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Basic Respiratory Therapy Procedures And Lab > BRTP07 Pharmacology > Flashcards

BRTP07 Pharmacology Flashcards

1
Q

4 forms of aerosol administration

A
  1. SVN- small volume nebulizer
  2. Breath actuated nebulizer
  3. DPI- dry powdered inhaler
  4. MDI- metered dose inhaler
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2
Q

Advantages of delivering inhaled drugs

A

Directly administered to target organs
smaller doses/ fewer side effects
rapid onset

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3
Q

disadvantages of delivering inhaled drugs

A

Delivered dosage may vary

Lack of knowledge by caregiver and or patient on proper administration

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4
Q

efficacy

A

a measurement term applied to a drugs EFFECTIVENESS at a receptor site. The higher the rating, the better it works.

refers to the maximum effect that a drug can deliver

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5
Q

potency

A

the amount of drug needed to produce the desired effect.

the lower the dose required, the higher the potency

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6
Q

tolerance

A

Receptor sites can change and adapt over time, increasing amounts of drug may be required to get the same therapeutic effect. The cells/ tissue becomes less sensitive to stimulation of the drug.

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7
Q

Half life

A

refers to the length of time it takes for the concentration of a drug to decrease by 1/2 through metabolism and elimination

half-life determines the frequency of drug administration

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8
Q

Steady state

A

refers to the amount of drug going in versus what is being eliminated. It takes 5-6 half lives to reach steady state, or its maximal concentration in the body

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9
Q

Agonist

A

STIMULATES

Stimulates or has affinity (attraction) for a receptor and causes a specific response

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10
Q

Antagonist

A

BLOCKS ACTION

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11
Q

Alpha receptors (1)

A

Vasoconstriction and vasopressor

Increase blood pressure

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12
Q

Beta 1

A

Increased heart rate and myocardial contractility

How hard the heart squeezes

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13
Q

Beta 2

A

Relaxes smooth bronchial muscle, stimulates mucociliary activity

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14
Q

Adrenergics

A

STIMULATE

Stimualte the SYMPATHETIC nervous system to DILATE bronchial smooth muscle, relieve bronchospasm in asthma, pnuemonia, cystic fibrosis, bronchiectasis, emphysema

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15
Q

Adrenergics are associated with what?

A

Agonist

Stimulate sympathetic nervous system

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16
Q

Anticholinergics

A

Aka antimuscarinic

BLOCK parasympathetic nervous system to block bronchospasm: helpful in asthma emphysema, chronic bronchitis

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17
Q

Anticholinergics are associated with what

A

Antagonist

Also known as antimuscarinic

Block parasympathetic

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18
Q

6 drug categories

A
  1. Adrenergic
  2. Anticholinergics (antimuscarinic)
  3. Mucoactive or mucolytic
  4. Anti-asthmatics
  5. Corticosteroids
  6. Anti-infectives
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19
Q

5 drug indications

A 
Sympathomimetics
Parasympatholytica
Racemic epi
Steroids or antiasthmatics
Antibiotics
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20
Q

If you have a patient with stridor what type of drug would you want to give and what type of receptor sure is utilized?

A

Racemic Epi

Alpha 1

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21
Q

COPD Patients respond well to what category of drug? And is it considered an agonist or antagonist?

A

Anticholinergics/ antagonist

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22
Q

If i want to cause bronchodilation what receptor site would I want to target? What category of drug?

A

Beta 2

Agonist

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23
Q

Mucoactive or mucolytic

A

Work to thin and LOOSEN SECRETIONS

Bronchial pneumonia, cystic fibrosis, bronchitis, bronchiectasis

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24
Q

Anti-asthmatics

A

Work to block the immune response that causes inflammation or bronchospasm

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25
Q

Corticosteroids

A

Block the immune response that causes bronchospasm, enhance the action of adrenergics: asthmatics

(Also emphysema and chronic bronchitis) only in moderate to severe cases

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26
Q

Anti-infectives

A

Antibiotics or antiviral drugs given to treat or prevent certain pneumonias, particulary chronic

Pneumocytis in HIV patients and recurrent pneumonias in cystic fibrosis patients

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27
Q

What indicates need for sympathomimetics

A

Asthma, COPD, wheezing

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28
Q

What indicates need for parasympatholytics

A

COPD

Severe or chronic asthma

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29
Q

What indicates racemic epi

A

Stridor, upper airway swelling or obstruction

30
Q

What indicates steroids or antiasthmatics

A

Chronic or severe asthma

31
Q

What indicates antibiotics

A

Infection, pneumonia, purulent (full of pus) secretions

32
Q

What is the purpose of giving a mucolytic? And to whom are these administered to?

A

Break down mucous/ move mucous

Given to people with bronchitis, pneumonia, cystic fibrosis

33
Q

You are treating a patient with cystic fibrosis. One of the medications you need to nebulize is TOBI.

  1. What category is TOBI?
A

Antibiotic

34
Q

6 rights of a patient

A
  1. Right patient
  2. Right drug
  3. Right dose
  4. Right time
  5. Right route
  6. Right documentation
35
Q

Bronchodilators

A

Broncho constriction is caused by stimulation of the parasympathetic nervous system. This results in bronchospasm and increased mucous secretion.

The parasympathetic nervous system can be stimulated by irritants, allergens or stress

36
Q

Bronchospasm can be treated by?

