8.6 Decongestants

Andrea Sullivan Degenhardt

8.6 Decongestants

Decongestant medications have been available over the counter for years. Although they are readily available, considerations are necessary when taking any drug. In this unit we will explore these drugs further.

Our prototype med is pseudoephedrine.

Pseudoephedrine

Pseudoephedrine is an over-the-counter (OTC) decongestant (see Figure 8.6a). More details regarding pseudoephedrine are described in Chapter 4.0 Autonomic Nervous System.

Figure 8.6a Sudafed is the brand name for the decongestant pseudoephedrine.

Mechanism of Action

Pseudoephedrine has agonist effects primarily on the alpha-adrenergic receptors and acts indirectly by releasing norepinephrine from its storage sites. This results in vasoconstriction of the nasal mucosa, which shrinks nasal mucosa membranes.

Indications for Use

Decongestants relieve nasal obstruction due to inflammation.

Nursing Considerations

Administration: oral, well absorbed. Onset within 15-30 minutes

Assess nasal congestion and lung sounds before and periodically after therapy. Assess blood pressure and heart rate due to side effects of potential hypertension and palpitations.

This medication is not recommended for children under the age of 4 years, seek medical advice.

Use with caution for clients who have cardiac dysrhythmias, hyperthyroidism, DM (diabetes mellitus), prostatic hypertrophy, and glaucoma (Frandsen & Pennington, 2018).

Decongestants are contraindicated in clients with severe hypertension, coronary artery disease (CAD), and narrow-angle glaucoma. Caution if client has been on the antidepressant, MAO inhibitors, within the last 14 days.

Adverse/Side Effects

Common side effects include anxiety, palpitations, anorexia

Other effects include hypertension, dysrhythmia, dizziness, headache, insomnia, and restlessness. Adverse effects: blurred vision, tinnitus, chest tightness, dry nose, and nasal congestion.

Rebound decongestion can occur with topical use.

Client Teaching

Client must take care to follow dosing recommendations.
If dosing standards are surpassed or if taking other cold remedies concurrently, may experience adverse stimulant effects such as palpitations, increased nervousness, breathing difficulties, heart rate changes, and hallucinations (Vallerand & Sanoski, 2024).
Encourage fluid intake of 1500-2000 mL/day to decrease secretion viscosity

Pseudoephedrine Medication Card

Now let’s take a closer look at the medication drug card on Pseudoephedrine. Medication cards are intended to assist students to learn key points about each medication class. Basic information related to a common generic medication in this class is outlined, including administration considerations, therapeutic effects, and side effects/adverse effects.