NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME
albuterol
BRAND NAME
Accuneb, Airomir, Apo-Salvent,
Proair HFA, Proventil HFA,
Salbutamol, Ventolin HFA,
Ventolin Diskus, Ventolin Nebules,
VoSpire ER
CLASS IFICATION
Therapeutic: bronchodilators
Pharmacologic: adrenergics
Binds to beta2-adrenergic
receptors in airway smooth
muscle, leading to activation of
adenyl cyclase and increased
levels of cyclic-3, 5-adenosine
monophosphate (cAMP).
Increases in cAMP activate
kinases, which inhibit the
phosphorylation of myosin and
decrease intracellular calcium.
Decreased intracellular calcium
relaxes smooth muscle airways.
Relaxation of airway smooth
muscle with subsequent
bronchodilation.
Relatively selective for beta2
(pulmonary) receptors.
INDICATION CONTRAINDICATION
Used as a bronchodilator to
control and prevent reversible
airway obstruction caused by
asthma or COPD.
Inhaln: Used as a quick-relief
agent for acute
bronchospasm and for
prevention of exercise-
induced bronchospasm.
PO: Used as a long-term
control agent
in patients with
chronic/persistent
bronchospasm.
NURSING CONSIDERATION
Hypersensitivity to adrenergic
amines.
● Assess lung sounds, pulse, and BP
before administration
and during peak of medication. Note
amount, color, and character of
sputum produced.
● Monitor pulmonary function tests
before initiating
therapy and periodically during
therapy.
● Observe for paradoxical
bronchospasm (wheezing).
If condition occurs, withhold
medication and
notify health care professional
immediately.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Results in the accumulation of
epinephrine cyclic adenosine monophosphate
(cAMP) at beta-adrenergic
receptors. Affects
both beta1(cardiac)-adrenergic
BRAND NAME receptors and
EpiPen, racepinephrine beta2(pulmonary)-adrenergic
receptor sites. Produces
bronchodilation. Also has alpha-
adrenergic agonist
properties, which result in
CLASS IFICATION vasoconstriction. Inhibits
Therapeutic: antiasthma tics, the release of mediators of
bronchodilators, immediate hypersensitivity
vasopressors reactions from mast cells.
Pharmacologic: adrenergics Therapeutic Effects:
Bronchodilation. Maintenance of
heart rate and BP.
Localization/prolongation of
local/spinal anesthetic.
INDICATION
Subcut, IV, Inhaln:
Management of reversible
airway disease due to
asthma or COPD.
Subcut, IM, IV:
Management of severe
allergic reactions.
IV, Intracardiac,
Intratracheal, Intraosseous
(part of advanced
cardiac life support [ACLS]
and pediatric
advanced life support
[PALS] guidelines):
Management
of cardiac arrest (unlabeled).
Inhaln: Management
of upper airway obstruction
and croup (racemic
epinephrine).
CONTRAINDICATION
Contraindicated in:
Hypersensitivity to adrenergic
amines; Some products may
contain bisulfites or
fluorocarbons (in some inhalers)
and should be avoided
in patients with known
hypersensitivity or intolerance.
NURSING CONSIDERATION
●Bronchodilator: Assess lung sounds,
respiratory pattern, pulse, and BP
before administration and
during peak of medication. Note
amount, color, and character of
sputum produced, and notify
health care professional of abnormal
findings.
● Monitor pulmonary function tests
before and periodically
during therapy.
● Observe for paradoxical
bronchospasm (wheezing).
If condition occurs, withhold
medication and notify health care
professional immediately.
● Observe patient for drug tolerance
and rebound bronchospasm. Patients
requiring more than 3 inhalation
treatments in 24 hr should be under
close supervision. If minimal or no
relief is seen after 3– 5 inhalation
treatments within 6–12 hr, further
treatment with aerosol alone is not
recommended.
● Assess for hypersensitivity reaction
(rash; urticaria; swelling of the face,
lips, or eyelids). If condition
occurs, withhold medication and notify
health care professional immediately.
● Vasopressor: Monitor BP, pulse,
ECG, and respiratory rate frequently
during IV administration.
Continuous ECG, hemodynamic
parameters, and urine output should
 be monitored continuously
during IV administration.
● Monitor for chest pain, arrhythmias,
heart rate 110 bpm, and hypertension.
Consult physician for parameters of
pulse, BP, and ECG changes for
adjusting dose or discontinuing
medication.
● Shock: Assess volume status.
Correct hypovolemia
prior to administering epinephrine IV.
● Nasal Decongestant: Assess patient
for nasal and
sinus congestion prior to and
periodically during
therapy.

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME
Formoterol fumarate
BRAND NAME
Foradil Aerolizer
CLASS IFICATION
Autonomic Nervous System Agent;
Beta-Adrenergic Agonist
(Sympathomimetic); Bronchodilator
Long-acting selective beta2-
adrenergic receptor agonist.
Stimulates production of
intracellular cyclic AMP, which
causes relaxation of bronchial
smooth muscle. Also inhibits
release of mediators of immediate
hypersensitivity (e.g., histamine
and leukotrienes) from mast cells
in the lung.
Treatment of asthma, Hypersensitivity to formoterol;
prevention of exercise significantly worsening or
induced asthma, prevention acutely deteriorating asthma;
of bronchospasm in COPD. severe asthmatic attacks;
paradoxical bronchospasm;
pregnancy (category C);
lactation. Safety and efficiency
in children <5 y are not
established.
 Monitor cardiovascular status
with periodic ECG, BP, and
HR determinations.
 Withhold drug and notify
physician immediately of S&S
of bronchospasm.
 Lab tests: Monitor serum
potassium and blood glucose
periodically.
 Monitor diabetics closely for
loss of glycemic control.

