylaxis for exercise- induced asthma
-prophylaxis for exposure to known antigens All nonselective effects: stimulation of cardiac beta Receptor such as tachycardia, arrhythmias and angina
Central nervous system: effects nervousness, anxiety, insomnia, dizziness and sweating It assess respiratory status
It decrease environmental irrantantsNeeds to improve humidification
Try to avoid OTC inhalers
Muscarinic-receptor antagonists (anticholinergics) -inhibits ACh mediated constriction of bronchial smooth muscle
-decr. vagal-stimulated mucus secretion -treat chronic conditions; not for acute use Has systemic side effects minimal in cardiovascular
Dryness of the oropharnyxMethylxanthines-inhibits phosphodiesterase leads to incr. cAMP so bronchodilation-decr. histamine release
-stimulates ciliary transport of mucus
-improve contractility of diaphragm
-incr. CO, produces diuresis & decr. PV -prophylaxis & treatment of asthma
-relieve SOB, wheezing & dyspnea
-stimulate newborns who don’t breath well Central nervous system: makes you nervous, insomnia, Headache, dizziness Monitor Blood levels
DrugMechanismUseSide/Adverse EffectsNursing Implications
Anti-Inflammatory Cromolyn Sodium
(non-steroidal) INTAL -prevents influx of Ca into mast cells, therefore inhibiting degranulation and release of histamine & leukotrines-inhibits the recruitment of inflammatory cells into airway
-inhibits late bronchoconstriction Use seasonal allergic rhinitis and opathalmic adminitrationm inallergic conjunctivitis Headache Help teach proper use of inhaler and nasal spray
Leukotriene Inhibitors
ZYFLO, ACCOLATE -blocks the formation of leukotrienes from arachiodonic acid
-prevents bronchoconstriction
& airway inflammation Maintain therapy in chronic asthma Drugs allergy with ACCOLATE Ensure increase plasma concentration of theophylline, warfarin, beta adrenigic blocker
Glucocorticoids -incr. CHO, protein & fat metabolism
-suppress inflammatory process
-suppress normal immune system Acute and maintain asthma management
Inspiration: Fungal infection known as Candida Teach proper use of inhalers
Decongestants
Oxymethazoline (AFRIN, DRISTAN) Phenylephrin (NEO-SYNEPHRINE) Pseudophederine + chlorpheniramine + dextromethorphan + acetaminophen (COMTREX)
Pseudoephedrin hydrochloride (SINUTAB, SUDAFED) -shrinks nasal membranes by a vasoconstrictive mechanism (alpha-1 adrenergic agonists) Use systemic relief of allgeric, rhinitis, sinusitis, colds and flu Central nevous system: nervousness, restlessness, insomnia
Rebounded engorgement
Congestion can worsen after increase use. Make sure not to overuse, it can be addictive.
Limit all caffeine intake
Sit up when taken nasal spray
Avoid taking diet pills
DrugMechanismUseSide/Adverse EffectsNursing Implications
Expectorants
Guaifenesin (ROBITUSSIN) -incr. respiratory tract fluid
-decr. viscosity of bronchial & tracheal secretions -persistent coughs
-mucus plugs
-common cold, bronchitis Can be allergic to drug
Can cause nausea and vomiting, anorexia Assess lung sounds and secretion
Use sufficient humidification
Teach coughing techniques
Drink plenty of water, including after taken a dosage
Antitussives
Nonnarcotic benzonatate (TESSALON) dextromethorphan (OTC cough syrups) diphenhydramine (BENYLIN)
Narcotic
codeine sulfate hydrocodone bitartrate (HYCODAN) -suppress cough reflex center in medulla -suppresses nonproductive cough Become sedated
Anesthesia of the mouth Tell the client to wait 15-20 min after taking medication before drinking liquid.
Take med at bedtime
Mucolytic drugs
MUCOMYST -reduce thickness of mucus
-makes mucus secretions less tenacious
-alters metabolism of acetaminophen -Inhaled—respiratory conditions
-Orally—acetaminophen overdose Can irritate all nasal passages. Smells like rotten eggs may cause Gastrointestinal upset.