7A: Pulmonary Meds Flashcards
How are bronchodilators delivered?
Inhalers
When should you use spacers with bronchodilators?
For young children and those with impaired inspiratory effect or impaired motor control
What are the two types of bronchodilators?
Meter dosed and rescue
What are the three causes of bronchoconstriction?
- Increase in bronchial smooth muscle tone
- Inflammation
- Bronchospasm
What is Serevent/Spiriva?
12 hour acting med for difficult to control or chronic asthmatics
What is Albuterol?
4 hour rescue inhaler for acute attacks
When does Albuterol peak?
15-30 minutes
What is the use of Beta2 Sympathomimetics?
Asthma
What is the action of Beta2 Sympathomimetics?
Specific adrenergic agent produces relaxation of bronchial smooth muscle by increasing cAMP and decreasing Ca concentrations
What are adverse effects of Beta2 Sympathomimetics?
Tremor, palpitations, headache, nervousness, dizziness, nausea, and hypertension
What are the Non-Selective Sympathomimeetics?
Epinephrine and Ephedrine
What is Epinephrine/Adrenalin?
Short duration med with strong effect in blood vessels, moderate effect on bronchial muscles
What is Ephedrine?
Long duration med with moderate effect on bronchial muscles
What are the uses of Non-Selective Sympathomimetics?
Asthma, acute bronchoconstriction, respiratory distress with bronchoconstriction
What is the action of Non-Selective Sympathomimetics?
Enhance specific and non-specific adrenergic receptors
What are the adverse effects of Non-Selective Sypathommetics?
Tremor, palpitations, headache, nervousness, dizziness, nausea, hypertension, increased myocardial contractility and heart rate
What drug is a Sympatholytic?
Phentolamine
What is the use of Sympatholytics?
Respiratory bronchodilator used to inhibit constriction
What is the action of Sympatholytics?
Inhibit bronchoconstriction
What are the adverse effects of Sympatholytics?
Agitation, tachycardia, palpitations, chest pain
What are Sympatholytics mostly used for?
Cardiac system
What are the Parasympatholytics?
Atropine and Atrovent
Describe Atropine
Absorbed quickly
Describe Atrovent
Inhaled and not absorbed quickly, so has less side effects
What is the use of Parasympatholytics?
Bronchoconstriction
What is the action of Parasympatholytics?
Block parasympathetic stimulation, anticholinergic agents, bronchodilation
What are the adverse effects of Parasympatholytics?
Depression, delirium, hallucinations
What drug is a Methylxanthine?
Theophylline
What is the use of Methylxanthines?
Bronchoconstriction
What is the action of Methylxanthines?
Autonomic-active bronchodilation agent that enhances diaphragmatic contractility
What are the adverse effects of Methylxanthines?
Agitation, tachycardia, hypotension, chest pain, possibile diuresis
What are Symbicort and Advair?
Combination of long-acting bronchodilator and steroid
What are the uses of combined inhaled corticosteroids and bronchodilators?
COPD and chronic asthma
What is the action of combined corticosteroids and bronchodilators?
Steroid reduces airway inflammation, promotes relaxation of airway, and controls mucous production
What are the adverse effects of combined inhaled corticosteroids and bronchodilators?
Tachycardia, respiratory infections, nausea and vomiting, headache, muscle cramps and tremors
What is the general function of Anti-Inflammatory Agents?
Suppress bronchoconstriction
What are Glucocorticoids?
Prednisone and Methylprednisolone
Describe Prednisone and Methylprednisolone
Used for acute episodes, given in decreasing doses over 7 or 10 days
Describe Beclovent and Flovent
Inhaled glucocorticoids for daily use
What is the use of glucocorticoids?
Acute or chronic bronchial inflammation
What is the action of Glucocorticoids?
Inhibit formation of inflammation mediators
What are adverse effects of Glucocorticoids?
Cushings, obesity, osteoporosis, immunosuppression, irritability, muscle weakness, hypertension
What is Cushing’s Syndrome?
Hyperfunction of adrenal cortex
What are the symptoms of Cushing’s?
Moon face and trunk obesity leading to poor wound healing
What are examples of Antihistamines?
Benadryl, Dramamine, Dimetapp
What are the uses of antihistamines?
Histamine causes inflammatory responses
What is the action of antihistamines?
These all bind to H receptors in smooth muscles to cause decreased congestion and irritation
What are the adverse effects of antihistamines?
Sedation, fatigue, dizziness, blurred vision, loss of coordination
What are examples of alpha receptor specific Sympathomimetics?
Primatene and Sudafed
What is the use of alpha receptor specific Sympathomimetics
Congestion
What is the action of alpha receptor specific Sympathomimetics?
Vasodilation
What are the adverse effects of alpha receptor specific Sympathomimetics?
Headache, dizziness, nausea, hypertension, heart palpitations
What are examples of Expectorants?
Robitussin and Mucinex
What is the use of Robitussin and Mucinex?
To clear secretions and protect airway
What is the action of Robitussin and Mucinex?
Increase secretion production
What are the adverse effects of Robitussin and Mucinex?
Sedation
What type of drug is Codeine?
Antitussives
What is the use of Codeine?
Decreased cough
What is the action of Codeine?
Block receptors in the brain to decrease irritation and suppress the cough reflex
What are the adverse effects of Codeine?
Sedation, GI distress, dissiness
What type of drug is Mucomyst?
Mucolytic
What is the use of Mucomyst?
Break up and assist with the mobilization of secretions
What is the action of Mucomyst?
Promote mobilization and removal of secretions by decreasing viscosity of mucous and increasing expectoration
What are the adverse effects of Mucomyst?
Mucosal irritation, coughing, bronchospasm if has asthma
Describe Penicillin
Inhibits cell wall synthesis, fights gram - and + bacteria
What are possible adverse effects of Penicllin?
Allergic reaction, hives, temperature, anaphylactic shock
Describe Amoxicillin and Ampicillin
Fights gram - and + bacteria
What are examples of Aminoglycosides?
Gentamicin
Describe Aminoglycosides
Broad spectrum, especially gram negative including E-coli and anaerobic bacteria
What is an adverse effect of Aminoglycosides?
Can cause kidney toxicity
Describe Macrolides/Erythromycin
Broad spectrum gram - and + (often used as an alternative to Penicillin)
Describe Tetracylines
Broad spectrum often used for resistant strains
Describe Cipro
Inhibits bacterial protein DNA/RNA synthesis, broad spectrum that is used for strong or resistant infections
What is the current drug of choice for treating Anthrax?
Cipro
Describe Cephalosprins
Alternatives to Penicillin - less allergic reactions
What are the adverse effects of Cephalosporins?
Stomach ache, cramps, nausea, vomiting
What are general adverse effects to antibiotics?
Hypersensitivity, stomach cramps, diarrhea, nausea, vomiting
What are CF meds?
Trikafta and Orkambi
Describe Trikafta
Works at the cellular level to try to cut down on secretion production
Describe Orkambi
Works to increase a certain cellular proteins function that lessens impact of CF