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Synthetic sympathomimetic amine.
Isoproterenol Acts directly on beta1-adrenergic
receptors with little or no effect on
alpha-adrenoceptors. Drug induced
stimulation of beta1-adrenergic
BRAND NAME receptors results in increased
Isuprel cardiac output and cardiac work by
increasing strength of contraction
and, to a slight degree, rate of
contraction of the heart. Produces
slight increase in systolic BP and
CLASS IFICATION decrease in diastolic pressure.
Autonomic Nervous System Agent;
Beta-Adrenergic Agonist
(Sympathomimetic); Bronchodilator
NAME OF THE DRUG MECHANISM OF ACTION
Bronchodilator in treatment
of bronchial asthma and
reversible bronchospasm
induced by anesthesia. Also
used as cardiac stimulant in
cardiac arrest, carotid sinus
hypersensitivity, cardiogenic
and bacteremic shock,
Adams-Stokes syndrome, or
ventricular arrhythmias.
Used in treatment of shock
that persists after
replacement of blood
volume.
INDICATION
Preexisting cardiac arrhythmias
associated with tachycardia;
tachycardia caused by digitalis
intoxication, central
hyperexcitability, cardiogenic
shock secondary to coronary
artery occlusion and MI;
simultaneous administration
with epinephrine. Safe use
during pregnancy (category C)
or lactation is not established.
CONTRAINDICATION
 Check pulse before and during
IV administration. Rate >110
usually indicates need to slow
infusion rate or discontinue
infusion. Consult physician for
guidelines. Incidence of
arrhythmias is high,
particularly when drug is
administered IV to patients
with cardiogenic shock or
ischemic heart disease,
digitalized patients, or to those
with electrolyte imbalance.
 Note: Tolerance to
bronchodilating effect and
cardiac stimulant effect may
develop with prolonged use.
 Discontinue drug if parotid
swelling occurs; has been
reported after prolonged use.
 Note: Once tolerance has
developed, continued use can
result in serious adverse
effects including rebound
bronchospasm.
NURSING CONSIDERATION
GENERIC NAME An isomer of albuterol with beta2-
Levalbuterol adrenergic agonist properties,
drug acts on the beta2 receptors
of the smooth muscles of the
bronchial tree, thus resulting in
BRAND NAME bronchodilation.
Xopenex
Treatment or prevention of
bronchospasm in patients
with reversible obstructive
airway disease.
Hypersensitivity to levalbuterol  Monitor for S&S of CNS or
or albuterol; angioedema; cardiovascular stimulation
pregnancy (category C); (e.g., BP, HR, respiratory
children <6 y; lactation. status).
 Lab tests: Periodic serum
potassium levels especially
with coadministered loop or
thiazide diuretics.
 Monitor diabetics for loss of
glycemic control.

CLASS IFICATION
Autonomic Nervous System Agent;
Beta-Adrenergic Agonist
(Sympathomimetic); Bronchodilator
(Respiratory Smooth Muscle
Relaxant)

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Aminophylline is a salt of
Aminophylline theophylline with effects similar to
those of other xanthines (e.g.,
caffeine and theobromine). Action
is dependent on theophylline
BRAND NAME content (approximately 80%) and
Truphylline is measured as theophylline in the
serum.
CLASS IFICATION
Bronchodilator (Respiratory Smooth
Muscle Relaxant); Xanthine
To prevent and relieve
symptoms of acute bronchial
asthma and treatment of
bronchospasm associated
with chronic bronchitis and
emphysema.
Hypersensitivity to xanthine  Monitor for S&S of toxicity
derivatives or to (generally related to
ethylenediamine component; theophylline serum levels over
cardiac arrhythmias. Safety 20 mg/mL). Observe patients
during pregnancy (category C) receiving parenteral drug
or lactation is not established. closely for signs of
hypotension, arrhythmias, and
convulsions until serum
theophylline stabilizes within
the therapeutic range.
 Note: High incidence of toxicity
is associated with rectal
suppository use due to erratic
rate of absorption.
 Monitor & record vital signs
and I&O. A sudden, sharp,
unexplained rise in heart rate
may indicate toxicity.
 Lab tests: Monitor serum
theophylline levels.
 Note: Older adults, acutely ill,
and patients with severe
respiratory problems, liver
dysfunction, or pulmonary
edema are at greater risk of
toxicity due to reduced drug
clearance.
 Note: Children appear more
susceptible to CNS stimulating
effects of xanthines
(nervousness, restlessness,
insomnia, hyperactive reflexes,
twitching, convulsions).
Dosage reduction may be
indicated.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Xanthine derivative that relaxes
Theophylline smooth muscle by direct action,
particularly of bronchi and
pulmonary vessels, and stimulates
medullary respiratory center with
BRAND NAME resulting increase in vital capacity.
Bronkodyl Also relaxes smooth muscles of
biliary and GI tracts. Stimulates
myocardium, thereby increasing
force of contractions and cardiac
output, and stimulates all levels of
CLASS IFICATION CNS, but to a lesser degree than
Bronchodilator (Respiratory Smooth caffeine.
Muscle Relaxant); Xanthine
INDICATION
Prophylaxis and symptomatic
relief of bronchial asthma, as
well as bronchospasm
associated with chronic
bronchitis and emphysema.
Also used for emergency
treatment of paroxysmal
cardiac dyspnea and edema
of CHF.
CONTRAINDICATION
Hypersensitivity to xanthines;
coronary artery disease or
angina pectoris when
myocardial stimulation might be
harmful; severe renal or liver
impairment. Safety during
pregnancy (category C) or
lactation is not established.
NURSING CONSIDERATION
 Monitor vital signs.
Improvement in respiratory
status is the expected
outcome.
 Observe and report early signs
of possible toxicity: Anorexia,
nausea, vomiting, dizziness,
shakiness, restlessness,
abdominal discomfort,
irritability, palpitation,
tachycardia, marked
hypotension, cardiac
arrhythmias, seizures.
 Monitor for tachycardia, which
may be worse in patients with
severe cardiac disease.
Conversely, theophylline
toxicity may be masked in
patients with tachycardia.
 Lab tests: Monitor plasma
level of theophylline. Be aware
that therapeutic plasma level
ranges from 10–20 mcg/mL (a
narrow therapeutic range).
Levels exceeding 20 mcg/mL
are associated with toxicity.
 Monitor drug levels closely in
heavy smokers. Cigarette
smoking induces hepatic
microsomal enzyme activity,
decreasing serum half-life and
increasing body clearance of
theophylline. An increase of
dosage from 50–100% is usual
in heavy smokers.
  Monitor plasma drug level
closely in patients with heart
failure, kidney or liver
dysfunction, alcoholism, high
fever. Plasma clearance of
xanthines may be reduced.
 Take necessary safety
precautions and forewarn
older adult patients of possible
dizziness during early therapy.
 Monitor patients on sustained
release preparations for S&S
of overdosage. Continued slow
absorption leads to high
plasma concentrations for a
prolonged period.
 Note: Neonates of mothers
using this drug have exhibited
slight tachycardia, jitteriness,
and apnea.
 Monitor CLOSELY for adverse
effects in infants <6 mo and
prematures; theophylline
metabolism is prolonged as is
the half-life in this age group.

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Quaternary compound, chemically Maintenance therapy in Use as primary treatment for  Monitor respiratory status;
Ipratropium bromide related to atropine, with low COPD including chronic acute episodes, hypersensitivity auscultate lungs before and
solubility; does not cross blood– bronchitis and emphysema; to atropine or derivatives. Safe after inhalation.
brain barrier. Produces local, site- nasal spray for perennial use in children < 3 y is not  Report treatment failure
specific effects on the larger rhinitis and symptomatic relief established. (exacerbation of respiratory
BRAND NAME central airways including of rhinorrhea associated with symptoms) to physician.
Atrovent bronchodilation and prevention of the common cold.
bronchospasms. Bronchodilation
inhibits acetylcholine at its
receptor sites, thereby blocking
cholinergic bronchomotor tone
CLASS IFICATION (bronchoconstriction); also
Autonomic Nervous System Agent; abolishes vagally mediated reflex
Anticholinergic (Parasympatholytic); bronchospasm triggered by such
Antimuscarinic; Bronchodilator nonspecific agents as cigarette
smoke, inert dusts, cold air, and a
range of inflammatory mediators
(e.g., histamine).

