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Pharm Test 5 > 30- drugs used to treat lower respiratory disease > Flashcards

30- drugs used to treat lower respiratory disease Flashcards

1
Q

These specialized mucous glands produce gelatinous mucous that forms a thin layer over the anterior surfaces of the trachea, bronchi and bronchioles

A

Goblet cells

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2
Q

what kind of hairs line the bronchi and trachea to the larynx

A

Ciliary hairs

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3
Q

Foreign bodies such a smoke particles and bacteria are caught up in the respiratory tract fluid and swept upward by ciliary hairs. How are the particles removed?

A

Cough reflex

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4
Q

The movement of air into and out of the lungs

A

Ventilation

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5
Q

Oxygen passes across the alveolar membrane to the blood in the capillaries and carbon dioxide passes from the blood to the alveolar sacs for exhalation. What is this process?

A

Diffusion

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6
Q

Respiratory diseases often divided into two types

A

Obstructive and restrictive

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7
Q

Diseases that narrow air passages, create turbulence, and increase resistance to airflow

A

Obstructive airway disease

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8
Q

Diseases that cause narrowing of the airways through smooth muscle constriction, edema, inflammation of the bronchial walls or excess mucus secretion. Examples are asthma and acute bronchitis.

A

Obstructive airway disease

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9
Q

Narrowing of the airways through smooth muscle constriction

A

Bronchospasm

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10
Q

Diseases in which lung expansion is limited from loss of elasticity (pulmonary fibrosis) or physical deformity of the chest (kyphoscoliosis)

A

Restrictive airway diseases

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11
Q

Examples of both restrictive, and obstructive lung disease

A

Chronic bronchitis and emphysema

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12
Q

Patients who have persistent airflow limitation associated with chronic inflammation in the airways and lung tissue, caused by noxious particles and gases, are referred to as having this

A

Chronic obstructive pulmonary disease (COPD) or chronic airflow limitation disease (CALD), terms are used interchangeably

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13
Q

What partial pressure gases are the best indicators of overall pulmonary function?

A

Arterial blood gases 

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14
Q

Pao2

A

Arterial partial pressure of oxygen

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15
Q

Paco2

A

Arterial partial pressure of carbon dioxide

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16
Q

Arterial blood gases (ABGs) are made up of what

A

Arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide and pH 

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17
Q

To determine ABGs, a sample of arterial blood must be drawn and immediately analyzed to measure what

A

pH, partial pressures of oxygen and carbon dioxide in the blood

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18
Q

Expressed as a percentage, this ratio of oxygen actually bound to hemoglobin compared with the maximum amount of oxygen that could be bound to hemoglobin

A

Oxygen saturation

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19
Q

Used to assess the capability of a patient’s lungs, thorax and respiratory muscles for moving volumes of air during inhalation and exhalation

A

Spirometry

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20
Q

Often the first symptom of respiratory disease is the presence of this

A

Cough

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21
Q

Common chronic, inflammatory airway disease of the bronchi and bronchioles, with intermittent periods of acute reversible airflow obstruction caused by bronchiolar inflammation and hyperresponsiveness to a variety of stimuli

A

Asthma 

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22
Q

irritation that causes inflammation and edema with excessive mucous secretion leading to airflow obstruction

A

bronchitis

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23
Q

Disease of alveolar tissue destruction without fibrosis. Areolar sacs, lose elasticity and collapse during exhalation, trapping air within the lungs

A

Emphysema

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24
Q

This drug therapy liquefies mucus by stimulating the secretion of natural lubricant fluids from the serous glands

A

Expectorants

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25
Q

This drug therapy acts by suppressing the cough center in the brain. Used when patient has a dry, hacking nonproductive cough.

A

Antitussives

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26
Q

Do antitussives stop the cough completely, or decrease the frequency and suppress the severe spasms that prevent adequate rest at night?

A

Antitussives decrease the frequency of coughs and suppress the severe spasms that prevent adequate rest at night

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27
Q

Which drug therapy agent reduces the stickiness and viscosity of pulmonary secretions by acting directly on the mucous plugs to cause dissolution

A

Mucolytic agents

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28
Q

Which drug therapy relaxes the smooth muscle of the tracheobronchial tree, allowing an increase in the opening of the bronchioles and alveolar ducts, which decreases the resistance to air flow into the alveolar sacs

A

Bronchodilators

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29
Q

This drug therapy plays an important role in the treatment of asthma to reduce inflammation. Corticosteroids are the most effective agents in the mainstay of all asthma therapy. What is added

A

Anti-inflammatory agents

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30
Q

This may be prescribed for patients who have been diagnosed with subtypes of asthma. These are used in addition to other maintenance treatments, such as corticosteroids and bronchialdilators to reduce the frequency of asthma exasperations

A

Immunomodulators

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31
Q

When taking the assessment history of respiratory symptoms, what details should I ask specifically about?

