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109: U4: Chronic Resp Disorders > 109: U4: Resp Meds > Flashcards

109: U4: Resp Meds Flashcards

1
Q

Decongestants Action

A

Stimulate receptors in nose causing vaso-constriction.

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2
Q

Decongestants SE’s

A

Insomnia.

Minimal: Jittery, nervousness, seizures in elderly, increased BP (in people prone to it).

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3
Q

Decongestants Drug Names

A

Pseudophedrine (Sudafed)
ephedrine (Ephedsol): systemic
oxymetazoline (Afrin): local (can only use nasal spray for 3 days max - rebound congestion can occur)

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4
Q

Decongestants Routes

A

PO

Nasal Inhaler

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5
Q

Decongestants NI’s

A

Do not give to pts with HTN or pts with glaucoma. Don’t use long term.

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6
Q

Antitussives Action

A

Suppresses cough center in medulla

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7
Q

Antitussives SE’s

A

CNS and resp depression only with codeine.

N, V, A, Constipation, Rash, Urine retention

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8
Q

Antitussives Drugs

A

Codeine

Dextromethorphan (mainly used - not many SE’s)

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9
Q

Antitussives Routs

A

PO

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10
Q

Antitussives NI’s

A

Use for a non-productive cough. Increase fluids for constipation and to loosen secretions. Use at HS so people can sleep (suppressing a cough also suppresses the mechanism getting stuff out of the lungs).

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11
Q

Expectorants Action

A

Loosens secretions so they can be coughed up.

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12
Q

Expectorants SE’s

A

Nausea/Vomiting, Drowsiness

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13
Q

Expectorants Drugs

A

Guaifenesin (Robitussin, Mucinex)

Robitussin is short acting, Mucinex is a 12 hour tablet.

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14
Q

Expectorants Route

A

PO

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15
Q

Expectorants NI’s

A

Drugs do not work unless you are hydrated! Drink at least 2 liters a day.

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16
Q

Sympathomimetics Action.

A

Bronchodilators (beta adrenergic agonists). Cause dilation of the bronchi.

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17
Q

Sympathomimetics SE’s

A 
MDI: mouth dryness, throat irritation.
Systemic: tremor
headache
nervousness
increased HR
cough
insomnia
palpitations
increased blood sugar
angina
dysrhythmias
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18
Q

Sympathomimetics Drugs

A

metaproterenol (Alupent) - acute S/S
albuterol (Proventil) - rescue med
levalbuterol (Xopenex) - Less SE’s, short acting
salmeterol (Serevent) - preventative, long acting (starts working after 1 hour)

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19
Q

Sympathomimetics Route

A

Frequently administered by MDI (1-2 puffs)
Nebulizer
Combinations

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20
Q

Sympathomimetics NI’s

A

Check HR, RR, breath sounds before and after.
Angina: monitor HR
Diabetics: monitor blood sugar
Can use albuterol before exercise

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21
Q

Methylxanthines Action

A

Bronchodilators. (Xanthine derivatives). Relaxes bronchial smooth muscle. Well absorbed PO - interacts with beta blockers and cimetidine.

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22
Q

Methylxanthines SE’s

A

Many Drug Interactions!!

Anorexia, N/V, heartburn, cardiac dysrhythmias, increased BP, increased HR, nervousness, palpitations.

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23
Q

Methylxanthines Drugs

A

Aminophylline (IV)

Theophylline (PO) (Theodor)

24
Q

Methylxanthines Routes

A

IV

PO

25
Q

Methylxanthines NI’s

A

Smoking will decrease effectiveness.
Narrow therapeutic range (10-20).
Caffeine intensifies SE’s.
Check drugs for interactions.

26
Q

Anti-Cholinergics Action

A

Bronchodilator. Results in bronchodilation by blocking the action of acetylcholine.

27
Q

Anti-Cholinergics SE’s

A

N/V, Cramps, dizziness, drying to oral mucosa, cough,, flushing of skin, bad taste, blurred vision, Anticholinergic SE’s.

28
Q

Anti-Cholinergics Drugs

A

ipratropium (Atrovent)
tiotropium (Spiriva)
ipratropium and albuterol (Combivent or Duoneb)

29
Q

Anti-Cholinergics Routes

A

Discus
HHN
MDI
Nasal spray

30
Q

Anti-Cholinergics NI’s

A

Do not over use.
Assess for HTN and glaucoma.
Do NOT use with BPH (urinary retention, blurred vision).

