5.7: Decongestants

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Ernstmeyer & Christman (Eds.)
Chippewa Valley Technical College via OpenRN

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Photo of Sudafed package — Figure 5.9 Pseudoephedrine (Sudafed) is a decongestant that is available OTC

Pseudoephedrine is an over-the-counter (OTC) decongestant (see Figure 5.9^{^[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 patients may experience blurred vision, tinnitus, chest tightness, dry nose, and nasal congestion.

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

Patient Teaching & Education

Patients must take care to follow dosing recommendations. If dosing standards are surpassed, some patients 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	Administration Considerations	Therapeutic Effects	Adverse/Side Effects
Decongestant	pseudoephedrine	Administration (drops, sprays) Avoid prolonged use > 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

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Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
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This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde is licensed under CC BY-NC-SA 4.0. ↵
Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
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