A

Stimulating the sympathetic nervous system to cause dilation (adrenergic bronchodilators)

Blocking the parasympathetic nervous system to prevent bronchospasm (anticholinergic)

Blocking an allergic reaction that is triggering the parasympathetic nervous system. These drugs are steroids or other drugs called anti asthmatics, not bronchodilators

37
Q

Indications for bronchodilators

A

Wheezing due to REVERSIBLE causes.

Usually reversible but can be due to unilateral issue or obstruction.

38
Q

More on wheezing

A

Anyone with inflammation if the airways can have wheezing, the inflammation triggers constriction if the smooth airway muscle which makes the airway smaller and causes wheezing.

39
Q

Ultra short acting drug

A

Drug name:
Racemic epinephrine

Brand name:
Micronefrin
Nephron

40
Q

Long acting adrenergic

A

Salmeterol
Arformoterol
Formoterol

Remember SAF aka long acting drugs are used to keep someone “safe”

41
Q

Brand names for long acting adrenergic

A

Salmeterol— serevent

Arformoterol— brovana

Formoterol— foradil (dpi) and perforomist (svn)

42
Q

Short acting adrenergic drugs

A

Albuterol (proventil/ ventolin)

Levalbuterol HCL (xopenex)

43
Q

Mucoactive drugs

A

Dornase alfa (pulmozyme)

Acetylcysteine (mucomyst)

44
Q

Anticholinergic

A

Ipratropium bromide (atrovent)

Tiotropium bromide (spiriva)

45
Q

Anticholinergic and adrenergic

A

Ipratropium bromide

And

Albuterol

(Brand name)
Combivent and duoneb

46
Q

Anti-infective

A

Pentamidine isethionate (NebuPent)

47
Q

Corticosteroids

A

Beclomethasone Dipropionate (QVAR)

Fluticasone Propionate (flovent) (flovent discus)

Budesonide (pulmicort)

48
Q

Adregenics work best in what patients?

A

Asthmatics

49
Q

Anticholinergics work better in who?

A

COPD patients

50
Q

SABA

A

Short acting beta adrenergic

51
Q

SAAC or SAMA

A

Short acting anticholinergics

Short acting antimuscarinic

52
Q

SABAs; SAACs; SAMAs

A

Rescue bronchodilators are fast acting (within 5-15 mins)

Quick peak (30-60 mins)

Usually shorter acting 4-6 hours (proventil or xopenex, atrovent)

53
Q

LABA

A

Long acting beta adrenergic

54
Q

LAAC OR LAMA

A

Long acting anticholinergic

Long acting antimuscarinic

55
Q

LABAs; LAACs; LAMAs

A

Long acting (12 hours) adrenergics and cholinergic blockers (anticholinergics) are controller drugs used for frequent symptomatic poorly controlled lung disease.

56
Q

3 Short acting bronchodilator adrenergics

A

Ultra short acting:
Racemic epinepherine

Short acting:
Albuterol
Levalbuterol

57
Q

Difference between albuterol and levalbuterol

A

Albuterol is a beta 1 and beta 2

Levalbuterol is Beta2

levalbuterol will not cause tachycardia and tremors

58
Q

Side effects of short acting and long acting adrenergics

A 
Tachycardia
Tremor
Headache
Insomnia
Dizziness
Nervousness
Hypokalemia
Nausea
Tachyphylaxis
59
Q

3 long acting bronchodilator adrenergics

A

Salmeterol (serevent)
Arformoterol (brovana)
Formoterol (foradil, performist)

60
Q

Formoterol and aformoterol are also considered?

A

Fast acting (12 hrs)

61
Q

Anticholinergic bronchodilators

A

Ipratropium (SAAC) (atrovent) (duoneb) (combivent) (called combivent when combined with albuterol)

Tiotropium (LAAC)

Umeclindinium (LAAC)

62
Q

Side effects of anticholinergic bronchodilators

A

Dry mouth

Increased HR
Urinary retention
Use with caution if glaucoma is present

63
Q

Clinical application

Your patient has been diagnosed with mild to moderate COPD

What would be the initial bronchodilator of choice?

A

Spirivia (tiotropium)
Atrovent (ipratropium)
(Proventil ventolin) (albuterol)

64
Q

When should you terminate a treatment?

A

Tachycardia

When HR increases of 20% or 20 bpm

65
Q

One of your adrenergic bronchodilators has a very special use for upper airway obstruction. What is it and what tyoes of situations would it be used in?

A

Racemic epinephrine

Rescue situations

66
Q

Mucoactive/ mucolytic drugs

A

Pulmozyme (dornase alfa)- breaks DNA strands to thin purulent(infected/ pus filled) secretions. Wonder drug for CYSTIC FIBROSIS patients. Main side effect is voice alteration

Mucomyst (acetylcysteine)- breaks disulfide bonds, used for thick mucous; ROTTEN EGG SMELL; common side effect bronchocontrictions. PRETREAT W BRONCHODILATOR

Hypertonic NaCl- salt attracts water into the airways thinning mucus

67
Q

Patients with thick or copious airway secretions are given what kinda of drugs?

A

Mucolytics

68
Q

Patients with secretions in their airway will have what breath sounds?

A

Rhonchi aka coarse crackles or low pitched wheezes

69
Q

Fine crackles are also called?

A

Rales or just “crackles”

70
Q

What causes rhonchi/ coarse crackles?

What causes fine crackles?

A
  1. Secretions in large airways

2. Fluid in small airways or atelectasis

71
Q

Your patient has a long standing diagnosis of cystic fibrosis.

What mucolytic of choice and what is the standard recommended dose?

A

Pulmozyme (dornase alfa)

2.5 mg a day

Basic Respiratory Therapy Procedures And Lab (11 decks)

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