The nurse is educating student nurses on the difference between the upper and lower respiratory tract. Which medications are primarily used for upper respiratory conditions? (Select All that Apply.)
Decongestants
H2 Antagonist
H1 Antagonist
Long-Acting Beta Agonist (LABA)
Short Acting Beta agonist (SABA)
Mast Cell Stabilizers
Correct Answer : A,C
A) Decongestants: These medications are primarily used to relieve nasal congestion associated with upper respiratory conditions such as allergic rhinitis and the common cold. They work by constricting blood vessels in the nasal passages, thereby reducing swelling and congestion. Common examples include pseudoephedrine and phenylephrine.
B) H2 Antagonist: H2 antagonists are primarily used to reduce gastric acid secretion and treat conditions such as peptic ulcers and gastroesophageal reflux disease (GERD). They are not indicated for upper respiratory conditions, so this option does not apply.
C) H1 Antagonist: H1 antagonists, or antihistamines, are used to alleviate symptoms of allergies, hay fever, and other upper respiratory conditions by blocking the effects of histamine. This class includes both first-generation antihistamines (like diphenhydramine) and second-generation antihistamines (like cetirizine), making them relevant for upper respiratory issues.
D) Long-Acting Beta Agonist (LABA): LABAs are primarily used for the management of asthma and chronic obstructive pulmonary disease (COPD), targeting the lower respiratory tract. They are not typically used for upper respiratory conditions, so this option does not apply.
E) Short Acting Beta Agonist (SABA): SABAs, such as albuterol, are primarily used for acute asthma attacks and bronchospasm in conditions like COPD. They act on the lower respiratory tract and are not indicated for upper respiratory conditions.
F) Mast Cell Stabilizers: These medications are used to prevent allergic reactions and asthma symptoms by stabilizing mast cells and preventing the release of histamine and other inflammatory mediators. While they may have a role in allergic rhinitis, they are not the primary treatment for upper respiratory tract conditions, making this option less applicable compared to decongestants and H1 antagonists.
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Correct Answer is A
Explanation
A) Cetirizine (Zyrtec): This medication is classified as a second-generation antihistamine. Second-generation antihistamines are designed to be less sedating than first-generation agents, as they are less likely to cross the blood-brain barrier. Cetirizine effectively alleviates symptoms of allergic rhinitis by blocking histamine receptors and is commonly used due to its efficacy and reduced sedation compared to older antihistamines.
B) Chlorpheniramine (Aller-Chlor): Chlorpheniramine is a first-generation antihistamine. It tends to cause more sedation and has a higher likelihood of causing side effects such as drowsiness, dry mouth, and dizziness. First-generation antihistamines are typically less selective and can affect the central nervous system more significantly than their second-generation counterparts.
C) Diphenhydramine (Benadryl): This medication is also a first-generation antihistamine. It is well-known for its sedative effects and is often used for allergic reactions, as well as for its sleep-inducing properties. Like other first-generation antihistamines, diphenhydramine can cause significant drowsiness and other anticholinergic effects.
D) Montelukast (Singulair): Montelukast is not an antihistamine but rather a leukotriene receptor antagonist. It is used for the management of allergic rhinitis and asthma but works through a different mechanism by blocking leukotriene receptors, thereby reducing inflammation and mucus production. It is not classified as an antihistamine, either first or second generation.
Correct Answer is C
Explanation
A) Palpitations: While palpitations can be concerning for many medications, they are not a commonly reported side effect of dextromethorphan. This medication primarily acts as a cough suppressant and does not typically have cardiovascular effects that would lead to palpitations. Therefore, clients should not primarily monitor for this side effect when taking dextromethorphan.
B) Hypertension: Dextromethorphan is not generally associated with causing hypertension. Its main action is to suppress the cough reflex, and it does not typically influence blood pressure levels. Patients taking this medication should focus on other side effects rather than worrying about hypertension.
C) Ataxia: Ataxia, or impaired coordination, is a notable adverse effect associated with dextromethorphan, especially at higher doses or when combined with other central nervous system depressants like alcohol. This side effect can lead to dizziness and increased risk of falls or accidents, making it important for clients to be aware of their coordination and alertness levels while on this medication. Advising patients to avoid driving or operating heavy machinery if they experience ataxia is essential for their safety.
D) Diarrhea: Diarrhea is not a common adverse effect of dextromethorphan. The medication is primarily used for its antitussive properties, and gastrointestinal disturbances like diarrhea are generally not associated with its use. If patients experience gastrointestinal symptoms while taking this medication, they may need to consider other factors or medications that could be contributing to those symptoms.