31
Q

Anti-Inflammatory Uses

A

Should be used for anyone with persistent asthma s/s. Inflammation symptoms of asthma triggered by allergic and environmental stimuli (release of eosinophils).

32
Q

Glucocorticoids

A

Decrease inflammation and bronchoconstriction.
Used in combo with bronchodilators.
Decreases edema.
Blocks late phase response and decreases hyperresponsiveness.
Inhibits release of mediators

33
Q

Anti-Inflammatory SE’s

A

MDI: oral fungal infections, hoarseness, dry cough.
PO or IV: many SE’s. Osteoporosis, immunosuppression, GI distress, increased blood sugar, weight gain, skin and muscle breakdown, edema. Especially with long term use. Thrush is the main SE.

34
Q

Anti-Inflammatory Drugs

A

MDI’s:
triamcinolone (Azmacort)
beclomethasone (Vanceril)
fluticasone (Flovent)
(Advair diskus is a combo of salmeterol and fluticasone)
PO: prednisone, prednisolone (Orapred)
IV: methylprednisolone (Solu-medrol) : rescue med only when used IV.

35
Q

Anti-Inflammatory Routes

A

PO (chewable)
MDI
IV (rescue med)

36
Q

Anti-Inflammatory NI’s

A

Wash mouth after use.
PO: Take with food/milk (d/t GI upset).
Watch blood sugar, BP, immune system.
Watch for s/s of Cushings.
Wean off if on >1 week d/t acute adrenal insufficiency (No BP, No BS).
Inhaled takes up to three weeks to get effect.

37
Q

Leukotriene Action

A

Decreases inflammation and bronchoconstriction. Used for asthma, not COPD. Controller med.

38
Q

Leukotriene SE’s

A

Generally few:

Dizziness, fatigue, headache, GI, cough, nasal congestion.

39
Q

Leukotriene Drugs

A

montelukast (Singulair)

40
Q

Leukotriene Routes

A

PO and chewable PO

41
Q

Mast Cell Stabilizers Action

A

Non-steroidal anti-inflammatory. Used prophylactically. Can be used wlong with bronchodilators. Inhibits the release of histamine and other mediators. Decrease inflammation and irritation: inhibits immediate response and prevents late response.

42
Q

Mast Cell Stabilizers SE’s

A

Cough, bad taste, throat irritation, rash, headache, N/V

43
Q

Mast Cell Stabilizers Drugs

A

cromolyn (Intal)
nedocromil (Tilade): Inhaled anti-inflammatory.
Not used often. Must give 4x a day = poor compliance.

44
Q

Mast Cell Stabilizers Routes

A

MDI
Neb
Nasal (for allergies)

45
Q

Mast Cell Stabilizers NI’s

A

Water before and after (for bad taste)

Do NOT d/c abruptly.

46
Q

Mucolytics Action

A

Liquify and loosen secretions.

Also increases hepatic glutathione, which is necessary for inactivation of toxic metabolites in Tylenol overdose.

47
Q

Mucolytics SE’s

A

N/V, oral sores, dizziness, drowsiness, rhinnorhea, bronchospasm.

48
Q

Mucolytics Drugs

A

acetylcysteine (Mucomyst)

49
Q

Mucolytics Routes

A

HHN

50
Q

Mucolytics NI’s

A

Smells like rotten eggs. Wash face after and provide gum/candy.

51
Q

Anti-immunoglobulin E antibody Use

A

Allergic type moderate to persistent asthma

52
Q

Anti-immunoglobulin E antibody SE’s

A

Risk for anaphylaxis

53
Q

Anti-immunoglobulin E antibody Drugs

A

omalizumab (Xolair) : long term usage

54
Q

Anti-immunoglobulin E antibody Route

A

SQ every 2-3 weeks

55
Q

Anti-immunoglobulin E antibody NI’s

A

For kids >12 years old.
Dose is based on serum IgE levels.
Must sit for 2 hours after dose is given (d/t risk for anaphylaxis).

109: U4: Chronic Resp Disorders (4 decks)

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