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME A long-acting, antispasmodic
Tiotropium agent. In the bronchial airways, it
exhibits inhibition of muscarinic
receptors of the smooth muscle
resulting in bronchodilation. The
BRAND NAME drug effect can last up to 24 h.
Spiriva
Maintenance treatment of Hypersensitivity to tiotropium,  Withhold drug and notify
bronchospasm associated atropine, or ipratropium; physician if S&S of
with chronic obstructive pregnancy (category C); angioedema occurs.
pulmonary disease (COPD). children <18 y.  Monitor for anticholinergic
effects (e.g., tachycardia,
urinary retention).

CLASS IFICATION
Autonomic Nervous System Agent;
Anticholinergic; Parasympatholytic;
Antimuscarinic; Antispasmodic

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Potent synthetic sympathomimetic
Metaproterenol amine similar to isoproterenol in
chemical structure and
pharmacologic actions. Acts
selectively on beta2-adrenergic
BRAND NAME receptors to relax smooth muscle
Alupent of bronchi, uterus, and blood
vessels supplying skeletal
muscles.
CLASS IFICATION
Autonomic Nervous System Agent;
Beta-Adrenergic Agonist;
Bronchodilator
NAME OF THE DRUG MECHANISM OF ACTION
Bronchodilator in
symptomatic relief of asthma
and reversible bronchospasm
associated with bronchitis
and emphysema.
INDICATION
Sensitivity to other
sympathomimetic agents;
cardiac arrhythmias associated
with tachycardia;
hyperthyroidism; pregnancy
(category C), lactation. Safety in
children <12 y (for aerosol use)
is not established.
CONTRAINDICATION
 Monitor respiratory status.
Auscultate lungs before and
after inhalation to determine
efficacy of drug in decreasing
airway resistance.
 Monitor cardiac status. Report
tachycardia and hypotension.
NURSING CONSIDERATION
GENERIC NAME Long-acting beta2-adrenoreceptor
Salmeterol agonist and an analog of albuterol.
Stimulation of beta2-
adrenoreceptors relaxes
bronchospasm and increases
BRAND NAME ciliary motility, thus facilitating
Serevent expectoration. Inhibits the release
of mediators (i.e., histamine) from
mast cells, macrophages, and
eosinophils.
CLASS IFICATION
Autonomic Nervous System Agent;
Beta-Adrenergic Agonist
(Sympathomimetic); Bronchodilator;
Respiratory Smooth Muscle Relaxant
NAME OF THE DRUG MECHANISM OF ACTION
Maintenance therapy for Hypersensitivity to salmeterol;  Withhold drug and notify
asthma or bronchospasm. primary treatment of status physician immediately if
Prevention of exercise- asthmaticus; pregnancy bronchospasms occur
induced bronchospasm. Do (category C), lactation; safety following its use.
not use to treat acute and efficacy in children <4 y not  Monitor cardiovascular status;
bronchospasm. established. report tachycardia.
 Monitor liver enzymes
periodically with long-term
therapy.
INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Synthetic adrenergic stimulant Orally or subcutaneously as a Known hypersensitivity to  Assess vital signs: Baseline
Terbutaline sulfate with selective beta2- and bronchodilator in bronchial sympathomimetic amines; pulse and BP and before each
negligible beta1-agonist (cardiac) asthma and for reversible severe hypertension and dose. If significantly altered
activity. Exerts preferential effect airway obstruction associated coronary artery disease; from baseline level, consult
on beta2 receptors in bronchial with bronchitis and tachycardia with digitalis physician. Cardiovascular
BRAND NAME smooth muscles, inhibits emphysema. intoxication; within 14 d of MAO adverse effects are more apt
histamine release from mast cells, inhibitor therapy; angle-closure to occur when drug is given by
Brethaire and increases ciliary motility. glaucoma. Used only after SC route or it is used by a
evaluation of risk-benefit ratio in patient with cardiac
pregnancy (category B) and arrhythmia.
lactation.  Most adverse effects are
CLASS IFICATION transient, however, rapid heart
rate may persist for a relatively
AUTONOMIC NERVOUS SYSTEM long time.
AGENT; BETA-ADRENERGIC  Be aware that onset and
AGONIST; BRONCHODILATOR degree of effect and incidence
and severity of adverse effects
of SC formulation resemble
those of epinephrine.
 Aerosolized drug produces
minimal cardiac stimulation or
tremors.
 Be aware that muscle tremor
is a fairly common adverse
effect that appears to subside
with continued use.
 Monitor for symptoms of
hypoglycemia in neonates
born of a mother who used
terbutaline during pregnancy.
 Monitor patient being treated
for premature labor for CV
S&S for 12 h after drug is
discontinued. Report
tachycardia promptly.
 Monitor I&O ratio. Fluid
 restriction may be necessary.
Consult physician.

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Has potent glucocorticoid and Treatment of allergic and Hypersensitivity to budesonide,  Monitor closely for S&S of
Budesonide weak mineralocorticoid activity. Its perennial rhinitis, maintain lactation. hypercorticism if concomitant
antiinflammatory action on nasal remission in mild to moderate doses of ketoconazole or other
mucosa is unknown. Crohn's disease; prophylaxis CYP3A4 inhibitors (see Drug
for asthma. Interactions) are being given.
BRAND NAME  Monitor patients with moderate
Rhinocort Turbuhaler to severe liver disease for
increased S&S of
hypercorticism.
 Lab tests: Periodic serum
potassium.
CLASS IFICATION
Hormone and Synthetic Substitute;
Adrenal Corticosteroid;
Glucocorticoid; Mineralocorticoid

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME
Fluticasone proportionate
BRAND NAME
Flonase, Flovent
CLASS IFICATION
Hormone and Synthetic Substitute;
Adrenal Corticosteroid;
Glucocorticoid; Mineralocorticoid
Oral inhalation to treat Nonasthmatic bronchitis,  Note that oral inhalation and
steroid-dependent asthma, primary treatment of status nasal inhalation products are
nasal inhalation for the asthmaticus, acute attack of not to be used
management of the asthma. interchangeably.
symptoms of seasonal or  Oral inhaler: Emphasize the
perennial rhinitis following:
 (1) Shake inhaler well before
using.
 (2) After exhaling fully, place
mouthpiece well into mouth
with lips closed firmly around
it.
 (3) Inhale slowly through
mouth while activating the
inhaler.
 (4) Hold breath 5–10 sec, if
possible, then exhale slowly.
 (5) Wait 1 min between puffs.
Clean inhaler daily. Separate
parts as directed in package
insert, rinse them with warm
water, and dry them
thoroughly. Rinsing mouth and
gargling with warm water after
each oral inhalation removes
residual medication from
oropharyngeal area. Mouth
care may also delay or prevent
onset of oral dryness,
hoarseness, and
candidiasis.Nasal inhaler:
Directions for use of nasal
inhaler provided by
manufacturer should be
carefully reviewed with patient.
 Emphasize the following
 points:
 (1) Gently blow nose to clear
nostrils.
 (2) Shake inhaler well before
using.
 (3) If 2 sprays in each nostril
are prescribed, direct one
spray toward upper, and the
other toward lower part of
nostril.
 (4) Wash cap and plastic
nosepiece daily with warm
water; dry thoroughly. Inhaled
steroids do not provide
immediate symptomatic relief
and are not prescribed for this
purpose.

