Upper Respiratory System Drugs

Upper Respiratory Disorders:
 Involves nasopharynx, pharynx, larynx, sinuses: Colds, rhinitis, sinusitis, pharyngitis

• ANTIHISTAMINES
• Block H1 and/or H2 receptors 
• Side effects: Decreased SLUDGE (anticholinergic), drowsiness
• Prototype drug: Diphenhydramine (Benadryl)—1st generation—PO, injectable (can be used for emergencies)
• 2nd generation antihistamines: Cetirizine (Zyrtec), fexofenadine (Allegra), loratidine (Claritin)—available only by PO

• DECONGESTANTS
• Alpha adrenergic effects
• Administered by nasal spray, PO
• Drugs: Ephedrine, pseudoephedrine (Sudaphed), phenylephrine (Neo-Synephrine), oxymetazoline (Afrin)—spray
• Side effects: Rebound congestion with overuse of spray; systemic: elevated BP, elevated blood glucose; dysrhythmias; avoid stimulants

• INTRANASAL GLUCOCORTICOIDS
• Systemic side effects rare; may cause nasal dryness
• Drugs: Fluticasone (Flonase), Triamcinolone (Nasacort)

• ANTITUSSIVES
• Suppress cough reflex
• Prototype drug: Dextromethorphan (Robitussin, Delsym)
• Available OTC
• Intoxication at high doses

• EXPECTORANTS
• Liquify sputum for easier production with coughing
• Need to increase PO fluid itake
• Drug: Guaifenesin (Robitussin, Mucinex)

Test 2 outline for respiratory meds

Bronchodilators:

• Anticholinergic: ipatropium(atrovent), itotropium(spiriva)
• first line unless contraindicated, dry mouth is the side effect
• Beta-2 agonist: albuterol, levalbuterol
• work faster than anticholinergic, best for emergencies, stimulate CNS is the side effects
• Methylxantines: Theodur, it also increases mucociliary action
• side effects: toxicity possible, n/v, seizures, insomnia

 Corticosteroids: decrease inflammation, increase sensitivity to cathecolamines

• Systemic: Prednisone, Hydrocortisone, Methylprednisolone
• Many side effects such as hyperglcemia,infection, tachycardia, easy bruising, weight gain
• Inhaled: fluticasone, beclamethasone
• for COPD maintenance, less side effects than systemic; rinse mouth after each use to prevent oral thrush

AntiHistamines:

• 1st generation: Benadryl; sedating, drowsiness, dry mouth
• 2nd generation: Claritin, Allegra; less sedating than 1st gen

Mucolytics: decrease thickness of mucous i.e Mucinex