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Pharmacology > 35+36: Upper and Lower Respiratory Meds > Flashcards

35+36: Upper and Lower Respiratory Meds Flashcards

1
Q

guidelines for starting antibiotics for sinusitis

A
  • sxs last 2 weeks or longer

- new/worsening sxs after 1 week of sxs

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2
Q

What is the drug class of diphenhydramine

A

antihistamine

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3
Q

MOA of diphenhydramine

A

blocks the effects of histamine by competing for and occupying H1 receptor sites (antagonizes histamine effects)

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4
Q

uses of diphenhydramine

A
  • allergic rhinitis
  • common cold
  • cough/sneezing
  • pruritus
  • urticaria
  • motion sickness
  • sleep aid
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5
Q

side effects of diphenhydramine

A
  • drowsiness (main)
  • dizziness
  • headache
  • urinary retention
  • blurred vision
  • dry mouth/throat
  • hypotension
  • ABD pain/constipation
  • photosensitivity
  • palpitations
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6
Q

life threatening effects of diphenhydramine

A
  • agranulocytosis
  • hemolytic anemia
  • thrombocytopenia
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7
Q

administration of diphenhydramine

A
  • PO w/ food
  • IM
  • IV
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8
Q

pt teaching for diphenhydramine

A
  • avoid driving or performing other dangerous activities if drowsiness occurs
  • avoid alcohol and other CNS depressants
  • sugarless candy for dry mouth
  • not recommended for breastfeeding mothers
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9
Q

paradoxical side effects of diphenhydramine

A
  • agitation/restlessness

- insomnia

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10
Q

explain the difference between first and second generation antihistamines

A
  • diphenhydramine is first generation

- 2nd generation: less sedating, less side effects, longer acting BUT not as effective

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11
Q

examples of 2nd generation antihistamines

A
  • fexofenadine (Allegra)
  • loratadine (Claritin)
  • cetirizine (Zyrtec)
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12
Q

at what age can you take diphenhydramine

A
  • 2 y/o and older can take diphenhydramine
  • under 2 if under direct supervision of provider
  • 2nd generation approved starting at 6 months old
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13
Q

What class of drugs is pseudoephedrine

A

nasal decongestants

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14
Q

MOA of pseudoephedrine

A
  • acts directly on adrenergic receptors

- produces vasoconstriction which shrinks nasal mucus membranes -> decreases nasal congestion

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15
Q

adverse effects of pseudoephedrine

A
  • HTN
  • dysrhythmia
  • impaired coordination
  • dizziness/vertigo
  • excitability
  • HA
  • insomnia
  • seizures
  • urinary retention
  • thrombocytopenia
  • blurred vision
  • tinnitus
  • chest tightness
  • dry nose
  • wheezing
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16
Q

which pts are recommended not to take pseudoephedrine

A

cardiovascular pts (due to HTN and dysrhythmias)

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17
Q

administration of pseudoephedrine

A
  • behind the counter tablets (used to make meth)

- nasal spray (only use 3 days or can cause rebound congestion)

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18
Q

What class of drugs is dextromethorphan

A

antitussives/expectorant

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19
Q

MOA of dextromethorphan

A
  • suppresses cough by depressing cough center in medulla oblongata or cough receptors in the throat, trachea, or lungs
  • reduces viscosity and adhesiveness of tenacious secretions
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20
Q

uses of dextromethorphan

A
  • dry, hacking, nonproductive cough

- to ease expelling secretions from lower respiratory tract and to produce a productive less frequent cough

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21
Q

adverse effects of dextromethorphan

A
  • nausea
  • drowsiness
  • rash
  • difficulty breathing
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22
Q

what do high doses of dextromethorphan cause

A
  • hallucinations
  • disassociation
  • serotonin syndrome
  • respiratory depression
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23
Q

at what age can you take dextromethorphan

A

6 y/o and older (due to possible respiratory depression)

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24
Q

What can be used as a cough suppressant in children

A

honey after a year of age (prevent botulism)

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25
Q

What class of drugs is guaifenesin

A

expectorants

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26
Q

MOA of guaifenesin

A

loosens bronchial secretions so they can be eliminated by coughing

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27
Q

uses of guaifenesin

A

productive cough

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28
Q

side effects of guaifenesin

A
  • skin rash
  • headache
  • N/V
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29
Q

parts of the upper respiratory tract

A
  • nares
  • nasal cavity
  • pharynx
  • larynx
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30
Q

most prevalent URI

A

common cold

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31
Q

acute inflammation of the mucous membranes of the nose; usually accompanies the common cold

A

acute rhinitis

32
Q

nasal irritation caused by pollen or foreign substances like animal dander

A

allergic rhinitis

33
Q

onset of action of diphenhydramine

A
  • within 15 minutes (PO or IM)

- for motion sickness: take 30 minutes before and also before meals and at bedtime during the event

34
Q

parts of lower respiratory tract

A
  • trachea
  • bronchi
  • bronchioles
  • alveoli
  • alveolar capillary membrane
35
Q

types of restrictive lung diseases

A
  • pulmonary edema
  • fibrosis
  • pneumonitis
  • lung tumors
  • thoracic deformities
36
Q

types of obstructive lungs diseases

A
  • chronic bronchitis
  • bronchiectasis
  • emphysema
  • asthma
37
Q

usual initial treatment for COPD

A

bronchodilator (steroids added to most serious patients)