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME
Triamcinolone acetonide
BRAND NAME
CLASS IFICATION
Hormone and Synthetic Substitute;
Adrenal Corticosteroid;
Glucocorticoid; Mineralocorticoid
Oral inhalation to treat Nonasthmatic bronchitis,  Note that oral inhalation and
steroid-dependent primary treatment of status nasal inhalation products are
asthma, nasal asthmaticus, acute attack of not to be used
inhalation for the asthma. interchangeably.
management of the  Oral inhaler: Emphasize the
symptoms of seasonal following:
or perennial rhinitis  (1) Shake inhaler well before
using.
 (2) After exhaling fully, place
mouthpiece well into mouth
with lips closed firmly around
it.
 (3) Inhale slowly through
mouth while activating the
inhaler.
 (4) Hold breath 5–10 sec, if
possible, then exhale slowly.
 (5) Wait 1 min between puffs.
Clean inhaler daily. Separate
parts as directed in package
insert, rinse them with warm
water, and dry them
thoroughly. Rinsing mouth and
gargling with warm water after
each oral inhalation removes
residual medication from
oropharyngeal area. Mouth
care may also delay or prevent
onset of oral dryness,
hoarseness, and
candidiasis.Nasal inhaler:
Directions for use of nasal
inhaler provided by
manufacturer should be
carefully reviewed with patient.
 Emphasize the following
 points:
 (1) Gently blow nose to clear
nostrils.
 (2) Shake inhaler well before
using.
 (3) If 2 sprays in each nostril
are prescribed, direct one
spray toward upper, and the
other toward lower part of
nostril.
(4) Wash cap and plastic nosepiece
daily with warm water; dry thoroughly.
Inhaled steroids do not provide
immediate symptomatic relief and are
not prescribed for this purpose.

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Oral inhalation to treat Nonasthmatic bronchitis,  Note that oral inhalation and
Flunisolide steroid-dependent primary treatment of status nasal inhalation products are
asthma, nasal asthmaticus, acute attack of not to be used
inhalation for the asthma. interchangeably.
management of the  Oral inhaler: Emphasize the
BRAND NAME symptoms of seasonal following:
AeroBid, Nasalide, Nasarel or perennial rhinitis  (1) Shake inhaler well before
using.
 (2) After exhaling fully, place
mouthpiece well into mouth
with lips closed firmly around
CLASS IFICATION it.
Hormone and Synthetic Substitute;  (3) Inhale slowly through
Adrenal Corticosteroid; mouth while activating the
Glucocorticoid; Mineralocorticoid inhaler.
 (4) Hold breath 5–10 sec, if
possible, then exhale slowly.
  (5) Wait 1 min between puffs.
Clean inhaler daily. Separate
parts as directed in package
insert, rinse them with warm
water, and dry them
thoroughly. Rinsing mouth and
gargling with warm water after
each oral inhalation removes
residual medication from
oropharyngeal area. Mouth
care may also delay or prevent
onset of oral dryness,
hoarseness, and
candidiasis.Nasal inhaler:
Directions for use of nasal
inhaler provided by
manufacturer should be
carefully reviewed with patient.
 Emphasize the following
points:
 (1) Gently blow nose to clear
nostrils.
 (2) Shake inhaler well before
using.
 (3) If 2 sprays in each nostril
are prescribed, direct one
spray toward upper, and the
other toward lower part of
nostril.
(4) Wash cap and plastic nosepiece
daily with warm water; dry thoroughly.
Inhaled steroids do not provide
immediate symptomatic relief and are
not prescribed for this purpose.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Synthetic asthma-prophylactic agent
Cromolyn with unique action. Inhibits release
of bronchoconstrictors—histamine
and SRS-A (slow-reacting
substance of anaphylaxis) from
BRAND NAME sensitized pulmonary mast cells,
Disodium Cromoglycate thereby suppressing an allergic
response. Has no intrinsic
bronchodilator, antihistaminic, or
vasoconstrictor properties, thus only
of value when taken prophylactically.
CLASS IFICATION
Mast cell stabilizer
INDICATION
Primarily for prophylaxis of
mild to moderate seasonal
and perennial bronchial
asthma and allergic rhinitis.
Also used for prevention of
exercise-related
bronchospasm, prevention of
acute bronchospasm induced
by known pollutants or
antigens, and for prevention
and treatment of allergic
rhinitis. Orally for systemic
mastocytosis. Ophthalmic
use: Allergic ocular disorders,
conjunctivitis, vernal
keratoconjunctivitis.
CONTRAINDICATION
Use of aerosol (because of
fluorocarbon propellants) in
patients with coronary artery
disease or history of
arrhythmias; dyspnea, acute
asthma, status asthmaticus;
patients unable to coordinate
actions or follow instructions,
pregnancy (category B),
lactation. Safe use in children
<6 y not determined; use of
capsule not recommended for
children.
NURSING CONSIDERATION
 Withhold drug and notify
physician if any of the
following occur, angioedema
or bronchospasm.
 Monitor for exacerbation of
asthmatic symptoms including
breathlessness and cough that
may occur in patients receiving
cromolyn during corticosteroid
withdrawal.
 For patients with asthma,
therapeutic effects may be
noted within a few days but
generally not until after 1–2 wk
of therapy.
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Long-acting antihistamine with Relief of symptoms of Hypersensitivity to loratadine.  Assess carefully for and report
Loratadine selective peripheral H1-receptor seasonal allergic rhinitis; distressing or dangerous S&S
sites, thus blocking histamine idiopathic chronic urticaria. that occur after initiation of the
release. drug. A variety of adverse
effects, although not common,
BRAND NAME are possible. Some are an
Alavert indication to discontinue the
drug.
 Monitor cardiovascular status
and report significant changes
in BP and palpitations or
CLASS IFICATION tachycardia.
Antihistamine; H1-Receptor
Antagonist; Nonsedating
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Cetirizine is a potent H1-receptor
Cetirizine antagonist and thus an
antihistamine without significant
anticholinergic or CNS activity.
Low lipophilicity combined with its
BRAND NAME H1-receptor selectivity probably
Zyrtec accounts for its relative lack of
anticholinergic and sedative
properties.
CLASS IFICATION
Antihistamine; H1-Receptor
Antagonist; Non-Sedating
INDICATION
Seasonal and perennial
allergic rhinitis and chronic
idiopathic urticaria.
CONTRAINDICATION
Hypersensitivity to H1-receptor
antihistamines; lactation,
children <2 y.
NURSING CONSIDERATION
 Monitor for drug interactions.
As the drug is highly protein
bound, the potential for
interactions with other protein-
bound drugs exists.
 Monitor for sedation,
especially the older adult.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Antihistamine competitively
Fexofenadine antagonizes histamine at the H1-
receptor site; does not bind with
histamine to inactivate it. Not
associated with anticholinergic or
BRAND NAME sedative properties.
Allegra
INDICATION
Relief of symptoms
associated with seasonal
allergic rhinitis, and chronic
urticaria.
CONTRAINDICATION NURSING CONSIDERATION
Hypersensitivity to  Monitor therapeutic
fexofenadine; pregnancy effectiveness, which is
(category C). indicated by decreased nasal
congestion, sneezing, watery
or red eyes, and itching nose,
palate, or eyes.

