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Nursing - Bloomberg > 💊370: Respiratory Drugs > Flashcards

💊370: Respiratory Drugs Flashcards

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1
Q

What are drugs given by inhalation?

A
  1. Beta2-agonists
    - Short acting (SABA)
    - Long acting (LABA)
  2. Muscarinic antagonists
    - Short acting (SAMA)
    - Long acting (LAMA)
  3. Inhaled corticosteroids (ICS)
  4. Bronchodilators
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2
Q

What are the 4 main types of inhalation devices?

A
  1. Metered-dose inhalers
  2. Respimats
  3. Dry powder inhalers
  4. Nebulizers
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3
Q

What are advantages of drug administration via inhalation?

A
  1. Direct to site of action
  2. Minimal systemic effects
  3. Rapid relief
  4. Portable, durable devices
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4
Q

What are disadvantages of drug administration via inhalation?

A
  1. Technique may be difficult for some
    - Efficacy
    - Side effects
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5
Q

What are the characteristics of Metered Dose Inhalers (MDIs)?

A
  1. “Press and breathe”
  2. Hand-lung coordination difficult for some
  3. ~10% of dose reaches lungs
  4. Dec efficacy of canister is cold
  5. Pressurized canisters (drug + propellant)
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6
Q

What are the characteristics of Dry Powder Inhalers (DPIs)?

A
  1. Breath-activated (no propellants)
  2. Less hand-lung coordination
  3. Better delivery to kings vs MDI
  4. Additives Amy cause cough and irritation
  5. Inadequate INSPIRATORY FLOW RATE
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7
Q

What are the 4 types of Dry Powder Inhalers (DPI)?

A
  1. Turbuhaler
  2. Diskus
  3. Breezhaler
  4. Handihaler
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8
Q

What are the characteristics of Respimats?

A
  1. “Press and breathe”
  2. Less hand-lung coordination and little inspiratory effort
  3. No propellant
  4. Generates smaller particle size
  5. Best delivery to lungs
  6. Expensive
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9
Q

What are characteristics of Wet Nebulizers?

A
  1. Converts drug solution into a mist
  2. Takes longer to deliver
  3. ~10% of dose delivered to lower airways
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10
Q

What are the uses of nebulization?

A
  1. Acute attacks
  2. Pts unable to use other devices
  3. Anxious patients
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11
Q

What are the disadvantages of nebulization?

A
  1. Less doses vs MDI or DPI
  2. Cost
  3. Care/maintenance
  4. Not portable
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12
Q

What are barriers to proper inhaler use?

A
  1. Patient factors (cognitive ability, dexterity, tremor, visual impairment)
  2. Inability to generate adequate inspiratory flow
  3. Side effects
  4. Device issues
  5. Older patients
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13
Q

What are the 2 classifications of asthma medications?

A
  1. Relievers (bronchodilators)

2. Controllers (maintenance therapy)

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14
Q

What are the types of asthma Relievers?

A
  1. Short-acting beta2 agonists

2. Anticholinergics

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15
Q

What are the types of asthma Controllers?

A
  1. Anti-inflammatory medications (corticosteroids, LTRAs, anti-allergic Agents)
  2. Bronchodilators (long-acting beta2 agonists, theophylline, anticholinergics)
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16
Q

What are the effects of corticosteroids?

A
  1. Breakdown of fats and proteins, glucose production and storage
  2. CV: increased BP, RBC, Hgb, WBC
  3. CNS excitement, insomnia, euphoria, psychosis
  4. Inc gastric acid production
  5. Dec calcium absorption, inc secretion
  6. Immunosuppression (dec lymphocytes)
  7. Anti-inflammatory
17
Q

What is the mechanism of anti-inflammatory action of corticosteroids?

A 
⬇️ synthesis and release of mediators 
⬇️ inflammatory cell infiltration 
⬇️ airway edema 
⬇️ bronchial hyper-activity, ⬇️ mucus
⬆️ bronchial beta2 receptors and responsiveness to beta agonists
18
Q

What is a prototype of Inhaled Corticosteroids (ICS)?

A

Fluticasone (Flovent)

First-line therapy

Onset in days, max effect in ~3months

19
Q

What is a prototype of oral corticosteroids (OCS)?

A

Prednisone

For severe asthma

Limit dose/duration of use as much as possible

20
Q

What are the side effects of inhaled corticosteroids (ICS)?

A
  1. Dyspnonia
  2. Orophanyngeal cadidiasis (thrush)
  3. Bone loss in women
  4. Adrenal insufficiency
  5. Exacerbation of glaucoma
21
Q

What are corticosteroid withdrawal symptoms?

A
  1. Hypotension
  2. Hypoglycemia
  3. Myalgia
  4. Arthralgia
  5. Fatigue

Tapering required (>14 days)

22
Q

What are other uses of corticosteroids?

A
  1. Rheumatic diseases (arthritis)
  2. Dermatológico disorders
  3. Inflammatory bowel disease
  4. Cerebral edema
  5. Cancer
  6. Organ transplantation
  7. Allergic diseases and reactions
23
Q

What is a prototype of inhaled short-acting beta2 agonists (SABA)?

A

Salbutamol (Ventolin)

For acute asthma attacks

PRN only

24
Q

What is a prototype of inhaled long-acting beta2 agonists (LABA)?

A

Salmeterol (Serevent)

Delayed onset (10-30min)

25
Q

What is a prototype of oral beta2 agonists?

A

Salbutamol (Ventolin liquid)

Longer acting
More side effects
NOT PRN

Nursing - Bloomberg (52 decks)

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