A

Smoking or exposure to secondhand smoke history of smoking is recorded in pack-years

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32
Q

How to figure smoking pack-years

A

Packs per day x how many years smoked = pack years

33
Q

What to ask about when taking the history of respiratory medication

A

What prescribed medications, over-the-counter medication’s or herbal products are being used or have been used for the treatment of the same or similar respiratory problems. Do any medication such as aspirin or nonsteroidal, anti-inflammatory drugs, precipitate an asthma attack. Ask about O2 use at home.

34
Q

When conducting social assessment, remember to ask about

A

Support system at home

35
Q

On collecting assessment: description of current symptoms includes the following questions

A

What is the patient’s chief complaint? When did the symptoms start? Does the patient have any idea what triggered them? Ask patient to describe the symptoms. What effect do the symptoms have on the patient’s ability to carry out activities of daily living?

36
Q

I’m doing respiratory physical assessment observe this

A

Patient’s general appearance and degree of respiratory impairment. Adapt, assessment, and prioritization of examination to the degree of respiratory impairment present

37
Q

What to assess in patients respiratory pattern

A

Assess rate depth and regularity of patients breathing. 12-20 adults, up to 44 breaths per minute in infants

38
Q

What to assess in mental status in regards to respiratory assessment

A

Mental status will deteriorate from alertness to progressively lower levels of functioning as oxygen level in the body diminishes and carbon dioxide accumulates, causing acidosis

39
Q

Inspection of the skin color during the respiratory assessment

A

Is the skin color normal or is patient cyanotic? Where is cyanosis visible?

40
Q

This type of cyanosis is defined as a bluish coloring of an isolated area of the body (earlobes, toes, feet, fingernails)

A

Peripheral cyanosis

41
Q

This type of cyanosis indicates a general lack of oxygen in the hemoglobin, tinting the entire body bluish. Most readily observed on the lips and mucous membranes of the mouth (circumoral cyanosis)

A

Central cyanosis

42
Q

What to note when assessing dyspnea

A

Occurring at rest or with exertion, observe breathing pattern (pursed lips, exertion required to exhale )

43
Q

What muscle involvement to observe during assessment of respiratory issues

A

Elevating the shoulders, retracting the spaces between the ribs, and using the abdominal muscles - associated with advanced respiratory disease

44
Q

Cause of finger nail clubbing related to the respiratory system

A

Hypoxia and lung cancer

45
Q

What to note when performing auscultation of the chest?

A

Intensity pitch, and relative duration of inspiratory and expiratory phases. Identify an additional sounds such as crackles or wheezes. Are the abnormal sounds inspiratory expiratory or both? Where are they located? Do they clear with deep breathing or coughing?

46
Q

What does a peak flowmeter measure?

A

Peak flowmeter measures the peak expiratory flow, assessing the severity of the patient’s symptoms

47
Q

These are the most common cause of allergies from indoor sources

A

Dust mites

48
Q

Where are dust mites found?

A

Carpeting, mattresses, stuffed animals, pillows

49
Q

How to get rid of dust mites

A

That’s mites are not removed by air cleaners. Wash bedding, frequently in hot water and wash or steam porous surfaces. Stuffed animals and pillows can be placed inside a plastic bag and put in the freezer overnight. In case mattresses pillows and box springs in non-allergenic covers when cleaning use a damp cloth to remove rather than spread the dust.

50
Q

What three pets are often a source of asthma triggers

A

Cats, dogs, birds

51
Q

In Pulmocare, nutritionally what should patients avoid, why?

A

Avoid caffeine containing beverages. Caffeine is a weak diuretic. Diuresis promotes thickening of lung secretions, making it more difficult to expectorate them. Milk and chocolate are also known to increase the thickness of secretions, and may need to be eliminated from the diet.

52
Q

Guaifenesin is a common over the counter drug of what drug class

A

Expectorant

53
Q

What are the actions of saline solutions in regard to respiratory diseases?

