I.

Drugs Affecting the URT:

DRUG NAME DRUG ACTION DRUG INDICATION NURSING

CONSIDERATIONS
1. Decongestants Decongestants Indications for History taking and
decrease the decongestants examination of a
Topical Nasal overproduction of include: client using
Decongestants: secretions by causing decongestants
Ephedrine, local vasoconstriction Topical nasal should include the
oxymetazoline, to the upper decongestants- following:
phenylephrine, respiratory tract. Relieves discomfort
tetrahydrozoline and of nasal congestion Assess for possible
xylometazoline This vasoconstriction associated with the cautions and
leads to a shrinking common cold, contraindications:
Oral Decongestants: of swollen mucous sinusitis, allergic any history of allergy
Pseudoephedrine, membranes and rhinitis. Relieves to the drug or a
beclomethasone and tends to open pressure of otitis component of the
budesonide clogged nasal media. drug vehicle;
passages, providing glaucoma;
Topical steroid nasal relief from the Oral decongestants- hypertension;
decongestants: discomfort of a Decreases nasal diabetes; thyroid
Dexamethasone, blocked nose and congestion disease; coronary
flunisolide, promoting drainage associated with the disease; and prostate
fluticasone and of secretions and common cold, problems; pregnancy
triamcinolone improved airflow. allergic rhinitis. Relief and lactation, and
of pain and acute infections, all
Topical nasal congestion of otitis of which could be
decongestants, oral media. exacerbated by the
decongestant, and sympathomimetic
topical steroid nasal Topical nasal steroid effects and which
decongestants are decongestants- require cautious use
classifications of Treatment of of the drug.
decongestants. seasonal allergic
rhinitis in patients Monitor pulse, blood
who are not pressure, and cardiac
obtaining a response auscultation to
with other assess cardiovascular
decongestants or and
preparations. sympathomimetic
Relieves effects.
inflammation
following removal of Evaluate respirations
nasal polyps. and adventitious
breath sounds to
 assess the
effectiveness of the
drug and the
potential excess
effect.
2. Mucolytics Mucolytics increase Mucolytics are History taking and
or liquefy respiratory indicated for the physical examination
Generic Name: secretions to aid the following: of a patient using
acetylcysteine and clearing of the mucolytics include:
dornase alfa airways in high-risk Liquefaction of
respiratory patients secretions in high- Assess for possible
who are coughing up risk respiratory contraindications and
thick, tenacious patients who have cautions: any history
secretions. difficulty moving of allergy to the drug;
secretions including persistent cough due
The desired actions postoperative to smoking, asthma,
of mucolytics patients (e.g., or emphysema,
include: patients with which would be
tracheostomies to cautions to the use of
Protect liver cells facilitate airway the drug; and very
from being damaged clearance and productive cough,
during episodes of suctioning). which would indicate
acetaminophen an underlying
toxicity because it Used orally to problem that should
normalizes hepatic protect the liver from be evaluated.
glutathione levels acetaminophen
and binds with a toxicity. Assess respirations
reactive hepatotoxic and adventitious
metabolite of Treatment of sounds to evaluate
acetaminophen. atelectasis from thick the respiratory
mucus secretions. response to the drug
Affects the effects.
mucoproteins in the
respiratory
secretions by
splitting apart
disulfide bonds that
are responsible for
holding the mucus
material together.

3. Expectorants Expectorants Expectorants are History taking and

increase productive indicated for the physical examination
following:
Generic Name: cough to clear the Symptomatic relief of of a patient using
Guaifenesin airways. respiratory expectorants include:
conditions
They liquefy lower characterized by a Assess for possible
respiratory tract dry, nonproductive contraindications and
secretions, reducing cough. cautions: any history
the viscosity of these of allergy to the drug;
secretions and persistent cough due
making it easier to to smoking, asthma,
cough them up. or emphysema,
which would be
cautions to the use of
the drug; and very
productive cough,
which would indicate
an underlying
problem that should
be evaluated.

Assess respirations
and adventitious
sounds to evaluate
the respiratory
response to the drug
effects.
4. Antihistamines Antihistamines block Antihistamines are History taking and
the release or action indicated for the examination of a
Generic Name: of histamine, a following: patient using
Brompheniramine, chemical released antihistamines may
diphenhydramine, during inflammation Relief of symptoms include the following:
cetirizine, loratadine that increases of seasonal and
and levocetirizine secretions and perennial allergic Assess for possible
narrows airways. rhinitis, allergic contraindications or
conjunctivitis, cautions: any history
Selectively block the uncomplicated of allergy to
effects of histamine urticarial, and antihistamines;
at the histamine-1 angioedema. pregnancy and
receptor sites, lactation; and
decreasing the Relief of nasal and prolonged QT
allergic response. non-nasal symptoms interval, which are
of seasonal and contraindications to
perennial allergic the use of the drug;
rhinitis. and renal or hepatic
impairment, which
 Relief of discomfort requires cautious use
associated with of the drug.
dermographism;
used as adjunctive Perform a physical
therapy in examination to
anaphylactic establish baseline
reactions. data for assessing the
effectiveness of the
drug and the
occurrence of any
adverse effects
associated with the
drug therapy.
5. Antitussives Antitussives act on Antitussives are The nursing
the cough-control indicated for the considerations in
Generic Name: center in the medulla following: administering
Benzonatate, to suppress the antitussives include:
codeine, cough reflex; if the For the treatment of
dextromethorphan cough is dry cough, drug Assess for possible
and hydrocodone nonproductive and withdrawal contraindications and
irritating, an syndrome, opioid cautions (e.g., history
antitussive may be type drug of allergy to the drug,
taken. dependence, and cough for more than
pain. 1 week, and
The desired actions pregnancy and
of antitussives are as For relief of lactation).
follow: moderate to
moderately severe Assess respirations
Acts directly on the pain. and adventitious
medullary cough sounds.
center of the brain to
depress the cough
reflex.