CLASS IFICATION
Antihistamine; H1-Receptor
Antagonist; Non-Sedating
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME H1-receptor antagonist and
Diphenhydramine antihistamine with significant
anticholinergic activity. High
incidence of drowsiness, but GI
side effects are minor. Effects in
BRAND NAME parkinsonism and drug-induced
Banophen extrapyramidal symptoms are
apparently related to its ability to
suppress central cholinergic
activity and to prolong action of
dopamine by inhibiting its reuptake
CLASS IFICATION and storage.
Antihistamine; H1-Receptor
Antagonist
INDICATION
Temporary symptomatic relief
of various allergic conditions
and to treat or prevent motion
sickness, vertigo, and
reactions to blood or plasma
in susceptible patients. Also
used in anaphylaxis as
adjunct to epinephrine and
other standard measures
after acute symptoms have
been controlled; in treatment
of parkinsonism and drug-
induced extrapyramidal
reactions; as a nonnarcotic
cough suppressant; as a
sedative-hypnotic; and for
treatment of intractable
insomnia.
CONTRAINDICATION
Hypersensitivity to
antihistamines of similar
structure; lower respiratory tract
symptoms (including acute
asthma); narrow-angle
glaucoma; prostatic
hypertrophy, bladder neck
obstruction; GI obstruction or
stenosis; pregnancy (category
C), lactation, premature
neonates, and neonates; use as
nighttime sleep aid in children
<12 y.
NURSING CONSIDERATION
 Monitor cardiovascular status
especially with pre-existing
cardiovascular disease.
 Monitor for adverse effects
especially in children and the
older adult.
 Supervise ambulation and use
side-rails as necessary.
Drowsiness is most prominent
during the first few days of
therapy and often disappears
with continued therapy. Older
adults are especially likely to
manifest dizziness, sedation, and
hypotension.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Antihistamine similar to
Brompheniramine diphenhydramine; shares
properties of other antihistamines.
Has less sedative effect than
diphenhydramine. Competes with
BRAND NAME histamine for H1-receptor sites on
Dimetane effector cells, thus blocking
histamine-mediated responses.
CLASS IFICATION
Antihistamine; (H1-Receptor
Antagonist)
INDICATION
Symptomatic treatment of
allergic manifestations. Also
used in various cough
mixtures and antihistamine-
decongestant cold
formulations.
CONTRAINDICATION
Hypersensitivity to
antihistamines; acute asthma;
pregnancy (category C),
lactation; newborns.
NURSING CONSIDERATION
 Drowsiness, sweating,
transient hypotension, and
syncope may follow IV
administration; reaction to drug
should be evaluated. Keep
physician informed.
 Note: Older adults tend to be
particularly susceptible to
drug's sedative effect,
dizziness, and hypotension.
Most symptoms respond to
reduction in dosage.
 Lab tests: Periodic CBC in
patients receiving long-term
therapy.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Antihistamine that competes with
Chlorpheniramine histamine for H1-receptor sites on
effector cells, thus it prevents
histamine action that promotes
capillary permeability and edema
BRAND NAME formation and constrictive action
Chlorate on respiratory, gastrointestinal,
and vascular smooth muscles. It
generally produces less
drowsiness than other
CLASS IFICATION antihistamines, but adverse effects
Antihistamine (H1-Receptor involving CNS stimulation may be
Antagonist) more common.
INDICATION
Symptomatic relief of various
uncomplicated allergic
conditions; to prevent
transfusion and drug
reactions in susceptible
patients, and as adjunct to
epinephrine and other
standard measures in
anaphylactic reactions.
CONTRAINDICATION
Hypersensitivity to
antihistamines of similar
structure; lower respiratory tract
symptoms, narrow-angle
glaucoma, obstructive prostatic
hypertrophy or other bladder
neck obstruction, GI obstruction
or stenosis; pregnancy
(category B in first and second
trimester and category D in third
trimester), lactation; premature
and newborn infants; during or
within 14 d of MAO INHIBITOR
therapy.
NURSING CONSIDERATION
 Monitor for CNS depression
and sedation, especially when
chlorpheniramine is given in
combination with other CNS
depressants.
 Monitor BP in hypertensive
patients since
chlorpheniramine may elevate
BP.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Long acting piperazine
Meclizine antihistamine, structurally and
pharmacologically related to
cyclizine compounds. Marked
effect in blocking histamine-
induced vasopressive response
BRAND NAME but only slight anticholinergic
Antivert action. Marked depressant action
on labyrinthine excitability and on
conduction in vestibular-cerebellar
pathways.
INDICATION
Management of nausea,
vomiting, and dizziness
associated with motion
sickness and in vertigo
associated with diseases
affecting vestibular system.
CONTRAINDICATION
Hypersensitivity to meclizine;
pregnancy (category B).
NURSING CONSIDERATION
Supervision of ambulation, particularly
with the older adult, since drug may
cause drowsiness.
Assess effectiveness of drug and
inform physician when prescribed for
vertigo; dosage adjustment may be
required.

