BNPH700 Respiratory & antimicrobial Flashcards
What are the effects of the sympathetic nervous system on Lungs and heart
Lungs - bronchodilation
Heart - Increased rate and force of contractions
What are the effects of the parasympathetic NS on heart and lungs
Lungs - bronchoconstriction
Heart - decreased rate and force of contractions
What is the neurotransmitter for the SNS
adrenaline
Neurotransmitter for PNS?
Acetylcholine
MOA of Beta-2 agonist medications
Engage beta-2 receptors resulting in Bronchodilation
Vasodilation
Uterine relaxation
Glucose release
Two types of beta-2 agonist medications?
SABA - Short acting beta agonists for acute onset (salbutamol)
LABA - Long acting beta agonists for regular use to control symptoms (Salmeterol)
ADR’s of B2 agonists
Tachycardia
Palpitations
Headaches
Restlessness and anxiety
Tremor
Hypokalaemia and hyperglycemia in high doses
Cautions for use of SABAs
Frequent use can result in a decrease in beta 2 receptor response leading to decreased bronchodilation
Increase of B1 stimulation causing increased HR, tremors and anxiety
Cautions for use of LABAs
Not for acute symptoms
Should be used in conjunction with an inhaled corticosteroid (prophylactic)
Anticholinergics MOA and ADR’s (think rest & digest)
Muscarinic antagonists - block the PNS response resulting in smooth muscle relaxation and bronchodilation
ADR’s - Dry mouth, metallic taste, nausea, constipation, headache, tachycardia, glaucoma (with nebs and face mask)
Preventers - (Inhaled corticosteroids) MOA and ADR’s (suffix - sone)
MOA - Mimic the action of glucocorticoids secreted from adrenal glands by:
Decreasing inflammatory response in lungs, Decreasing bronchial mucus, decreasing bronchial hyper-reactivity and increasing B2 agonist responsiveness.
ADR’s
Dysphonia (hoarse voice)
Oral thrush
(Use spacer and rinse mouth to minimise these)
ADR’s of systemic steroids
Moon face
Hyperglycaemia
Muscle wasting and weakness
Osteoporosis
Increased susceptibility to infection
Slow healing
Peptic ulceration
Ocular changes
Psychosis
Adrenal suppression
… and many more
Important patient education for corticosteriods
- Can take weeks to reach full effect.
- Must be taken continuously.
- Do not stop taking without Dr consultation
- When used with a spacer it can greatly reduce systemic adverse effects
- May reduce exacerbations in severe COPD
Patient education for Bronchodilators and corticosteriods
Inhaler technique
Use of spacer
Action plan for symptom management
ADR’s
For LABA and corticosteriods - Use regularly as prescribed and do not stop taking.
Definition of antibiotics
Chemicals used to kill or slow growth of infection causing micro-organisms
Bactericidal
Kill bacteria
Bacteriostatic
Inhibit growth of bacteria allowing the host defenses to eventually kill bacteria
What is a superinfection?
A secondary infection occuring during antibiotic therapy. AB’s destroy normal flora and opportunistic bacteria grow e.g vaginal thrush
MOA of penicillins and cephalosporins
Inhibit bacterial cell wall synthesis by disrupting the cross-link structure causing lysis and cell death. (Bactericidal)
What is the purpose of adding clavulanic acid to penicillin?
Bacteria produce enzymes called beta-lactamases that destroy penicillin. Clavulanic acid is a beta-lactamase inhibitor that prevents this. (amoxycillin + clavulanic acid)
Penicillin ADR’s
Nausea, vomiting, diarrhea, abdo pain
Candidiasis
Allergic reactions
Cephalosporins
Similar to penicillin
Pt with allergy to penicillin may also be allergic to cephalosporins
Broad spectrum
Similar side effects
What is antibiotic resistance and how can nurses help to minimise this
Bacteria are becoming more sophisticated and are able to overcome the effects of AB’s. (E.g. beta-lactamase)
Educate patient on how and when to take antibiotics, stress the importance of finishing the whole course, don’t take anything that is not prescribed
Nursing role for antibiotics
Educate on how and when to take the antibiotics
What it is for
Possible side effects
Red flags and when to call or come back in.
