5.7 Decongestants
Pseudoephedrine is an Alpha-1 agonist and an over-the-counter (OTC) decongestant (see Figure 5.9[1]). Pseudoephedrine has had recent limitations placed on its use because it is a common ingredient in the illicit manufacturing of the drug methamphetamine. Pharmacies now require individuals to provide identification to purchase pseudoephedrine and must track the number of purchases. As a result, most over-the-counter decongestants now contain phenylephrine. 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: Decongestants relieve nasal obstruction due to inflammation.
Nursing Considerations: This medication is not safe for children under the age of 4 years.
Side Effects/Adverse 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, use with caution in clients who have cardiac dysrhythmias, hyperthyroidism, DM (diabetes mellitus), and prostatic hypertrophy.[2]
Health Teaching & Health Promotion: Clients 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 grid on pseudoephedrine in Table 5.7.[4],[5],[6]
Table 5.7 Pseudoephedrine Medication Grid
Class/Subclass |
Prototype/Generic |
Nursing Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Decongestant | pseudoephedrine | Administration (drops and sprays)
Avoid prolonged use for greater than 7 days Use cautiously with cardiovascular disease Maintain hydration (2-3 liters/day) |
Temporarily relieves nasal congestion due to the common cold, hay fever, or other upper respiratory allergies
Temporarily relieves sinus congestion and pressure |
Cardiovascular stimulation
Rebound congestion with nasal route |
- “Project 366 #165: 130612 Helping Hand?” by Pete is licensed under Public Domain. ↵
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0 ↵
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