CLASS IFICATION
Antihistamine; H1-Receptor
Antagonist; Anti-Vertigo Agent
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Long-acting derivative of
phenothiazine with marked
Promethazine antihistamine activity and
prominent sedative, amnesic,
antiemetic, and anti-motion-
BRAND NAME sickness actions. Unlike other
Pentazine phenothiazine derivatives,
relatively free of extrapyramidal
adverse effects; however, in high
doses it carries same potential for
toxicity.
CLASS IFICATION
Gastrointestinal Agent; Antiemetic;
Antivertigo Agent; Phenothiazine
INDICATION
Symptomatic relief of various
allergic conditions, to
ameliorate and prevent
reactions to blood and
plasma, and in prophylaxis
and treatment of motion
sickness, nausea, and
vomiting. Preoperative,
postoperative, and obstetric
sedation and as adjunct to
analgesics for control of pain.
CONTRAINDICATION
Hypersensitivity to
phenothiazines; narrow-angle
glaucoma; stenosing peptic
ulcer, pyloroduodenal
obstruction; prostatic
hypertrophy; bladder neck
obstruction; epilepsy; bone
marrow depression; comatose
or severely depressed states;
pregnancy (category C),
lactation, newborn or premature
infants, acutely ill or dehydrated
children; children <2 y; Reye's
syndrome, encephalopathy,
hepatic diseases.
NURSING CONSIDERATION
 Supervise ambulation.
Promethazine sometimes
produces marked sedation and
dizziness.
 Be aware that antiemetic
action may mask symptoms of
unrecognized disease and
signs of drug overdosage as
well as dizziness, vertigo, or
tinnitus associated with toxic
doses of aspirin or other
ototoxic drugs.
 Patients in pain may develop
involuntary (athetoid)
movements of upper
extremities following
parenteral administration.
These symptoms usually
disappear after pain is
controlled.
 Monitor respiratory function in
patients with respiratory
problems, particularly children.
Drug may suppress cough
reflex and cause thickening of
bronchial secretions.
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME H1-receptor antagonist and salt of Chiefly in prevention and Narrow-angle glaucoma,  Use side rails and supervise
Dimenhydrinate diphenhydramine, with which it treatment of motion sickness. prostatic hypertrophy. Safe use ambulation; drug produces
shares similar properties. Also has been used in during pregnancy (category B), high incidence of drowsiness.
management of vertigo, lactation, or in children <2 y is  Note: Tolerance to CNS
nausea, and vomiting not established. depressant effects usually
BRAND NAME associated with radiation occurs after a few days of drug
Calm-X, Dimentabs sickness, labyrinthitis, therapy; some decrease in
Ménière's syndrome, antiemetic action may result
stapedectomy, anesthesia, with prolonged use.
and various medications.  Monitor for dizziness, nausea,
and vomiting; these may
CLASS IFICATION indicate drug toxicity.
Antihistamine (H1-Receptor
Antagonist); Antiemetic; Antivertigo
Agent
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Antihistamine with mild CNS
Tripelennamine depressant effects and relatively
high incidence of GI side effects.
Antagonizes histamine action (i.e.,
increased capillary permeability,
BRAND NAME edema formation, itching, and
PBZ-SR, Pelamine constriction of respiratory, GI, and
vascular smooth muscle). Does
not inhibit gastric secretion.
CLASS IFICATION
Antihistamine (H1-Receptor
Antagonist)
INDICATION
To relieve symptoms of
various allergic conditions, to
ameliorate reactions to blood
or plasma, and in
anaphylaxis as adjunct to
epinephrine and other
standard measures after
acute symptoms have been
controlled. Also to provide
oral mucous membrane
analgesia in young children
with herpetic gingiva-
stomatitis.
CONTRAINDICATION
Narrow-angle glaucoma;
symptomatic prostatic
hypertrophy; bladder neck
obstruction; GI obstruction or
stenosis; lower respiratory tract
symptoms, including asthma;
within 14 d of MAO inhibitor
therapy. Safety during
pregnancy (category B),
lactation, or in neonates and
prematures is not established.
NURSING CONSIDERATION
 Assist older adults during
ambulation; dizziness,
sedation, and hypotension are
more likely to occur in this age
group.
 Lab tests: Obtain periodic
blood cell counts during long-
term therapy with
antihistamines.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME An antihistamine (H1-receptor
antagonist) which competes for H1
Clemastine receptor sites on effector cells,
thus blocking histamine release.
Has greater selectivity for
BRAND NAME preripheral H1 receptors and,
Tavist consequently, it produces little
sedation. Has prominent
antipruritic activity and low
incidence of unpleasant adverse
effects.
CLASS IFICATION
Antihistamine (h1-receptor antagonist)
INDICATION
Symptomatic relief of allergic
rhinitis (sneezing, rhinorrhea,
pruritus) and mild
uncomplicated allergic skin
manifestations such as
urticaria and angioedema.
CONTRAINDICATION
Hypersensitivity to clemastine or
to other antihistamines of similar
chemical structure; lower
respiratory tract symptoms,
including acute asthma;
concomitant MAO INHIBITOR
therapy; pregnancy (category
B), lactation.
NURSING CONSIDERATION
 Monitor for drowsiness, poor
coordination, or dizziness,
especially in the older adult or
debilitated. Supervision of
ambulation may be warranted.
 Assess for symptomatic relief
with use of the medication.
 Lab tests: Periodic
hematological studies with
long-term use.
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION
GENERIC NAME Piperazine derivative structurally Emotional or psychoneurotic
Hydroxyzine and pharmacologically related to states characterized by
other cyclizines (e.g., buclizine, anxiety, tension, or
chlorcyclizine). In common with psychomotor agitation; to
such agents, it causes CNS relieve anxiety, control
BRAND NAME depression. nausea and emesis, and
Atarax reduce narcotic requirements
before or after surgery or
delivery. Also used in
management of pruritus due
to allergic conditions, e.g.,
CLASS IFICATION chronic urticaria, atopic and
Antihistamine; Antipruritic contact dermatoses, and in
treatment of acute and
chronic alcoholism with
withdrawal symptoms or
delirium tremens.
CONTRAINDICATION
Known hypersensitivity to
hydroxyzine; use as sole
treatment in psychoses or
depression. Safe use during
early pregnancy (category C) or
lactation is not established.
NURSING CONSIDERATION
 Evaluate alertness.
Drowsiness may occur and
usually disappears with
continued therapy or following
reduction of dosage.
 Monitor condition of oral
membranes daily when patient
is on high dosage of
hydroxyzine.
 Reevaluate usefulness of drug
periodically.
 Reduce dosage of the
depressant up to 50% when
CNS depressants are
prescribed concomitantly.
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Potent piperidine antihistamine Symptomatic relief of various Older adult and debilitated  Monitor level of alertness. In
Cyproheptadine with pharmacologic actions similar allergic conditions, including patients; patients predisposed some patients, the sedative
to those of azatadine. Acts by hay fever, vasomotor rhinitis, to urinary retention; glaucoma; effect disappears
competing with histamine for H1- allergic conjunctivitis, urticaria asthma; hyperthyroidism; spontaneously after 3–4 d of
receptor sites on effector cells, caused by cold sensitivity, cardiovascular disease, drug administration.
BRAND NAME thus preventing histamine- and pruritus of allergic hypertension; GI or GU tract  Since drug may cause
Periactin mediated responses. dermatoses. Effective in obstruction. dizziness, supervision of
treatment of anaphylactoid ambulation and other safety
reactions as adjunct to precautions may be warranted.
epinephrine and other
standard measures after
CLASS IFICATION acute symptoms have been
Antihistamine, H1-Receptor controlled.
Antagonist; Antipruritic
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Competes for H1 receptor sites on Perennial and seasonal Hypersensitivity to  Supervise ambulation and take
Dexchlorpheniramine cells thus blocking histamine allergic rhinitis, other antihistamines of similar class; safety precautions, especially
release. manifestations of allergy, and acute asthmatic attack, lower with older adult patients.
vasomotor rhinitis. Also as respiratory tract symptoms,  Monitor I&O and assess for
adjunct to epinephrine in newborns, premature infants. difficulty voiding (e.g.,
BRAND NAME treatment of anaphylactic Safe use during pregnancy frequency or retention).
Dexchlor reactions. (category B) or lactation is not
established.