Reference: https://nurseslabs.com/decongestants/
Expectorants and Mucolytics - Nursing Pharmacology Guide - Nurseslabs

Antihistamines Nursing Pharmacology Study Guide - Nurseslabs

Antitussives - Nursing Pharmacology Study Guide - Nurseslabs

II. Drugs Affecting the LRT:

DRUG NAME DRUG ACTION DRUG INDICATION NURSING

CONSIDERATIONS
1. Drugs for
Asthma
a. Bronchodilators Bronchodilators are Bronchodilators or Assess for
a type of antiasthmatics are possible
medication that medications used contraindications
make breathing to facilitate or cautions: any
easier by relaxing respiration by known allergies to
the muscles in the dilating the prevent
lungs and widening airways. They are hypersensitivity
the airways helpful in reactions;
(bronchi). symptomatic relief cigarette use
or prevention of which affects the
bronchial asthma metabolism of the
and for drug; peptic ulcer,
bronchospasm gastritis, renal or
associated with hepatic
COPD. dysfunction, and
coronary disease,
all of which could
be exacerbated
and require
cautious use; and
pregnancy and
lactation, which
are
contraindications
because of the
potential for
adverse effects on
the fetus or
nursing baby.
I. Sympathomimetics Sympathomimetics Monitor blood
Sympathomimetics are drugs that are indicated for pressure, pulse,
mimic the effects of the following: cardiac
Generic Name: the sympathetic auscultation,
isoetharine, nervous system. Treatment of peripheral
isoproterenol, acute perfusion, and
levalbuterol, One of the actions bronchospasm in baseline
metaproterenol of the sympathetic adults and electrocardiogram
and terbutaline nervous system is children, although to provide a
 dilation of the epinephrine is the baseline for
bronchi with drug of choice. effects on the
increased rate and cardiovascular
depth of Treatment and system.
respiration. prophylaxis of Perform a
acute asthma physical
attacks in children examination to
more than 6 years establish baseline
old. data for assessing
the effectiveness
of the drug and
the occurrence of
any adverse
effects associated
with drug
therapy.
II. Anticholinergics are Anticholinergics Assess for
Parasympatholytics drugs that oppose are indicated for contraindications
(Anticholinergic) the effects of the following or cautions (e.g.,
acetylcholine. In medical history of allergy
Generic Name: essence, they also conditions: to drug, GI
Atropine, lyse and block the obstruction,
ipratropium, effects of Prevention of hepatorenal
meclizine, parasympathetic nausea, vomiting, dysfunction, etc.)
methscopolamine nervous system and dizziness to avoid adverse
and tiotropium (PNS) so they are associated with effects.
also called as motion sickness.
parasympatholytics. Establish baseline
Maintenance physical
Competitively treatment of assessment to
blocking the ACh bronchospasm monitor for any
receptors at associated with potential adverse
muscarinic COPD. effects.
cholinergic receptor
sites that are Treatment of
responsible for irritable or
mediating the hyperactive bowel
effects of the in adults.
parasympathetic
postganglionic
impulses.
III. A direct effect on Xanthines are Assess for
Methylxanthines the smooth muscles indicated for the possible
of the respiratory following: contraindications
Generic Name: tract, both in the or cautions: any
Aminophylline, bronchi and in the Relief of symptoms known allergies to
caffeine, blood vessels. or prevention of prevent
dyphylline and bronchial asthma. hypersensitivity
theophylline Xanthines also reactions;
inhibit the release cigarette use
of slow-reacting Reversal of which affects the
substance of bronchospasm metabolism of the
anaphylaxis and associated with drug; peptic ulcer,
histamine, COPD. gastritis, renal or
decreasing the hepatic
bronchial swelling dysfunction, and
and narrowing that coronary disease,
occurs as a result of all of which could
these two be exacerbated
chemicals. and require
cautious use; and
pregnancy and
lactation, which
are
contraindications
because of the
potential for
adverse effects on
the fetus or
nursing baby.
b. Corticosteroids Bind to cytoplasmic Short-term Assess for
receptors of target treatment of contraindications
Generic Name: cells to form inflammatory or cautions (e.g.
Beclomethasone, complex reactions disorders by history of allergy,
betamethasone, needed to reduce blocking the pregnancy, acute
budesonide, inflammation and actions of infections, etc.) to
dexamethasone to suppress arachidonic acid avoid adverse
and immune system. leading to effects.
hydrocortisone decrease in
formation of
prostaglandins and
leukotrienes.
 Local agents are
used to treat local
inflammation.

c. Cromolyn The desired actions Inhaled steroids Assess

Sodium of inhaled steroids are indicated for respirations and
include: the following: adventitious
Generic Name: sounds to
Beclomethasone Decrease the Prevention and monitor drug
and budesonide inflammatory treatment of effectiveness.
response in the asthma.
airway. Perform a
Treatment of physical
Increase airflow chronic steroid- examination to
and facilitate dependent establish baseline
respiration. bronchial asthma. data for assessing
Used as adjunctive the effectiveness
therapy for asthma of the drug and
patients who do the occurrence of
not respond to any adverse
traditional effects associated
bronchodilators. with drug
therapy.

Reference: Bronchodilators and Antiasthmatics Nursing Pharmacology - Nurseslabs

Anticholinergics (Parasympatholytics) Nursing Pharmacology Study Guide (nurseslabs.com)
Adrenocortical Drugs Nursing Pharmacology and Study Guide (nurseslabs.com)
Inhaled Steroids Nursing Pharmacology Study Guide - Nurseslabs