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 ["C","E"]
Explanation
A. This medication (Benadryl) targets H2 receptors to alleviate symptoms: This statement is incorrect. Diphenhydramine is an H1 receptor antagonist, not an H2 antagonist. H1 receptors are primarily involved in allergic reactions, whereas H2 receptors are related to gastric acid secretion.
B. Take this medication on an empty stomach before breakfast. Drowsiness is a common side effect of diphenhydramine (Benadryl): While drowsiness is indeed a common side effect, taking diphenhydramine on an empty stomach is not necessarily required and may lead to gastrointestinal discomfort. It can be taken with food if preferred.
C. Avoid CNS depressants while taking diphenhydramine (Benadryl): This is an important teaching point. Diphenhydramine can cause sedation, and the use of other CNS depressants (like alcohol or sedatives) can enhance this effect, increasing the risk of excessive drowsiness or other complications.
D. This medication is a 2nd generation antihistamine: This statement is incorrect. Diphenhydramine is actually a first-generation antihistamine. First-generation antihistamines tend to cause more sedation and other side effects compared to second-generation antihistamines, which are less sedating.
E. Paradoxical reactions can be seen with this medication: This is true. In some individuals, particularly children, diphenhydramine can cause paradoxical reactions, such as increased excitability or hyperactivity, rather than the expected sedation. This is an important consideration to discuss with clients.
Correct Answer is ["B","D","E","F"]
Explanation
A) Ipratropium is the drug of choice for acute asthma exacerbations: This statement is incorrect. While ipratropium is used in the management of asthma, it is not the first-line treatment for acute exacerbations. Short-acting beta-agonists, such as albuterol, are the preferred choice for rapid relief during an acute asthma attack due to their quick onset of action.
B) Mechanism of action includes blocking acetylcholine receptors in the airway: This statement is accurate. Ipratropium is an anticholinergic agent that works by blocking acetylcholine receptors in the bronchial smooth muscle. This action leads to bronchodilation and helps to decrease mucus production, making it effective for managing airway constriction.
C) Mechanism of action includes antagonizing histamine receptors of the upper airway: This statement is incorrect. Ipratropium does not act on histamine receptors; rather, it specifically targets acetylcholine receptors. Antihistamines are the medications that block histamine receptors, primarily used for allergic reactions and rhinitis, but not for bronchodilation in asthma.
D) Client's who are allergic to soybean should avoid taking ipratropium: This statement is true. Ipratropium bromide may contain soy lecithin, which can pose a risk for patients with soybean allergies. Therefore, it is essential for healthcare providers to assess a patient’s allergy history before prescribing this medication.
E) Urinary retention is a side effect of Ipratropium bromide: This is correct. Anticholinergic medications, including ipratropium, can lead to urinary retention as a side effect due to their action of inhibiting acetylcholine, which plays a role in bladder function. Patients should be monitored for this side effect, especially if they have a history of urinary issues.
F) Ipratropium (Atrovent) is a medication for asthma and chronic obstructive pulmonary disease (COPD): This statement is accurate. Ipratropium is indicated for both asthma and COPD management, as it helps to relieve bronchospasm and improve airflow. It is often used as an adjunct therapy in combination with other bronchodilators for better management of respiratory conditions.