NURS 133 Pseudoephedrine and Captorpril

jasmine's version from 2016-05-16 23:02

Section 1

Question Answer
PseudoephedrineAdrenergics; Alpha adrenergic agonist; Allergy, cold, and cough remedies, nasal drying agents/decongestants; Symptomatic management of nasal congestion associated with acute viral upper respiratory tract infections; Used in combination with anti-histamines in the management of allergic conditions; Used to open obstructed eustachian (a narrow passage leading from the pharynx to the cavity of the middle ear, permitting the equalization of pressure on each side of the eardrum) tubes in chronic otic inflammation or infection. Drug examples: Sudafed, SudoGest, Wal-Phed, Suphedrine, and Rugby
Pseudoephedrine actionsA decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose). Stimulates alpha and beta adrenergic receptors; Produces vasoconstriction in the respiratory tract mucosa (alpha-adrenergic stimulation) and possibly bronchodilation (beta2 adrenergic stimulation)
Pseudoephedrine therapeutic usesReduction of nasal congestion, hyperemia, and swelling in nasal passages; Also used for congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes
Elimination/Excretion of Pseudoephedrine Partially metabolized by the liver; 55-75 percent excreted unchanged by the kidneys (depends on urine pH)
Adverse/Side Effects of Pseudoephedrine Seizures, anxiety, nervousness; Cardiovascular collapse, palpitations; Anorexia
Contraindications of Pseudoephedrine Hypersensitivity to sympathomimetic amines; Hypertension, severe coronary artery disease; Concurrent MAO inhibitor therapy; Known alcohol intolerance (some liquid products); Use cautiously in hyperthyroidism, diabetes mellitus, prostatic hyperplasia, ischemic heart disease, glaucoma. Avoid OTC cough and cold products containing this medication in children <4 years of age
Drug/Food interactions of PseudoephedrineConcurrent use with MAO inhibitors (a type of antidepressant and are used to treat mental depression) may cause hypertensive crisis; Additive adrenergic effects with other adrenergics; Concurrent use with beta blockers may result in hypertension or bradycardia; Drugs that acidify the urine may decrease effectiveness; Phenothiazines and tricyclic anti-depressants potentiate pressor effects; Drugs that alkalinize the urine (sodium bicarbonate, high dose antacid therapy) may intensify effectiveness; Foods that acidify the urine may decrease effectiveness; Foods that alkalinize the urine (e.g., Barley Grass, Beets, Beet Greens, Broccoli, Brussel Sprouts, Cabbage, Carrot, Cauliflower, Celery, Chard Greens, Cucumber, Daikon, Dandelion, Fermented Vegetables, Garlic, Green Beans, Kale, Kohlrabi, Lettuce, Mushrooms, Nori, Onions, Peas, Peppers, Pumpkin, Radishes) may intensify effectiveness
Medication administration of Pseudoephedrine PO
Nursing interventions of PseudoephedrineAssess congestion (nasal, sinus, Eustachian tube) before and periodically during therapy; Monitor pulse and BP before beginning therapy and periodically during therapy; Assess lung sounds and character of bronchial secretions; Maintain fluid intake of 1500-2000 mL/day to decrease viscosity of secretions; Administer pseudoephedrine at least 2 hours before bedtime to minimize insomnia; PO: Extended-release tablets and capsules should be swallowed whole-do not crush, break, or chew; Contents of capsule can be mixed with jam or jelly and swallowed without chewing for patients with difficulty swallowing
Client education of Pseudoephedrine Instruct patient to take medication as directed; Caution parents to avoid OTC cough and cold products while breast feeding or to children <4 years of age; Instruct patient to notify health care professional if nervousness, slow or fast heart rate, breathing difficulties, hallucinations, or seizures occur due to these symptoms may indicate overdose; Instruct patient to contact health care professional if symptoms do not improve within 7 days or if fever is present
Evaluation/Desired outcomes of Pseudoephedrine Decreased nasal, sinus, or Eustachian tube congestion
Potential nursing diagnoses of Pseudoephedrine Ineffective airway clearance (indications)

Section 2

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