Antitussives, Mucolytics, and Expectorants -- Ch 32
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What are antitussives?
A drug used to relieve coughing. Many are combined with another drug (antihistamine or expectorant) and sold OTC ... some are Rx only.
How do antitussives work?
- -depress cough center (located in the medulla) <-- these are centrally-acting drugs (e.g. codeine and dextromethorphan)
- -anesthetizing stretch receptors in respiratory passages <-- peripherally-acting (e.g. Benzonatate (Tessalon))
Give an example of centrally-acting antitussive and peripherally-acting antitussive.
- central-acting --> codeine and dextromethorphan
- peripheral-acting --> benzonatate (Tessalon)
What can antitussives be used for?
-relieve a nonproductive cough
Name some adverse reactions of Antitussives.
- -drowsiness or sedation
- *drugs with two or more ingredients tend to cause less adverse reactions then drugs containing a single ingredient
What important interaction must a nurse consider when giving antitussives?
Monoamine oxidase inhibitors antidepressants will cause hypotension, fever, nausea, jerking motions to the leg, and coma when given with dextromethorphan
After how long of taking antitussives should a pt wait to see a doctor?
If in 10 days the cough isn't releived then see a doctor. If the cough is accompanied with a fever, chest pain, severe headache, or skin rash, the pt should consult the primary health care provider.
WHat happens if you chew bensonatate (tessalon) tablets?
A local anesthetic effect with possible choking as a risk will occur if Tessalon tablets are chewed. DO NOT Chew!!
What should the nurse monitor for in a pt taking antitussives?
- -Risk for injury r/t the drugs tendancy to cause drowsiness, dizziness, or sedation
- -Impaired cognitive functioning
- -Ineffective airway clearance r/t the drugs action ( depression of the cough reflex can result in pooling secretions in the lungs. <-- this could lead to a pneumonia, atelectasis.)
How much fluid should a pt be encouraged to drink?
If not contraindicated by disease processes ... 1500-2000 ml is recommended fluid intake
How long after taking a lozenge (cough drop) should a pt wait to drink fluids or eat?
30 minutes. that way the effect of the lozenge is not minim,ized
What is a mucolytic?
A drug that breaks down thick, tenacious mucus in the lower portions of the lungs
WHat is an expectorant?
A drug that thins respiratory secretions to remove them more easily.
How do expectorants work?
They increase the production of respiratory secretions, which in turn appears to dercrease the viscosity of the mucus. This helps to raise secretions from the respiratory tract.
What does acetylcysteine smell like?
-codeine (Used for suppression of nonproductive cough, releif of mild to moderate pain)
- -benzonatate (Tessalon)
- -dextromethorphan (Robitussin, Delsym, DexAlone)
- -dextromethorphan and benzocaine (cough-x, tetra-formula)
- -diphenhydramine (AllerMax, hydramine cough, Tusstat)
- -guaifenesin (glyceryl guaiacolate) (Robitussin)
- -potassium iodide
potassium iodide [Pima, SSKI]
use: symptomatic releif of chronic pulmonary disease complicated by tenacious mucus
adv. reaction: iodidne sensitivity or iodism (sore mouth, metallic tase, increased salivation, N/V, epigastric pain, parotid swelling, and pain)
Dosage ranges: 300-1000 mg orally after meals BID or TID, to 1.5g orally TID
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