1. Respiratory Medications

2. Antihistamines Histamine is released in response to injury and produces inflammation. Antihistamines counteract this by competing for receptor sites blocking the effects of histamine.

3. Antihistamines Used to relieve allergy symptoms, including rhinitis (runny nose), and anaphylactic shock. Drowsiness common S/E. Other S/E include photosensitivity, dry mouth &nose. The drying effect is why antihistamines are NOT given to pts with lower resp infections, it actually thickens secretions.

4. Antihistamines Most antihistamines are taken with food. Claritin (loratadine) and Hismanal (astemizole) are give on an empty stomach Phenergen (Promethazine) is given IM with narcotics to enhance the pain relief and prevent nausea. Give deep IM, irritating to subcutaneous tissue

5. Antihistamines

6. Bronchodilators When bronchospasms occur, bronchi decrease in diameter and narrowing of the lumens decrease air flow. Bronchodilators can be given orally, injection, inhaler, or nebulizer,

7. Bronchodilators Drink plenty of water to thin secretions. Avoid smoking, affects half-life of meds. Monitor blood levels of theophylline to avoid toxicity. Therapeutic range 10-20mcg/ml. Inhalers- wait one min between same med. Wait 3-5 mins between different meds.

8. Sympathomimetics Terbutaline and albuterol Have beta-adrenergic activity and dilate the bronchi Side effects include anxiety- REASSURE, hypertension, cardiac arrhythmias, and insomia.

9. Xanthine Derivatives Theophylline and aminophylline Have direct effect on smooth muscles of the bronchi causing relaxation.

10. Decongestants Reduce swelling, oopen clogged passages, and enhance drainage of sinuses. Used to tx congestion associated with rhinitis, hay fever, colds & allergies. Neo-synephrine, Afrin, sudafed, and epinephrine

11. Decongestants Overuse can cause rebound congestion and make symptoms worse. Do not take vaccines if sick with nasal congestion or taking intranasal steroids.

12. Antitussives- relieve coughing Do not exceed recommended dose. Narcotic antitussives depress the cough reflex by acting on the cough center (medulla) in the brain. Antitussives should only be used for a NONPRODUCTIVE cough because depression of the cough reflex can lead to a pooling of secretions in the lungs.

13. Mucolytics Mucomyst or acetylcysteine is given by nebulizer to primarily hospitalized patients. Smells bad- like sulfur or rotten eggs. If used with a trach, have suction available.

14. Expectorants Aid in raising thick, tenacious mucus. Increase the production of secretions and decrease their thickness. Robitussin (guaifenesin). Tastes nasty. When using expectants:

15. Steroids/ Corticosteroids Used to decrease inflammation in the bronchioles. May increase risk of infection. Do no allow sick visitors.