MOA:

Block action of histamine at the H1 receptor sites

Compete with histamine for binding at unoccupied receptors, thus preventing effects of histamine stimulation (Vasodilation, increase GI and Resp secretions, increase capillary permeability)

INDICATIONS:

Nasal allergies, seasonal/perinnial allergic rhinitis (hay fever), allergic rxns, motion sickness, sleep disorders, symptomatic tx of common cold (sneezing & runny nose)

INDICATIONS:

Antihistamine

SE:

anticholinergic (drying), drowsiness

SE:

Antihistamine

IMPLICATIONS:

Gather data about the condition/allergic rxn that required tx. Also assess for drug allergies.

CONTRA: acute asthma attakcs and lower resp disease

CAUTION: Increased IOP, renal disease, COPD, PUD, BPH, or pregnancy

IMPLICATIONS:

Antihistamine

MOA:

Prevent leukotrienes from attaching to receptors on cells & circulation, blocking inflammation and relieving asthma effects

Decrease: mucus secretion, neutrophil & leukocyte infiltration to lungs

Prevent: sm muscle contraxn of bronchial airways, vascular permeability

MOA:

Antileukotriene

INDICATIONS:

Prophylaxis and chronic treatment of asthma in adults and children >2

Montelukast approved for children>2

INDICATIONS:

Antileukotriene

SE:

__________:Headaches, dyspepsia, nausea, dizziness, insomnia liver disfunction

__________: Headache, nausea, diarrhea, liver disfunction

SE:

Antileukotriene

zileuton, zafirlukast

IMPLICATIONS:

Ensure drug is being used for chronic mgmt of asthma

Improvement should be seen in about 1 wk

Assess liver fxn before beginning therapy

Continue taking even if symptoms improve

IMPLICATIONS:

Antileukotriene

MOA:

Bind to ACh receptors to prevent ACh effects, thus resulting in the PREVENTION of BRONCHOCONSTRIXN

MOA:

Anticholinergic

INDICATIONS:

PREVENTION OF BRONCHOCONSTRICTION

INDICATIONS:

Anticholinergic

SE:

dry mouth, dry throat

GI distress

headaches

coughing

anxiety

SE:

Anticholinergic

IMPLICATIONS:

Atrovent is the only drug within this classification used for respiratory disease. Atrovent has a slow and prolonged action

IMPLICATIONS:

Anticholinergic

MOA:

Opiods in this class suppress cough by direct action on the cough center in the medulla

Nonopiods of this class suppress the cough refex by numbing stretch receptors in the respiratory tract, thus preventing cough reflex stimulation

MOA:

Antitussives

INDICATIONS:

stop cough reflex

INDICATIONS:

Antitussive

SE:

_________: dizziness, headahce, sedation, nausea

_________: dizziness, drowsiness, nausea

_________: sedation, n/v, lightheadedness, constipation

SE:

Antitussives

Benzonatate, dextromethorphan, Opioids

IMPLICATIONS:

Report cough lasting >1wk, persistent headache, fever, and rashes

IMPLICATIONS:

Antitussives

MOA:

Activate beta 2 receptor, activate cAMP, relax smooth muscle of airway

MOA:

Bronchodilator: Beta Adrenergic Agonists

INDICATIONS:

Bronchospasm r/t ashtma, bronchitis, pulmonary disease

Acute asthma attacks

hypotension, shock, uterine relaxation to prevent premature labor, hyperkalemia

INDICATIONS:

Bronchodilator

Beta-Adrenergic Agonists

SE:

________(epinephrine): Insomnia, restlessness, anorexia, vascular headache, hyperglycemia, tremors, cardiac stimulation

________(isoproterenol): cardiac stimulation, tremors, vascular headache, hypotension, angina

________(albuterol): hypo/hypertension, vascular headaches, tremors

SE:

Bronchodilator

Beta Adrenergic Agonists

Alpha&Beta, Beta1 & Beta2, Beta 2

IMPLICATIONS:

Excessive albuterol loses beta actions at large doses, resulting in beta 1 stimulation and causing nausea, increased anxiety, palpitations, tremors, and increased heart rate

Report: insomnia, jitteriness, restlessness, palpitations, chest pain, or change in symptoms

IMPLICATIONS:

Bronchodilator

Beta Adrenergic Agonists

MOA:

Increase cAMP competitively with PDE, inhibits PDE, and results in INCREASE cAMP LEVELS. Increased cAMP levels in turn result in smooth muscle relaxation, bronchodilation, increased airflow, and CNS stimulation.

