Decongestants

- Are drugs, usually adrenergics or sympathomimetics, that cause local vasoconstriction

therefore decreasing the blood flow to the irritated and dilated capillaries of the mucous
membranes that lines the nasal passages and sinus cavities. This vasoconstriction leads to
the shrinking of swollen membranes and tends to open clogged nasal passages, providing
relief from the discomfort caused by a blocked nose and promoting drainage of secretions
and improved air flow.
- Frequent or prolonged use of decongestants can have an adverse effect of rebound
congestion, officially called rhinitis medicamentosa.

A. Topical Nasal Decongestants

- Drugs that can be available as nasal sprays that are used to relieve the discomfort of nasal
congestion that accompanies the common cold, sinusitis and allergic rhinitis.
- Can also be used when dilation of the nares is desired to facilitate medical examination or to
relieve the pain and congestion of otitis media.
- Not generally absorbed systemically but any absorbed portion of these decongestants is still
metabolized in the liver and excreted in the urine.

1. Ephedrine

I. Generic Name: Ephedrine

II. Brand Name: Pretz-D
III. Drug Classification: Nasal Decongestant
IV. Dosage/Stock Dose/Preparations: Instill solution in each nostril q4h. Do not use for children
below 6 years old unless advised by physician
V. Indication: Relief of the discomfort of nasal congestion associated with the common cold,
sinusitis, allergic rhinitis; relief of pressure of otitis media
VI. Drug Action/Therapeutic Effect: Reducing swelling and constricting blood vessels in the
nasal passages and widening the lung airways, allowing you to breathe more easily.
VII. Contraindications
i. Do not use medication if allergic to it
ii. Caution should be used in patients with any condition that might be aggravated
by sympathetic activity (glaucoma, hypertension, diabetes, thyroid disease or
coronary disease)
VIII. Nursing Responsibilities
a. Adverse effects: disorientation, confusion, light-headedness, nausea, vomiting, fever,
dyspnea, rebound congestion
b. Drug Interaction: Combined use with other sympathomimetic drug or sympathetic-
blocking drug could results in toxic or non-effective responses.
c. Reassessment/ Drug Effect
i. Monitor for any adverse effects to the patient such as local burning and
stinging, adrenergic effects such as increased pulse, blood pressure and urinary
retention
ii. Relief from symptoms of nasal and nasopharyngeal congestion due to common
cold, hay fever or other respiratory allergies
iii. Decrease congestion around the eustachian ostia.
d. Health Teaching
 i. Teach patient the proper administration of the drug to ensure that therapeutic
effect can be achieved
Caution the patient to not use the drug for longer than 5 days and to seek for medical evaluation if
symptoms persist to facilitate detection of underlying condition that may need a treatment.

2. Phenylephrine

I. Generic Name: Phenylephrine

II. Brand Name: Coricidin
III. Drug Classification: Nasal Decongestant
IV. Dosage/Stock Dose/Preparations:
i. Pediatric (2-6 years old): 2 to 3 drops of 0.125% solution in each nostril q4h PRN
ii. Pediatric and Adult (6 years old and above): 1 to 2 sprays in each nostril q3-4h
V. Indication: Relief of the discomfort of nasal congestion associated with the common cold,
sinusitis, allergic rhinitis
VI. Drug Action/Therapeutic Effect: Decreases swelling in the nose and ears, thereby lessening
discomfort and making it easier to breathe.
VII. Contraindications
i. Product may contain inactive ingredients, which can cause allergic reactions or
other problems.
VIII. Nursing Responsibilities
a. Adverse effects: Troubles in sleeping, dizziness, lightheadedness, headache,
nervousness, shaking and fast heartbeat.
b. Drug Interaction: Combined use with other sympathomimetic drug, sympathetic-
blocking drug or MAO inhibitors could results in toxic or non-effective responses.
c. Reassessment/ Drug Effect
i. Monitor for any adverse effects to the patient
ii. Monitor patient’s relief from discomfort of nasal congestion caused by common
cold, sinusitis and allergic rhinitis.
d. Health Teaching
i. To decrease the risk for serious side effects, carefully follow all dosage directions
advised by the doctor
ii. Teach the patient the proper administration of the drug to ensure therapeutic
effect
iii. Caution the patient to not use the drug for longer than 5 days and to seek for
medical evaluation if symptoms persist to facilitate detection of underlying
condition that may need a treatment

1. Pseudoephedrine

I. Generic Name: Pseudoephedrine

II. Brand Name: Sudafed, Decofed, Dorcol
III. Drug Classification: Oral Decongestant
IV. Dosage/Stock Dose/Preparations:
i. Adult: 60 mg PO q4-6h
 ii. Pediatric: 3 drops/kg PO q4-6h (3-12 months)
0.02ml/kg PO q4-6h (1-2 years old)
15 mg PO q4-6h (2-5 years old)
30 mg PO q4-6h (6-12 years old)
V. Indication: Decrease nasal congestion associated with the common cold, allergic rhinitis;
relief of pain and congestion of otitis media
VI. Drug Action/Therapeutic Effect: Shrinks the nasal mucous membrane by stimulating the
alpha-adrenergic receptors in the nasal mucous membranes resulting in a decrease in
membrane size, promoting drainage of the sinuses and improving airflow.
VII. Contraindications: Since it has adrenergic properties, patients with any condition that might
be aggravated by sympathetic activity such as glaucoma, hypertension, diabetes, thyroid
disease, coronary disease and prostate problems should be cautious.
VIII. Nursing Responsibilities
a. Adverse effects: rebound congestion, sympathetic effects such as anxiety, tenseness,
being restless, tremors, hypertension, arrhythmias, sweating and pallor.
b. Drug Interaction: Taking many over the counter products containing pseudoephedrine
such as cold and flu remedies and allergy medications concurrently can cause serious
adverse effects. Patients should be taught to read the labels of OTC medicines to avoid
inadvertent overdose.
c. Reassessment/ Drug Effect
i. The effect of this drug is noticeable within 30 minutes of oral administration and
reaches a peak within one to two hours
ii. Monitor the patient’s response to the drug if there is an improvement in nasal
congestion or if the patient is experiencing any adverse effects such as
increased pulse, blood pressure, pallor, anxiety and arrhythmias
d. Health Teaching
i. Encourage patient to not use the drug for longer than a week and to seek
medical evaluation if symptoms persist to encourage the detection of
underlying medical conditions for appropriate treatment
ii. Provide thorough teaching to the patient about the drug name, prescribed
dosage, measures to take to avoid adverse effects, warning signs that may
indicate problems and the need for monitoring and evaluation.

Phenylpropanolamine

Generic Name
Brand Name
Drug Classification
Dosage/Stock Dose/Preparations
Indication
Drug Action/Therapeutic Effect
Contraindication
Nursing Responsibilities
Adverse effect
Drug interaction
Reassessment/Drug effect
 Health teaching

Salinase

Generic Name
Brand Name
Drug Classification
Dosage/Stock Dose/Preparations
Indication
Drug Action/Therapeutic Effect
Contraindication
Nursing Responsibilities
Adverse effect
Drug interaction
Reassessment/Drug effect
Health teaching