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Pharmacology for Advanced Practice Nurses > Asthma/COPD > Flashcards

Asthma/COPD Flashcards

1
Q

Asthma

A 
Common chronic disorder
Complex
Characterized by
Variable, recurring symptoms
Airway inflammation
Hyper-responsiveness
Airflow obstruction

Treatment is relief inhalers and/or controller medications

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2
Q

Asthma treatment

A

reliever inhalers like beta agonist

controller medications inhaled corticosteroid or corticosteroid with long acting bronchodilator

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3
Q

Beta-adrenergic Agonists (beta-agonists)

A

Relax bronchial smooth muscle resulting in bronchodilation – non-selective versus selective

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4
Q

Selectivity for beta-2 receptors

A

on bronchial smooth muscle without tachycardia – albuterol, levalbuterol, salmeterol, formoterol (less cardiac stimulation)

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5
Q

Short (?) or long-acting (?)

A

rescue

up to 12 hours

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6
Q

LABA still have a

A

black box warning. Should not be used by themselves

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7
Q

Brhroncodialator ADR

A

palpitations, headaches, throat irritation

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8
Q

Alternative to bronchodilator

A

anti-cholinergic like ipatropium bromide

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9
Q

Combinations

A

anti-cholinergic/beta-agonist

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10
Q

Combinations ADR

A

AE: dry mouth, headache, cough, GI distress, headache, and anxiety

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11
Q

Methylxanthines

Chemically

A

related to caffeine

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12
Q

Methylxanthines long-term management of

A

persistent asthma that is unresponsive to beta agonists or inhaled corticosteroids.

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13
Q

Methylxanthines narrow

A

safey margin

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14
Q

Methylxantinges SE

A

nausea, vomiting, CNS stimulation (frequenty); dysrhythmias (high doses); nervousness and insomnia.

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15
Q

Methylxanthines significant interactmeions

A

with numerous other drugs

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16
Q

methlxanthines can be given

A

oral or IV

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17
Q

methylxanthine example

A

theophylline

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18
Q

methylxanine is used

A

not as often as before, but in instances where asthma has not been responsive to traditional medications

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19
Q

Inhaled Corticosteroids (ICS) Prevention

A

anti-inflammatory; mucus and edema reduction; sensitize bronchial smooth muscle to beta-agonist stimulation; reduce bronchial hyper-responsiveness to allergens

20
Q

ICS

A

Qvar or Flovent

21
Q

ICS used as

A

prevention medicaions

22
Q

ICS are the preferred prevention medication and symtpmos improve in

A

1 to 2 weeks, up to 4 to 8 weeks maximum therpay

23
Q

If patient has very severe asthma

A

LABA is added to ICS

24
Q

ICS rarely have

A

systemic effects – SE – hoarseness, oropharyngeal candidiasis (education – rinse mouth out after use)

25
Q

Long term effects of ICS

A

Long-term effects – requires careful, long-term follow-up studies

26
Q

Patient ed for ICS

A

rinse mouth out. avoid thrush

27
Q

Oral Corticosteroids (OC)

A

prednisone

28
Q

Prednisone

A

used for uncontrolled symptoms. Should be used for the shortest time possible

29
Q

oral corticosteroid dose and term

A

1-2mg/kg orally once a day x 5 to 7 days

40mg orally once a day x 5 to 7 days; could do a taper

30
Q

oral corticosteroid ADR

A

adrenal gland atrophy, peptic ulcers, and hyperglycemia.

31
Q

oral corticosteroid concern in children

A

growth retardation

32
Q

Long term use of oral corticosteroids

A

have the potential to affect bone physiology in adults and childern

33
Q

Oral corticosteroids adults who are at risk for

A

osteoporosis should receive periodic bone mineral density tests.

34
Q

Oral Corticosteroids taken longer

A

than 14 days, corticosteroids should be discontinued slowly, by gradually reducing the dose

35
Q

oral corticosteroids are

A

dose and time dependent; limit to less than 10 days

36
Q

Additional treatment options for asthma

A

leukotriene modifiers and mast cell stabilizers

37
Q

leukotriene modifiers

A

Reduce inflammation and ease bronchoconstriction

38
Q

Leukotrienes

A

second line medications are mediators of the immune response that are involved in allergic and asthmatic reactions

39
Q

leukotriene side effects

A

headache, cough, nasal congestion, or GI upset

40
Q

Mast Cell Stabilizers

A

used for prevention

Inhibit release of histamine from mast cells & other chemical mediators of inflammation

41
Q

Mast cell stabilizers example and use

A

Cromolyn

used 4 to 6 times a day due to short half life

42
Q

cromolyn ADR

A

stinging or burning of the nasal mucosa, irritation of the throat, and nasal congestion bronchospasm and anaphylaxis (uncommon)

43
Q

Monoclonal Antibodies

A

Xolair – attach to a specific receptor on a target cell or molecule

44
Q

Evidence-Based Guidelines

A

Asthma Quick Care Reference Guide

Global Initiative for Asthma (GINA)

45
Q

Asthma Patient Education

A 
Side effects
Asthma Control Tests
Asthma Action Plan
Rule of 2’s.
Asthma triggers
When to follow-up
46
Q

Asthma control test

A

reviews symptoms a patient can have to determine if their asthma is under control

Pharmacology for Advanced Practice Nurses (50 decks)

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