There is an increase in cardiac output and blood flow to the kidneys, producing a diuretic effect

MOA:

Bronchodilator

Xanthine Derivative

INDICATIONS:

asthma, chronic bronchitis, emphysema

mild to moderate acute asthma attacks

COPD

INDICATIONS:

Bronchodilator

Xanthine Derivative

SE:

n/v, anorexia, GERD (sleep), sinus tach, extrasystole, palpitations, ventricular dysrhythmias, transient increased urination

SE:

Bronchodilator

Xanthine Derivative

IMPLICATIONS:

Contra: PUD, GI disorders

Caution: Heart disease

Report: Convulsions, chest pain, weakness, palpitations, n/v, dizziness

Interaxns: cimetidine, oral contraceptives, allopurinol

IMPLICATIONS:

Bronchodilator

Xanthine Derivative

MOA:

Stabilize membranes of leukocytes

Increase responsiveness of bronchial smooth muscle to beta adrenergic stimulation

MOA:

Corticosteroids

INDICATIONS:

treatment of bronchospastic disorders

INDICATIONS:

Corticosteroids

SE:

Pharyngeal irritation, coughing, xerostomia, oral fungal infection

SE:

Corticosteroid

IMPLICATIONS:

Contra: psychosis, fungal infexn, AIDS, TB

Caution: diabetes, glaucoma, osteoporosis, PUD, renal disease, HF, edema

Wean 1-2 weeks

Report wt gain >5lbs/wk or chest pain

IMPLICATIONS:

Corticosteroids

MOA:

Site of axn: bl vessels surrounding nasal sinuses.

Adrenergics of this class constrict small bl vessels that supply upper respiratory structures. Tissues then shrink, allowing swollen mucous membranes to drain easily

Steroids of this class have an antiinflammatory effect

MOA:

Decongestant

SE:

Adrenergics: nervousness, insomnia, palpitations, tremors

Steroids: local mucosal dryness, irritation

SE:

Decongestants

IMPLICATIONS:

May cause HTN, palpitations, and CNS stimulation. Avoid pts with these conditions

NO caffeine

Report fever, cough, or other symptoms lasting more than 1 wk

IMPLICATIONS:

Decongestants

MOA:

Reflex stim causes irritation in GI tract, loosening and thinning respiratory tract secretions

Stimulates secretory glands to incerase secretions

MOA:

Expectorants

INDICATIONS:

Relief of nonproductive cough r/t common cold, bronchitis, laryngitis, pharyngitis, pertussis, influenza, measles

Cough caused by paranasal sinsitis

INDICATIONS:

Expectorants

IMPLICATIONS:

Caution: elderly, asthma, respiratory insufficiency

Increase fluid intake

Report fever, cough, or symptoms lasting >1wk

IMPLICATIONS:

Expectorants

SE:

Guaifenesin: n/v, gastric irritation

Iodinated Glycerol: GI irritation, rash, enlarged thyroid

Potassium Iodide: Iodism, n/v, taste perversion

SE:

Expectorants

MOA:

Stabilize cell membranes of mast cells, monocytes, and macrophages

No direct bronchodilator activity

Prophylaxis

MOA:

Mast Cell Stabilizer

INDICATIONS:

Adjunct prophylaxis for asthma

Exercise-induced bronchospasm

PREVENT bronchospasm assoc w/ triggers or precipitating factors

INDICATIONS:

Mast Cell Stabilizers

IMPLICATIONS:

Prophylaxis only

Contra: acute asthma exacrebations and children <5

Therapeutic effects can take up to 4 weeks to be seen

Gargle after use

IMPLICATIONS:

Mast cell stabilizer

INDICATIONS:

relief of nasal congestion assoc w/ chronic rhinitis, common cold, sinusitis, Hay fever, allergies; Preop

INDICATIONS:

Decongestant

SE:

coughing, sore throat, rhinitis, bronchospasm, taste changes, dizziness, headache

SE:

Mast Cell Stabilizers