Medications to control airway secretions: Nursing pharmacology

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MEDICATIONS TO CONTROL AIRWAY SECRETIONS, PART 1 | ||
DRUG NAME | oxymetazoline (e.g., Afrin nasal spray, Dristan spray), pseudoephedrine (e.g., Sudafed), fluticasone (e.g., Flonase) | codeine, dextromethorphan (e.g., Robitussin), diphenhydramine (e.g., Benadryl), benzonatate (Tessalon Perles) |
CLASS | Nasal decongestants | Antitussives |
MECHANISM OF ACTION | Constrict nasal mucosal blood vessels, reduce edema; shrink the nasal mucus membranes; decrease inflammation | Suppress cough reflex at the level of the cough control center |
INDICATIONS | Rhinitis, nasal congestion | Non-productive cough |
ROUTE(S) OF ADMINISTRATION | PO, NAS | PO |
SIDE EFFECTS |
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Opioids:
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CONTRAINDICATIONS AND CAUTIONS |
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Non-opioids
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NURSING CONSIDERATIONS | All medications to control airway secretions: Assessment and monitoring
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Intranasal decongestants Assessment and monitoring
Client education
Oral decongestants Client education
| Assessment and monitoring
Client education
|
MEDICATIONS TO CONTROL AIRWAY SECRETIONS, PART 2 | ||
DRUG NAME | guaifenesin (e.g., Mucinex) | acetylcysteine (Acetadote), dornase alfa (Pulmozyme) |
CLASS | Expectorant | Mucolytics |
MECHANISM OF ACTION | Increases water content of respiratory secretions and decreases its viscosity | Break down components of mucus and decreases its viscosity |
INDICATIONS | Chest congestion | |
ROUTE(S) OF ADMINISTRATION | PO | PO, nebulization |
SIDE EFFECTS |
| |
CONTRAINDICATIONS AND CAUTIONS | Chronic cough | acetylcysteine - Asthma |
NURSING CONSIDERATIONS | All medications to control airway secretions: Assessment and monitoring
| |
Client education
| Client education
|
Transcript
There are certain medications that can be used to control airway secretions, which refers to the mucus secreted by the respiratory tract epithelium.
These medications are typically used when the airway secretions are either too much or too thick to be coughed out normally. They can broadly be divided into 4 classes; nasal decongestants, expectorants, mucolytics, and antitussives.
The most commonly used nasal decongestants include sympathomimetic medications like oxymetazoline and pseudoephedrine, and corticosteroids like fluticasone and mometasone; and can be administered orally or intranasally.
Nasal decongestants are usually used to treat a congested, or stuffy, nose, such as from allergic rhinitis. They act by constricting the blood vessels in the nasal mucosa, which ultimately reduces the local tissue edema and shrinks the congested mucosa; while corticosteroids also help decrease inflammation.
Nasal decongestants can lead to side effects like anxiety, tremors, insomnia, hypertension, and increased blood glucose. Prolonged use of decongestants, typically for more than 48 hours, may lead to rebound nasal congestion once the decongestant is stopped.
Additional side effects specific to corticosteroid nasal decongestants include a bad taste after administration, and dryness of the nasal mucosa following continuous use.
Nasal decongestants should be used with caution in clients with hypertension, cardiac disease, hyperthyroidism, or diabetes mellitus, due to their adverse effects on blood pressure and blood glucose.
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology 8th Edition: A Patient-Centered Nursing Process Approach" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2019)
- "Mucoactive drugs" European Respiratory Review (2010)
- "Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 13e" McGraw-Hill Education (2018)