1. Medications That Affect the Respiratory System
UNIT 24
Medications That Affect the Respiratory System

2. Key Terms Allergic rhinitis Common cold Histamine Pruritus Rhinorrhea
Rhinovirus
Urticaria

3. Causes of Respiratory Conditions
Allergies
Infections
Environment
Heredity

4. Coryza Common cold No cure Caused by rhinovirus Palliative treatment
Antihistamines
Decongestants
Antitussives
Analgesics
Antipyretics

5. Respiratory Infections
Types
Viral
Bacterial
Fungal
Pertussis, sinusitis, laryngitis, bronchitis, pneumonia, TB
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6. Respiratory Infections
Environmental factors
Smoke
Chemicals
Metals
Gases
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7. Respiratory Infections
Warning!
Avoid the use of aspirin in children with any viral infection because of the increased risk of Reye’s Syndrome.
Warning!
An FDA public health advisory recommends that OTC cough and cold products should not be used for infants and children younger than 2 years of age because of potentially life-threatening side effects.

8. Antihistamines Work by blocking histamine 1 receptors
Do not interfere with production and release of histamine
Uses
Allergies
Motion sickness
Sedation
Cold remedy
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9. Antihistamines Adverse effects Drowsiness Dizziness Dry mouth
Thickening of secretions
Epigastric distress
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10. Antihistamines Patient teaching Increase fluids Take only when needed
Alcohol or sedatives enhance drowsiness
Do not take with anticoagulants or MAO inhibitors
Do not drive if drowsiness or dizziness occur

11. Decongestants Relief of nasal congestion due to
Infection
Allergy
Inflammation
Emotional upset
Act by stimulating alpha-adrenergic receptors of vascular smooth muscle
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12. Decongestants Adverse effects Rebound congestion Mucosal dryness
Headache
Palpitations
Nausea and vomiting
Anorexia
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13. Decongestants Warning!
Consult a doctor before taking decongestants if you have
Heart disease or hypertension
Thyroid disease
Glaucoma
Diabetes
BPH

14. Cough Cough is protective action
Cough helps keep respiratory passages clear
Antitussives provide palliative treatment for relief of cough
Ease respiratory discomfort
Facilitate sleep
Reduce irritation

15. Antitussives Narcotic Nonnarcotic Depress cough center in medulla
Raise threshold for incoming cough impulse
Nonnarcotic
Local anesthetic action in respiratory passages
Reduces cough reflex at its source
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16. Antitussives Patient teaching
Narcotic antitussives may be habit forming
Antitussives may impair mental alertness
Do not chew or allow to dissolve in mouth
Do not follow liquid with water
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17. Expectorants
Stimulate and decrease thickness of respiratory tract secretions
Make cough more productive
Loosen secretions
Will NOT make patient stop coughing
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18. Expectorants Patient teaching Did you know?
Humidification helps loosen secretions
Dilute SSKI in juice or water
Did you know?
SSKI is also used to treat hyperthyroidism.

19. Mucolytics Reduce the viscosity of respiratory tract fluids Mucomyst
Reduces viscosity of secretions
Do not mix with antibiotics, iron, copper, or rubber
Store in refrigerator
Use within 96 hours of opening
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20. Mucolytics
Warning!
Asthmatic patients are at increased risk of bronchospasm with Mucomyst use.
Open airway may have to be maintained by suction, due to increased liquefied secretions.

21. Bronchodilators Used to improve airflow for COPD and asthma
Sympathomimetics
Xanthine
Leukotriene receptor antagonist
Anticholinergic agents
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22. Bronchodilators Sympathomimetics
Mimic action of sympathetic nervous system
Act on beta-2 adrenoreceptors to relax smooth muscle cells of bronchi
Vasoconstriction response
Increase heart rate
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23. Bronchodilators Xanthine
Relax smooth muscle of bronchial airways and pulmonary blood vessels by blocking phosphodiesterase
Prevent breakdown of AMP
May produce stimulation of other body systems

24. Bronchodilators Leukotriene blockers Anticholinergic agents
Block leukotrienes and receptors
Leukotrienes cause edema, inflammation, muscle contraction
Used to treat asthma
Anticholinergic agents
Decrease concentrations of cGMP
Also used as intranasal application
Used to treat wheezing associated with COPD

25. Bronchodilators: Special Considerations
Patients taking sympathomimetics should not take MAO inhibitors
Patients taking xanthines should avoid products that contain caffeine
Increased potential for hypertension, tachycardia, convulsions, or bronchospasm
Instruct patients in reduction of environmental triggers

26. Glucocorticoids
Anti-inflammatory agents chemically related to cortisone
Inhaled forms used for asthma and allergies
Available as MDI or nasal preparations
Flonase and Rhinocort used to treat allergic rhinitis
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27. Glucocorticoids: Nasal Preparations
Flonase
Nasal spray
24 hour relief of allergy symptoms
Adults and children ages 4 and older
Rhinocort
Nasal inhaler
May be used once or twice daily
Adults and children ages 6 and older
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28. Glucocorticoids Warning!
Patients using glucocorticoids should avoid exposure to infectious diseases such as chickenpox. If exposed, notify physician immediately.

29. Tuberculosis (TB) Facts
Contagious disease spread by airborne transmission
Caused by Mycobacterium tuberculosis
Primarily seen in
AIDS patients
Homeless
Drug abusers
Prisoners
Immigrants

30. TB Symptoms Chronic cough Fatigue Weight loss Hemoptysis Night sweats
Anorexia
Low-grade fever
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31. TB Symptoms Did you know?
Once a person has a positive TB skin test, they will most likely ALWAYS test positive.
If TB testing is required, those with a history of a positive test should have a chest x-ray.

32. TB Diagnosis History and physical TB skin test Chest x-ray
Sputum analysis
Bronchoscopy
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33. TB Diagnosis Did you know?
Positive TB skin test reading means that person has been exposed, but may NOT have TB.
If patient tests positive, they may prevent illness with 1 year of medication.

34. TB Treatment Medication for 6 to 9 months Combination of drugs used
Primary drug regimen for active TB
INH, RIF, EMB
Not contagious after 2 to 4 weeks on medication
MDR-TB is suspected if resistant to two TB drugs
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35. TB Treatment At risk for drug-resistant TB
Recently exposed to drug-resistant TB
Immunocompromised
TB patients who fail to take meds as prescribed
TB patients who were prescribed ineffective treatment regimen
Persons previously treated for TB
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36. TB Treatment Discussion Questions:
Why is TB prevalent among the homeless and prisoners?
Would a child be treated differently for TB than an adult?
Who would be at risk for drug-resistant TB?

37. TB: Special Considerations
Some TB drugs may discolor body fluids red-orange
Monitor LFTs
Patients placed in isolation until no longer contagious
Respirators and masks to be worn

38. TB in the Older Adult Increased risk due to
Childhood exposure to Mycobacterium tuberculosis
Insufficiently treated TB as a younger person
Age-related changes increasing susceptibility
Decline in protective mechanisms of mucosa
Decreased effectiveness of bronchial cilia
Changes in connective tissues of lungs and chest
Decline in elastic recoil of lungs

39. TB in Children Greater risk of contracting TB because of
Smaller airway diameter increases potential for obstruction
Highly vascular mucous membranes susceptible to trauma, edema, infection, spasm
Accessory muscles of respiration not as strong
Children with respiratory problems more prone to TB infection