Author Question: The client asks the nurse which antihistamines are available as intranasal sprays. Which response by ... (Read 29 times)

jc611 · **on:** Jul 23, 2018

The client asks the nurse which antihistamines are available as intranasal sprays. Which response by the nurse is most appropriate?(Select all that apply.)

1. Loratadine (Claritin)
2. Diphenhydramine (Benadryl)
3. Olopatadine (Patanase)
4. Azelastine (Astelin)
5. Neo-synephrine (Afrin)

Question 2

A client asks the nurse what the most commonly used OTC antitussive is. Which response by the nurse is most appropriate?

1. Dextromethorphan
2. Guaifenesin (Mucinex)
3. Benzonatate (Tessalon)
4. Acetylcysteine (Mucomyst)

irishcancer18 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

3, 4

Rationale 1: Loratadine (Claritin) is not available as a nasal spray.
Rationale 2: Diphenhydramine (Benadryl) is not available as a nasal spray.
Rationale 3: Azelastine (Astelin) is approved for nonallergic rhinitis. Although it is a first-generation agent, azelastine causes less drowsiness than do others in its class because it is applied locally to the nasal mucosa, and limited systemic absorption occurs. Olopatadine (Patanase) is a second-generation antihistamine approved in 2008 for allergic rhinitis.
Rationale 4: Azelastine (Astelin) is approved for nonallergic rhinitis. Although it is a first-generation agent, azelastine causes less drowsiness than do others in its class because it is applied locally to the nasal mucosa, and limited systemic absorption occurs. Olopatadine (Patanase) is a second-generation antihistamine approved in 2008 for allergic rhinitis.
Rationale 5: Neo-synephrine (Afrin) is a decongestant.

Global Rationale: Azelastine (Astelin) is approved for nonallergic rhinitis. Although it is a first-generation agent, azelastine causes less drowsiness than do others in its class because it is applied locally to the nasal mucosa, and limited systemic absorption occurs. Olopatadine (Patanase) is a second-generation antihistamine approved in 2008 for allergic rhinitis.

Answer to Question 2

1

Rationale 1: The most frequently used OTC antitussive is dextromethorphan, which is included in most severe cold and flu preparations. Dextromethorphan is chemically similar to the opioids and also acts on the CNS to raise the cough threshold. Although it does not have the abuse potential of opioids, in large amounts, dextromethorphan can cause slurred speech, dizziness, drowsiness, euphoria, and lack of motor coordination.
Rationale 2: Guaifenesin (Mucinex) is an expectorant.
Rationale 3: Benzonatate (Tessalon) is not available OTC.
Rationale 4: Acetylcysteine (Mucomyst) is a mucolytic.

Global Rationale: The most frequently used OTC antitussive is dextromethorphan, which is included in most severe cold and flu preparations. Dextromethorphan is chemically similar to the opioids and also acts on the CNS to raise the cough threshold. Although it does not have the abuse potential of opioids, in large amounts, dextromethorphan can cause slurred speech, dizziness, drowsiness, euphoria, and lack of motor coordination.