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Chapter 36: Antihistamines, Decongestants, Antitussives, Expectorant Test, Pseudoephedrine

The key terms in this Pharmacology course include Antihistamines, Decongestants, Antitussives, Expectorant, Pseudoephedrine, Pharmacology for Nurses: Practical Applications

The nurse would question a prescription for pseudoephedrine in a patient with a history of what condition?




Peptic ulcer disease

Adrenergic drugs are contraindicated in patients with hypertension, narrow-angle glaucoma, diabetes, uncontrolled cardiovascular disease, hyperthyroidism, prostatitis, or a known hypersensitivity to such drugs.

What advantage does loratadine have compared with traditional antihistamines such as diphenhydramine?

Less sedative effect

Increase in bronchodilation

Decreased risk of cardiac dysrhythmias

Minimal gastrointestinal upset

Loratadine is a nonsedating antihistamine and it does not readily distribute into the central nervous system, what diminishes the sedative effects associated with traditional antihistamines.

The nurse is discussing use of antitussive medications with a patient. What common adverse effect does the nurse include in the patient teaching?

Tremors and palpitations

Flushing and decreased heart rate

Diarrhea and abdominal cramping

Drowsiness and dizziness

Antitussive medications suppress cough through its action on the central nervous system, thus causing drowsiness and dizziness.

The nurse is discussing use of antihistamines for allergic rhinitis. What medications would be included in the list of H1 antagonists used in the treatment of allergic rhinitis? (Select all that apply.)






Antihistamines are drugs that directly compete with histamine for specific receptor sites. For this reason, they are also called histamine antagonists. H1 antagonists include drugs such as diphenhydramine, chlorpheniramine, fexofenadine, loratadine, and cetirizine.

What body system will the nurse assess for known common adverse effects of traditional antihistamines?



Central nervous


The most common adverse effect of antihistamines is drowsiness, but the sedative effects vary among antihistamine drug classes.

A patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 to 4 hours for the past 5 days. The nurse explains this based on what knowledge?

Oxymetazoline is not an effective nasal decongestant

The patient is probably displaying an idiosyncratic reaction to oxymetazoline

Oxymetazoline should be administered in an hourly regimen for severe congestion

Sustained use of nasal decongestants over several days may result in rebound congestion

Oxymetazoline is an effective nasal decongestant, but overuse results in worsening or “rebound” congestion. The medication should be used twice daily for no more than 3 days total.

The nurse is discussing with the patient management of symptoms of an upper respiratory tract infection. What classes of medications are often used in treating the symptoms of upper respiratory tract infections? (Select all that apply.)


Nasal decongestants




Treatment of the common symptoms of upper respiratory tract infections involves the combined use of antihistamines, nasal decongestants, antitussives, and expectorants. Upper respiratory tract infections are often viral or allergic in nature and the symptoms would not be managed with antibiotics.