5.7 Decongestants

Decongestants

Decongestant medications have been available over the counter (drugs that you can buy at a pharmacy without a prescription) for years.  Although they are readily available, considerations are necessary when taking any drug. In this chapter we will explore these drugs further.

Pseudoephedrine

Pseudoephedrine is an over-the-counter (OTC) decongestant (see Figure 5.7^[1]).  More details regarding pseudoephedrine are described in the “Autonomic Nervous System” chapter.

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 Across the Lifespan

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

Adverse/Side Effects

Common adverse/side effects include hypertension, dysrhythmia, dizziness, headache, insomnia, and restlessness. Some clients may experience blurred vision, tinnitus, chest tightness, dry nose, and nasal congestion.

Decongestants are contraindicated in clients with severe hypertension, coronary artery disease (CAD), narrow-angle glaucoma, and some antidepressant use. Also, clients who have cardiac dysrhythmias, hyperthyroidism, DM (diabetes mellitus), prostatic hypertrophy, and glaucoma should use with caution.^[2]

Client Teaching & Education

Client must take care to follow dosing recommendations.  If dosing standards are surpassed, some clients may experience side effects such as increased nervousness, breathing difficulties, heart rate changes, and hallucinations.^[3]

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.  Prototype/generic medication listed in the medication card is also hyperlinked to a free resource from  Daily Med.  Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.in Table 5.7.^{[4], [5], [6].} 

Table 5.7 Pseudoephedrine Medication Card