A

Sailing solutions act by hydrating mucus, reducing its viscosity

54
Q

Hydrocodone is in what drug class in regards to drugs affecting the respiratory system

A

Hydrocordone is in the drug class: antitussive agent

55
Q

Acetylcysteine is in what drug class in regards to respiratory system

A

Acetylcysteine is in drug class: mucolytic agents

56
Q

What is the action of the drug acetylcysteine

A

Dissolves chemical bonds within the mucous itself, causing it to separate and liquefy, reducing viscosity

57
Q

Acetylcysteine is also used to treat this kind of toxicity

A

Acetaminophen toxicity

58
Q

Therapeutic outcome of acetylcysteine

A

Improved airway flow with more comfortable breathing

59
Q

How is the drug therapy acetylcysteine available?

A

Inhalation

60
Q

Rescue inhalers are short acting or long acting

A

Short acting inhalers

61
Q

What are long acting bronchodilators used for?

A

Prevent attacks

62
Q

Formoterol, indacaterol, and olodaterol are in what drug class

A

Beta-adrenergic bronchodilating agents

63
Q

Formoterol, indacaterol, and olodaterol have an onset of action in how many minutes with a duration of action of how many hours, how often is this administered?

A

Onset of action is 5 to 15 minutes, duration is 24 hours, administered once a day

64
Q

Therapeutic outcome for beta- adrenergic bronchodilator therapy

A

Bronchodilation resulting in reduced wheezing and easier breathing

65
Q

Beta-adrenergic broncodilator therapy, serious adverse effects to the cardiovascular system

A

Tachycardia and palpitations. Because most symptoms are dosed related, alterations should be reported to the healthcare provider. Monitor patient’s heart rate and rhythm at regular intervals throughout therapy with bronchodilators. An increase of 20 beats a minute or more after treatment should be reported to the prescriber always report palpitations and suspected dysrhythmias to the healthcare provider.

66
Q

What should be done if patient is on beta adrenergic bronchodilator, and they feel panicky or they have increased heart rate

A

Stop medication immediately notify healthcare provider

67
Q

Actions of Anticholinergic broncodilating agents

A

They produce bronchodilation by competitive inhibition of Cornerkick, receptors on bronchial, smooth muscle. They block the bronchoconstriction action of vagal efferent impulses. There is minimal affect on ciliary activity, mucus secretion, sputum volume, and viscosity with these agents

68
Q

Atrovent, Spiriva are examples of what drug class. When used patients should avoid breathing into what

A

Inhaled anticholinergic bronchodilators. When used patients should avoid breathing into the mouthpiece.

69
Q

Two types of combination, anticholinergic, and beta-adenerergic broncodilators

A

Short acting and long acting combinations of anticholinergic, and beta-adrenergic broncodilator, inhalers

70
Q

Patients with the potential for closed, angle, glaucoma, prosthetic hyperplasia, or bladder neck obstruction, should use which kind of bronchodilators with caution

A

Use anticholinergic bronchodilators with caution

71
Q

Common adverse effects on the GI while taking anticholinergic broncodilating agents

A

Mouth dryness, throat irritation. These effects are usually mild and tend to resolve with continue therapy. Encourage patient not to discontinue therapy without first consulting the healthcare provider. Patient’s can suck on ice chips or hard candy to alleviate dryness

72
Q

Serious adverse effects on Anticolinergic receptors while taking anticholinergic broncodilator’s

A

Tachycardia, urinary retention, exasperation of pulmonary symptoms. Patient should consult prescriber before continuing with further therapy if these symptoms appear.

73
Q

(Respiratory antiinflammatory agents - corticosteroids used for obstructive airway disease: preparation before admission)
Patients receiving bronchodilators by inhalation should be advised to use what before the corticosteroid inhalant

A

Bronchodilator

74
Q

If patient is on a bronchodilator, why should they use the bronchodilator before the corticosteroid inhalant?

A

To enhance penetration of the corticosteroid into the bronchial tree. Patient should wait several minutes after using the bronchodilator before inhaling the corticosteroid to allow time for the bronchodilator to relax the smooth muscle.

75
Q

After each corticosteroid aerosol treatment, what should patients be instructed to do

A

Patient should be instructed on good oral hygiene, and told to gargle and rinse the mouth with the mouthwash after each aerosol treatment

76
Q

zafirlukast (Accolate), montelukast (Singulair) are in what drug class

A

Antileukotriene agents

77
Q

Actions of drug class antileukotriene agents

A

Competitive receptor antagonist of the cysteinyl leukotriene receptor. This is the receptor that leukotriene D4 stimulates to trigger symptoms of asthma.

78
Q

Therapeutic outcome of drug class immunomodulator agents

A

Primary therapeutic outcomes associated with immunomodulator agents is reduce frequency of acute asthmatic exasperations

Pharm Test 5 (2 decks)

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