CLASS IFICATION
Antihistamine (h1-receptor antagonist)
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME First generation antihistamine that Seasonal allergic rhinitis, Hypersensitivity to azelastine;  Monitor level of alertness
Azelastine is a potent histamine H1 receptor itching associated with concurrent use of CNS especially in older adults and
antagonist. allergic conjunctivitis. depressants; pregnancy with concurrent use of other
(category C), lactation, children CNS depressants.
<3 y.
BRAND NAME
Astelin

CLASS IFICATION
Antihistamine; H1-Receptor
Antagonist; Ocular Antihistamine
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Potent, synthetic, direct-acting Parenterally to maintain BP Severe coronary disease,  Monitor pulse, BP, and central
Phenylephrine sympathomimetic with strong during anesthesia, to treat severe hypertension, ventricular venous pressure (q2–5min)
alpha-adrenergic and weak beta- vascular failure in shock, and tachycardia; narrow-angle during IV administration.
adrenergic cardiac stimulant to overcome paroxysmal glaucoma (ophthalmic  Control flow rate and dosage
actions. supraventricular tachycardia. preparations); pregnancy to prevent excessive dosage.
BRAND NAME Used topically for rhinitis of (category C), lactation. IV overdoses can induce
AK-Dilate Ophthalmic common cold, allergic rhinitis, ventricular dysrhythmias.
and sinusitis; in selected  Observe for congestion or
patients with wide-angle rebound miosis after topical
glaucoma; as mydriatic for administration to eye.
ophthalmoscopic examination
CLASS IFICATION or surgery, and for relief of
Autonomic Nervous System Agent; uveitis.
Alpha-Adrenergic Agonist; Eye and
Nose Preparation; Mydriatic;
Decongestant
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION
GENERIC NAME Both indirect- and direct-acting Temporary relief of
Ephedrine sympathomimetic amine. Thought congestion of hay fever,
to act indirectly by releasing tissue allergic rhinitis, and sinusitis;
stores of norepinephrine and and in treatment and
directly by stimulation of alpha-, prophylaxis of mild cases of
BRAND NAME beta1-, and beta2-adrenergic acute asthma and in patients
Efedron receptors. with chronic asthma requiring
continuing treatment. Also
has been used for its CNS
stimulant actions in treatment
of narcolepsy, to improve
CLASS IFICATION respiration in narcotic and
Autonomic Nervous System Agent; barbiturate poisoning, to
Alpha- And Beta-Adrenergic Agonist combat hypotensive states,
(Sympathomimetic); Bronchodilator especially those associated
with spinal anesthesia; in
management of enuresis or
impaired bladder control; as
adjunct in treatment of
myasthenia gravis; as
mydriatic; to relieve
dysmenorrhea; and for
temporary support of
ventricular rate in Adams-
Stokes syndrome; for
peripheral edema secondary
to type I diabetic neuropathy.
CONTRAINDICATION
History of hypersensitivity to
ephedrine or other
sympathomimetics; narrow-
angle glaucoma; pregnancy
(category C), lactation.
NURSING CONSIDERATION
 Supervise continuously
patients receiving ephedrine
IV. Take baseline BP and
other vital signs. Check BP
repeatedly during first 5 min,
then q3–5min until stabilized.
 Monitor I&O ratio and pattern,
especially in older male
patients. Encourage patient to
void before taking medication
(see ADVERSE EFFECTS).
 Monitor for systemic effects of
nose drops that can occur
because of excessive dosage
from rapid absorption of drug
solution through nasal
mucosa. This is most likely to
occur in older adults.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Direct-acting imidazoline
Naphazoline derivative with marked alpha-
adrenergic activity. Differs from
other sympathomimetic amines in
that systemic absorption may
BRAND NAME cause CNS depression rather than
Allerest stimulation.
INDICATION CONTRAINDICATION
Nasal decongestant and Narrow-angle glaucoma;
ocular vasoconstrictor. concomitant use with MAO
inhibitors or tricyclic
antidepressants. Safety during
pregnancy (category C),
lactation, or in infants is not
established.
NURSING CONSIDERATION
 Watch for rebound congestion
and chemical rhinitis with
frequent and continued use.
 Monitor BP periodically for
development or worsening of
hypertension, especially with
ophthalmic route.
 Overdose: Bradycardia and
hypotension can result. Report
promptly.

CLASS IFICATION
Vasoconstrictor; Decongestant;
Autonomic Nervous System Agent;
Alpha-Adrenergic Agonist
(Sympathomimetic)
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Related to naphazoline but shares Symptomatic relief of minor Hypersensitivity to any  Discontinue medication and
Tetrahydrozoline more marked alpha-adrenergic eye irritation and allergies component; use of ophthalmic consult physician if relief is not
than beta-adrenergic activity; large and for nasopharyngeal preparation in glaucoma or obtained within 48 h or if
doses cause CNS depression congestion of allergic or other serious eye diseases; use symptoms persist or increase.
rather than the stimulation inflammatory origin. within 14 d of MAO inhibitor  Do not exceed recommended
BRAND NAME produced by other therapy. Use in children <2 y; dosage. Rebound congestion
Mallazine sympathomimetic amines. use of 0.1% or higher strengths and rhinitis may occur with
in children <6 y. Safety during frequent or prolonged use of
pregnancy (category C) is not nasal preparation.
established.  Do not breast feed while using
CLASS IFICATION this drug without consulting
Vasoconstrictor; Decongestant physician.
NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Enhances reflex outflow of To combat dry, Hypersensitivity to guaifenesin;  Monitor for therapeutic
Guaifenesin respiratory tract fluids by irritation nonproductive cough pregnancy (category C), effectiveness. Persistent
of gastric mucosa. associated with colds and lactation. cough may indicate a serious
bronchitis. A common condition requiring further
ingredient in cough mixtures. diagnostic work.
BRAND NAME  Notify physician if high fever,
Amonidrin rash, or headaches develop.

