8.6 Decongestants V2

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 acts directly on the adrenergic receptors and acts indirectly by releasing norepinephrine from its storage sites. The drug produces vasoconstriction, 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 congestion and lung sounds before and periodically after therapy.

This medication is not safe for children under the age of 4 years.

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), narrow-angle glaucoma, and some antidepressant use.

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.

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.

Downloadable file (.docx):Pseudoephedrine Medication Card

Media Attributions

References

Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. 

Vallerand, A. & Sanoski, C. (2024). Davis’s Canadian drug guide for nurses (19th ed.). F.A. Davis Company: Canada

License

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Fundamentals of Nursing Pharmacology - 2nd Canadian Edition Copyright © 2026 by Andrea Sullivan Degenhardt is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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