38
Q

preferred management of asthma

A
  • all adults and adolescents w/ asthma should receive regular low dose inhaled corticosteroids (ICS) to reduce risk of exacerbations (decrease need of rescue inhalers)
39
Q

what type of drug is albuterol

A

sympathomimetic (beta 2 adrenergic agonist)

40
Q

MOA of albuterol

A

stimulate beta 2 adrenergic receptors in smooth muscle of bronchi and bronchioles (bronchodilator)

41
Q

use of albuterol

A

prevention of bronchospasm, asthma, reversible obstructive airway disease, and exercise induced asthma

42
Q

administration of albuterol

A
  • PO

- inhalation (2 puffs every 4 hours)

43
Q

adverse effects of albuterol

A
  • muscle tremor

- excessive cardiac and CNS stimulation

44
Q

what type of inhaler is albuterol

A

“rescue medication” when given via MDI or inhalation

45
Q

what class of drug is tiotropium

A

anticholinergic

46
Q

MOA of tiotropium

A
  • blocks muscarinic cholinergic receptors and antagonizes ACh action by inhibiting M3 receptor response to ACh
  • relaxes smooth muscle of bronchi and dilate bronchi
47
Q

uses of tiotropium

A

maintenance treatment of asthma and COPD

48
Q

adverse effects of tiotropium

A
  • dysrhythmias
  • angioedema
  • chest pain
  • hyperglycemia
  • insomnia
  • cough/dry mouth (suck on candy)
  • urinary rentention
49
Q

what class of drugs is theophylline

A

xanthines

50
Q

MOA of theophylline

A

relaxes bronchial smooth muscle promoting bronchodilation

- suppresses airway responsiveness to bronchospam triggers

51
Q

uses of theophylline

A

second line drug for severe asthma, emphysema, and bronchitis

52
Q

administration of theophylline

A
  • short and long acting forms

- IV or PO

53
Q

adverse effects of theophylline

A
  • N/V, anorexia
  • agitation/nervousness
  • insomnia
  • tachycardia
  • dysrhythmias (toxic)
  • convulsions (toxic)
  • cardiac collapse (toxic)
54
Q

therapeutic range for theophylline

A

5-15 mcg/mL (narrow; drug levels should be monitored)

55
Q

what class of drug is montelukast

A

leukotriene modifiers

56
Q

MOA of montelukast

A

binds w/ leukotriene receptors to inhibit smooth muscle contraction and bronchoconstriction

57
Q

uses of montelukast

A
  • prophylactic treatment for long term treatment of asthma

- prevent acute asthma attacks induced by allergens, exercise, cold air, hyperventilation, irritants, and NSAIDs

58
Q

adverse effects of montelukast

A
  • headache
  • nausea
  • diarrhea
  • infection
  • suicidal ideation
  • SJS
  • aggressive behavior and restlessness
59
Q

T/F: montelukast is effective in relieving acute asthma attacks

A

False

60
Q

when are glucocorticoids giving for asthma

A

when bronchodilator therapy alone is not enough

61
Q

administration of glucocorticoids

A
  • MDI
  • tablet
  • IV
62
Q

side effects from inhaled version fo glucocorticoids

A
  • Candida albicans (thrush)
  • dry mouth/irritation
  • hoarseness
63
Q

what class of drugs is cromolyn (Nasalcrom)

A

mast cell stabilizers

64
Q

MOA of cromolyn

A

prevent release of bronchoconstrictive and inflammatory substances in response to allergens or other stimuli

65
Q

use of cromolyn

A

prophylaxis of acute asthma in mild persistent asthma

66
Q

administration of cromolyn

A
  • inhalation (also a nasal preparation)

- must be taken daily

67
Q

adverse effects of cromolyn

A
  • dysrhythmias
  • hypotension
  • chest pain
  • restlessness
  • dizziness
  • convulsions
  • anorexia, N/V
  • sedation
  • rebound bronchospasm is a serious adverse effect
68
Q

T/F: cromolyn is not effective in acute bronchospasm or status asthmaticus

A

True

69
Q

what class of drugs is acetylcysteine

A

mucolytics

70
Q

MOA of acetylcysteine

A

liquifies and loosens thick secretions

71
Q

uses of acetylcysteine

A
  • cystic fibrosis

- any condition to liquefy thick secretions

72
Q

administration of acetylcysteine

A
  • nebulizer (smells like rotten eggs)

- PO or IV

73
Q

adverse effects of acetylcysteine

A
  • drowsiness
  • N/V
  • bronchospasm
74
Q

2 categories of beta adrenergic albuterol

A
  • SABA: short acting beta agonist

- LABA: long acting beta agonist

75
Q

2 categories of anticholinergics

A
  • SAMA: short acting muscarinic antagonists

- LAMA: long acting muscarinic antagonists

76
Q

pt teaching for albuterol

A
  • avoid caffeine

- notify provider if experiencing palpitations, chest pain, or tachycardia

77
Q

how to prevent thrush w/ inhaled glucocorticoids

A
  • use a spacer with the inhaler (decreases amount of drug that comes into contact w/ mouth
  • rinse mouth after use

Pharmacology (22 decks)

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