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- Control of non-productive cough.
- Acts directly on the medullary cough center of the brain to depress cough reflex. CNS Depression. Side effects-drying effect on mucous membranes. Can increase viscosity of resp. tract secretions. Drowsiness. Do not use with MAOI r/t hypotension.
Topical Nasal Decongestants
Sympathemimetics (imitate the effects of the SNS to cause vasoconstriction). Risk of rebound. Not with glaucoma, hypertension, DM, thyroid disease, CAD, BPH).Relieve congestion, swelling, and inflammation by contricting arterioles-decreases blood flow to nasal mucosa.
Pseudoephedrone (sudafed, Decofed)
- Promote drainage of the sinuses and improve air flow. Risk of Rebound.
- Shrinks the nasal mucous membrane by stimulating the Alpha-Adrenergic receptors in the nasal mucous membrane. Adverse effects r/t sympathomimetic effects (anxiety, hypertension, arrhythmias. Found in many OTC meds.
Topical Nasal Steroid Decongestants
- Maintenance treatment of asthma.
- Potent locally acting anti-inflammatory and immune modifier. For chronic not acute inflammation. Caution with active infection like TB.
Diphenhydramone (Benadryl), Hydroxyzone (Vistarel)
- Relief of seasonal/perennial allerigic rhinitis, allergic conjunctivitis, uncomplicated uritcaria and angioedema.
- Selectively blocks the effect of histamine at the histamine receptor sites, decreases the allergic response also have anticholinergic and antipruritic effects. Side effects-drowsiness, anticholinergic-SLUD
- Enhances the output of respiratory tract fluid by reducing the adhesivness and surface tension of the fluid facilitating the removal of viscous mucus.
- Do not use for more than 1 week.
- Increase fluids.
Mucolytics (Muco=mucous, lytic=breakdown)
Acetylcysteine (Mucomyst), Dornase Alfa (Pulmozyme)
- Pts with difficulty coughing up tenacious secretions who develop atelectasis undergoing bronchoscopy, pt with trachs, and post operative pts.
- Works to breakdown mucus in order to aid the high-risk pt (cystic fibrosis) in coughing up thick secretions.
- Inhaled mucomist could put pt into bronchospasm-not safest!