CLASS IFICATION
Antitussive; Expectorant

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Nonnarcotic antitussive chemically
Benzonatate related to tetracaine. Antitussive
activity reported to be somewhat
less effective than that of codeine.
Does not inhibit respiratory center
BRAND NAME at recommended doses.
Tessalon
Decreases frequency and
intensity of nonproductive
cough in acute and chronic
respiratory conditions. Also
used in bronchoscopy,
thoracentesis, and other
procedures when coughing
must be avoided.
Safe use during pregnancy  Auscultate lungs anteriorly and
(category C) or lactation is not posteriorly at scheduled
established. intervals.
 Observe character and
frequency of coughing and
volume and quality of sputum.
Keep physician informed.

CLASS IFICATION
Antitussive

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Nonnarcotic derivative of Temporary relief of cough Children <2 y, asthma,  Monitor for dizziness and
Dextromethorphan levorphanol. Chemically related to spasms in nonproductive productive cough, persistent or drowsiness, especially when
morphine but without central coughs due to colds, chronic cough; hepatic function concurrent therapy with CNS
hypnotic or analgesic effect or pertussis, and influenza. impairment; pregnancy depressant is used.
capacity to cause tolerance or (category C).
BRAND NAME addiction. Antitussive activity
Robitussin DM comparable to that of codeine but
is less likely than codeine to cause
constipation, drowsiness, or GI
disturbances.

CLASS IFICATION
Antitussive

NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION

GENERIC NAME Synthetic sympathomimetic amine
Salbutamol and moderately selective beta2-
adrenergic agonist with
comparatively long action. Acts
more prominently on beta2
BRAND NAME receptors (particularly smooth
Accuneb muscles of bronchi, uterus, and
vascular supply to skeletal
muscles) than on beta1 (heart)
receptors. Inhibits histamine
release by mast cells. Produces
CLASS IFICATION bronchodilation, regardless of
Antitussive administration route, by relaxing
smooth muscles of bronchial tree.
To relieve bronchospasm
associated with acute or
chronic asthma, bronchitis, or
other reversible obstructive
airway diseases. Also used to
prevent exercise-induced
bronchospasm.
Pregnancy (category C),  Monitor therapeutic
lactation. Use of oral syrup in effectiveness which is
children <2 y. indicated by significant
subjective improvement in
pulmonary function within 60–
90 min after drug
administration.
 Monitor for: S&S of fine tremor
in fingers, which may interfere
with precision handwork; CNS
stimulation, particularly in
children 2–6 y, (hyperactivity,
excitement, nervousness,
insomnia), tachycardia, GI
symptoms. Report promptly to
physician.
 Lab tests: Periodic ABGs,
pulmonary functions, and
pulse oximetry.
 Consult physician about giving
last albuterol dose several
hours before bedtime, if drug-
induced insomnia is a
problem.
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Enhances reflex outflow of To combat dry, Hypersensitivity to guaifenesin;  Monitor for therapeutic
Robitussin AC respiratory tract fluids by irritation nonproductive cough pregnancy (category C), effectiveness. Persistent
of gastric mucosa. associated with colds and lactation. cough may indicate a serious
bronchitis. A common condition requiring further
ingredient in cough mixtures. diagnostic work.
BRAND NAME  Notify physician if high fever,
Amonidrin rash, or headaches develop.

CLASS IFICATION
Antitussive; Expectorant
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION
GENERIC NAME Acetylcysteine probably acts by Adjuvant therapy in patients
Acetylcysteine disrupting disulfide linkages of with abnormal, viscid, or
mucoproteins in purulent and inspissated mucous
nonpurulent secretions. secretions in acute and
chronic bronchopulmonary
BRAND NAME diseases, and in pulmonary
Mucomyst complications of cystic
fibrosis and surgery,
tracheostomy, and
atelectasis. Also used in
diagnostic bronchial studies
CLASS IFICATION and as an antidote for acute
Skin and mucous membrane agent; acetaminophen poisoning.
mucolytic; antidote
CONTRAINDICATION
Hypersensitivity to
acetylcysteine; patients at risk
of gastric hemorrhage.
NURSING CONSIDERATION
 During IV infusion, carefully
monitor for fluid overload and
signs of hyponatremia (i.e.,
changes in mental status).
 Monitor for S&S of aspiration
of excess secretions, and for
bronchospasm
(unpredictable); withhold drug
and notify physician
immediately if either occurs.
 Lab tests: Monitor ABGs,
pulmonary functions and pulse
oximetry as indicated.
 Have suction apparatus
immediately available.
Increased volume of
respiratory tract fluid may be
liberated; suction or
endotracheal aspiration may
be necessary to establish and
maintain an open airway.
Older adults and debilitated
patients are particularly at risk.
 Nausea and vomiting may
occur, particularly when face
mask is used, due to
unpleasant odor of drug and
excess volume of liquefied
bronchial secretions.
 NAME OF THE DRUG MECHANISM OF ACTION
GENERIC NAME Dornase is a solution of
Dornase alfa recombinant human
deoxyribonuclease (DNAse), an
enzyme that selectively cleaves
DNA. In cystic fibrosis (CF)
BRAND NAME patients, viscous, purulent
Pulmozyme secretions in the airway reduce
pulmonary function and lead to
exacerbations of infection.
Purulent pulmonary secretions
contain very high concentrations
CLASS IFICATION of DNA released by degenerating
Antitussive, expectorant, and leukocytes that are present in
mucolytic agents; mucolytic response to infection.
INDICATION
In combination with standard
therapies to reduce the
frequency of respiratory
infections in patients with CF
and to improve pulmonary
function.
CONTRAINDICATION
Hypersensitivity to dornase.
NURSING CONSIDERATION
 Monitor for improvement in
dyspnea and sputum
clearance.
 Monitor for S&S of
hypersensitivity Patients with a
history of hypersensitivity to
bovine pancreatic dornase are
at high risk.
 Monitor for adverse effects;
rarely, dosage adjustments
may be required.
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME Selective peptide leukotriene Prophylaxis and chronic Hypersensitivity to zafirlukast;  Assess respiratory status and
Zafirlukast receptor antagonist (LTRA) of treatment of asthma in adults acute asthma attacks, including airway function regularly.
leukotriene D4 and E4, thus and children >5 y (not for status asthmaticus, acute  Lab tests: Periodic liver
inhibiting bronchoconstriction. acute bronchospasm). bronchospasm; lactation, function tests.
Leukotriene production and children <5 y.  Monitor closely PT and INR
BRAND NAME receptor affinity have been with concurrent warfarin
Accolate correlated with the pathogenesis therapy.
of asthma.  Monitor closely phenytoin level
with concurrent phenytoin
therapy.
CLASS IFICATION
Bronchodilator (respiratory smooth
muscle relaxant); leukotriene receptor
antagonist
 NAME OF THE DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION NURSING CONSIDERATION
GENERIC NAME
Montelukast

BRAND NAME

CLASS IFICATION