264 Exam 2 Flashcards by Jason Wardle

What are the indications for medications for maintaining gas exchange?

1) Maintaining patency of respiratory tract.
2) ensure effective gas exchange between blood and tissues.

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What do bronchodilators do?

Help to control and prevent symptoms.

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What are some SABAs?

Salbutamol, Terbutaline

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What are some LABAs?

Eformoterol, Indacaterol, Salmeterol, Vilanterol

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What are some Sympathomimetic agents?

Adrenaline, Ephedrine

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What are some antimuscarinic agents?

Aclidinium,, Glycopyrronium, Ipatropium, Tiotroipium

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What are some methylxanthines?

Aminophylline, Theophylline

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What are some topical (inhaled) corticosteroids?

Beclomethasone, Budesonide, Ciclesonide, Fluticasone

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oxapramWhat are some systemic corticosteroides

Betamethasone, Dexamethasone, Hydrocortisone, Methylprednisolone, Prednisone

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What are some respiratory stimulants?

Doxapram

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What are some Asthma prophylactics

nedocromil sodium, sodium cromoglycate

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Name a Leukotriene receptor antagonists

Montelukast

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What are some surfactants?

Beractant, Poractant alfa

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What are the 2 kinds of bronchdilators, and what are the 3 groups these are broken into?

SABAS and LABAS
3 groups - Beta2 agonists, antimuscarinic agents, methylxanthines

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How do B2 agonists work

B2 agonists stimulate the B2 adrenergic receptors on bronchial smooth muscle

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How do Antimuscarinic agents work

Block muscarinic cholinergic receptors in bronchial smooth muscle

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How do Methylxanthines work?

Elevate the levels of intracellular messenger molecule cycle adenosine monophosphate modulating cellular activity.

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What are some adverse effects fo B2 agonists?

Fine motor tremor
Palpitations
Peripheral vasodilation resulting in hypotension and headaches

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What is the onset and duration of action for SABAs and LABAs?

SABAs = 15-20min and lasts 3-6 hours
LABAs = 1-30 min and lasts 12-24 hours

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How do sympathomimetics work?

Produce bronchodilation by activating beta receptors and reducing oedema through pulmonary vasoconstriction

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What do Antimuscarinic agents do?

Causes bronchodilation by blocking M3-muscarinic receptors associated with parasympathetic stimulation of the bronchial airways - results in reduction in visous mucous production related to obtstructive aiway diseases.

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What are some adverse side effects of antimuscarinic agents?

Dry mouth
pupil dilation
urinary retention
glaucoma

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How do methylxanthines work

Elevate the levels of intracellular messenger molecule cycle adenosine monophosphate modulating cellular activity

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What are some adverse effects of methylxanthines?

Over stimulation of the nervous system
Insomnia
nervousness
epigastric distress
N and V
Tachycardia
siezures
venticular dysrhythmias

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What do inhaled corticosteroids do?

Potent anti-inflammatories Reduce the synthesis of inflammatory mediator Reduces the rupturing of mast cells Prevents antibody production Suppresses activity of immune cells Results in the reduction of oedema, mucous production and bronchconstriction

What are some adverse side effects of inhaled corticosteroids?

Hoarse voices Thrush (throat)

What are some prophylactic anti asthma medications?

Cromoglycate Nedocromil Leukotriene receptor anatagonist Omalizumab

What indications are there for medications of the URT?

hay fever Allergic rhinitis URTI

What are histamines and prostaglandins?

Chemical mediators released from mucosal and submucosal calls that trigger vasodilation and inflammation.

What is the method of action of antitussive agents?

Reduces freq and sev of cough by interrupting tussive reflex

What are the side effects of antitussive agents?

Nausea, vomiting, drowsiness, sedation

What are some examples of antitussive agents?

Codeine, petoxyverine, dextrmethorphan

What do expectorants do?

Stimulates mucous secretion in irritated areas of the respiratory tract

What are some side effects of expectorants?

N and V Rash D+ Dizziness headache

What do mucolytic agents do?

Believed to alter the structure of viscous mucous Increases the removal of mucous from the respiratory tract

What are some side effects of mucolytic agents?

Mild GI dist Pharyngeal pain Cough Haemoptysis

What is Dornase Alfa?

Used in CF Inhalant increases expectoration DNA degrading enzyme Reduces risk of RTI

What do decongestants do?

Usually alpha agonists Stimulates vasoconsgtriction

What are some side effects of decongestants?

Pupil dilation, constipation, hypertension

What do antimuscarinic agents do?

Blocks the parasympathetic muscarinic receoptrs rseulting in decreased in excessive mucous production

What are some side effects of antimuscarinic agents?

Dry moth Facial flushing Tachycardia pupil dilation constipation

How do antihistamines work?

Decreases capillary permeability, erythema, and oedema

What are some side effects of antihistamines?

Sedation Reduced concentration Blurred vision Contipation Urinary retention

What medications are used for asthma?

Relievers - SABAs Controllers - LABAs Preventers - inhaled corticosteriods

What medications are used for COPD?

Inhaled meds - bronchodilators, corticosteriods Oral lmeds - Methylxanthines, phosphodiesterase 4 inhibitors

What are nursing priority care areas for asthma?

Education on reducing triggers Avoiding cold air

What are some goals in nursing care of acute asthma

Montior RR, BP, HR and cardiovascular system Auscultating lungs sounds ABGs, spo2, peak flow Decrease pt panic Position for chest expansion Pursed lip breathing Abdominal breathing

What is the O2 flow rate with NP

1L (24%) to 6L(44%)

What is the O2 flow rate with a face mask?

6L (35%) to 12L (50%)

what is the O2 flow rate with a partial and rebreather mask?

60-90% 10-15L

What is the flow rate ofa venturi mask

Precise high flow

What medications are usually used for TB?

abs called Isoniazid, Rifampicin, Pyrazinamide and Ethambutol.

What are adventitious airway sounds?

Crackles rhonchi wheezes stridor, friction rub

What are crackles and what cause them?

Air through fluid Caused by collapse alveolar opening

What are rhonchi and what cause them?

Continuous breath sound, low pitched rumbling caused by secretions in large airways

What are wheezes and what cause them?

Obstructed narrowed airways

What is stridor and what causes it?

High pitched sound on inspiration. Caused by obstruction or narrowing of airway

What are normal breath sounds?

Vesicular Bronchovesicular Bronchial Tracheal

Describe viscular breath sounds

Low pitched, most lung fields

Describe bronchovesicular sounds

Medium pitched on inspriation and expiration

Describe bronchial sounds

High pitched. On inspiration, 2+3 ICS anterior

Describe tracheal sounds

Loud, hi pitched. Equal insp/exp over trachea