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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
Corticosteroids
Block the immune response that causes bronchospasm, enhance the action of adrenergics: asthmatics (Also emphysema and chronic bronchitis) *only in moderate to severe cases*
26
Anti-infectives
Antibiotics or antiviral drugs given to treat or prevent certain pneumonias, particulary chronic Pneumocytis in HIV patients and recurrent pneumonias in cystic fibrosis patients
27
What indicates need for sympathomimetics
*Asthma*, COPD, wheezing
28
What indicates need for parasympatholytics
*COPD* | Severe or chronic asthma
29
What indicates racemic epi
Stridor, upper airway swelling or obstruction
30
What indicates steroids or antiasthmatics
Chronic or severe asthma
31
What indicates antibiotics
Infection, pneumonia, purulent (full of pus) secretions
32
What is the purpose of giving a mucolytic? And to whom are these administered to?
Break down mucous/ move mucous Given to people with bronchitis, pneumonia, cystic fibrosis
33
You are treating a patient with cystic fibrosis. One of the medications you need to nebulize is TOBI. 1. What category is TOBI?
Antibiotic
34
6 rights of a patient
1. Right patient 2. Right drug 3. Right dose 4. Right time 5. Right route 6. Right documentation
35
Bronchodilators
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
Bronchospasm can be treated by?
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
Indications for bronchodilators
Wheezing due to REVERSIBLE causes. Usually reversible but can be due to unilateral issue or obstruction.
38
More on wheezing
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
Ultra short acting drug
Drug name: Racemic epinephrine Brand name: Micronefrin Nephron
40
Long acting adrenergic
Salmeterol Arformoterol Formoterol Remember SAF aka long acting drugs are used to keep someone “safe”
41
Brand names for long acting adrenergic
Salmeterol— serevent Arformoterol— brovana Formoterol— foradil (dpi) and perforomist (svn)
42
Short acting adrenergic drugs
Albuterol (proventil/ ventolin) Levalbuterol HCL (xopenex)
43
Mucoactive drugs
Dornase alfa (pulmozyme) Acetylcysteine (mucomyst)
44
Anticholinergic
Ipratropium bromide (atrovent) Tiotropium bromide (spiriva)
45
Anticholinergic and adrenergic
Ipratropium bromide And Albuterol (Brand name) Combivent and duoneb
46
Anti-infective
Pentamidine isethionate (NebuPent)
47
Corticosteroids
Beclomethasone Dipropionate (QVAR) Fluticasone Propionate (flovent) (flovent discus) Budesonide (pulmicort)
48
Adregenics work best in what patients?
Asthmatics
49
Anticholinergics work better in who?
COPD patients
50
SABA
Short acting beta adrenergic
51
SAAC or SAMA
Short acting anticholinergics Short acting antimuscarinic
52
SABAs; SAACs; SAMAs
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
LABA
Long acting beta adrenergic
54
LAAC OR LAMA
Long acting anticholinergic Long acting antimuscarinic
55
LABAs; LAACs; LAMAs
Long acting (12 hours) adrenergics and cholinergic blockers (anticholinergics) are controller drugs used for frequent symptomatic poorly controlled lung disease.
56
3 Short acting bronchodilator adrenergics
Ultra short acting: Racemic epinepherine Short acting: Albuterol Levalbuterol
57
Difference between albuterol and levalbuterol
Albuterol is a beta 1 and beta 2 Levalbuterol is Beta2 *levalbuterol will not cause tachycardia and tremors*
58
Side effects of short acting and long acting adrenergics
``` Tachycardia Tremor Headache Insomnia Dizziness Nervousness Hypokalemia Nausea Tachyphylaxis ```
59
3 long acting bronchodilator adrenergics
Salmeterol (serevent) Arformoterol (brovana) Formoterol (foradil, performist)
60
Formoterol and aformoterol are also considered?
Fast acting (12 hrs)
61
Anticholinergic bronchodilators
Ipratropium (SAAC) (atrovent) (duoneb) (combivent) (called combivent when combined with albuterol) Tiotropium (LAAC) Umeclindinium (LAAC)
62
Side effects of anticholinergic bronchodilators
***Dry mouth*** Increased HR Urinary retention Use with caution if glaucoma is present
63
Clinical application Your patient has been diagnosed with mild to moderate COPD What would be the initial bronchodilator of choice?
Spirivia (tiotropium) Atrovent (ipratropium) (Proventil ventolin) (albuterol)
64
When should you terminate a treatment?
Tachycardia When HR increases of 20% or 20 bpm
65
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?
Racemic epinephrine Rescue situations
66
Mucoactive/ mucolytic drugs
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
Patients with thick or copious airway secretions are given what kinda of drugs?
Mucolytics
68
Patients with secretions in their airway will have what breath sounds?
Rhonchi aka coarse crackles or low pitched wheezes
69
Fine crackles are also called?
Rales or just “crackles”
70
What causes rhonchi/ coarse crackles? What causes fine crackles?
1. Secretions in large airways | 2. Fluid in small airways or atelectasis
71
Your patient has a long standing diagnosis of cystic fibrosis. What mucolytic of choice and what is the standard recommended dose?
Pulmozyme (dornase alfa) 2.5 mg a day

Basic Respiratory Therapy Procedures And Lab (11 decks)

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