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Nursing Pharmacology > C5- Resiratory Medications > Flashcards

C5- Resiratory Medications Flashcards

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1
Q

What are the two components of the respiratory system?

A

Upper respiratory system

Lower respiratory system

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2
Q

What are some of the functions of the respiratory system?

A

Brings air into the body and expels CO2 and other waste

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3
Q

What are two common upper respiratory disorders?

A

Common cold

Allergic rhinitis

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4
Q

Common cold cause:

A

Rhinovirus
CONTAGIOUS BEFORE SYMPTOMS

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5
Q

Common cold symptoms

A

Nasal congestion
Cough
Increased mucosal secretions
Rhinorrhea/rhinitis

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6
Q

Allergic rhinitis cause

A

Pollen or foreign substances

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7
Q

Allergic rhinitis symptoms:

A

Acute inflammation of the nasal mucosa

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8
Q

Antihistamine action in upper respiratory:

A

Competes with histamine for receptor sites

Prevents histamine response

Tissue engorgement/inflammation of mucosal linings

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9
Q

Antihistamines are treatment of which conditions?

A

Mild allergic reactions
Anaphylaxis
Anxiety
Motion sickness
Nausea treatment
Insomnia

** DOES NOT REDUCE CONGESTION**

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10
Q

Antihistamine 1st generation

A

Diphenhydramine (Benadryl)

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11
Q

Antihistamine 2nd generation

A

Cetirizine (Zyrtec)
-non-sedating

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12
Q

Side effects of antihistamines for upper respiratory:

A

Sedation (1st generation only)
GI upset
Anticholinergic effects
-dry mouth
-constipation
-urinary retention

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13
Q

Use caution with antihistamines if:

A

3rd trimester and breastfeeding
In children and older adults
Asthma
Prostatic hypertrophy/urinary retention
Open angle glaucoma

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14
Q

Major difference between 1st and 2nd antihistamines:

A

NO SEDATION with 2nd generation

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15
Q

CNS/Alcohol with antihistamines

A

Additive effect

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16
Q

Antihistamine administration guidelines:

A

For motion sickness
-give 30 minutes before motion
Administer with food or milk
Caution client about drowsiness
-don’t drive or operate heavy machinery

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17
Q

Antihistamine nursing teaching:

A

Advise clients to avoid medications causing CNS depression (additive effect)
-alcohol
-opioids
-barbiturates
-benzodiazepines

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18
Q

Action of decongestants:

A

Stimulate alpha1 adrenergic receptors causing vasoconstriction and reduction in inflammation of the nasal membranes (decreases stuffy nose)

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19
Q

Systemic decongestant

A

Pseudoephedrine

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20
Q

Local (nasal drops/spray) decongestants

A

Phenylephrine

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21
Q

Decongestant therapeutics

A

Allergic rhinitis
Sinusitis and common cold

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22
Q

Systemic vs. Local decongestants:

A

Local =
-more effective and work faster
-shorter duration
-vasoconstriction and CNS stimulation uncommon

Systemic=
-Don’t cause rebound congestion

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23
Q

What are two therapeutics associated with decongestants?

A

Allergic Rhinitis

Sinusitis and common cold

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24
Q

Decongestant side effects: (Rebound Congestion occurs in?)

A

Only with local decongestants

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25
Q

Decongestant side effects (what happens with the CNS stimulation)

A

Nervousness
Agitation
Palpitations

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26
Q

Decongestant side effects (Vasoconstriction concerns?)

A

Hypertension

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27
Q

Decongestant side effect voiding/elimination?

A

Difficulty voiding

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28
Q

Decongestant side effect teaching (rebound congestion)

A

Advise client to use LOCAL DECONGESTANT for no more than 3-5 days

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29
Q

Decongestant side effects teaching (CNS stimulation)

A

Advise client to observe for signs of CNS stimulation and notify PCP if symptoms occur

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30
Q

Decongestant side effects teaching (Vasoconstriction)

A

Advise client with HTN and CAD to avoid using these medications

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31
Q

Decongestant side effects teaching elimination/ voiding

A

Monitor urine output/flow

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32
Q

Contraindication/cautions of decongestants

A

Glaucoma
Benign Prostatic Hypertrophy (BPH)
Difficulty voiding

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33
Q

Decongestant drug interactions

A

Caffeine
-restlessness
-palpitations

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34
Q

(Decongestants) report symptoms of

A

Eye pain
Difficulty voiding
Palpitations

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35
Q

Intranasal glucocorticoids (ACTION)

A

Prevent inflammation
Suppress airway mucus
Promote responsiveness of beta2 receptors in bronchial tree
Action is not immediate
-it does work long term

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36
Q

Intranasal glucocorticoids example:

A

Fluticasone (Flonase)

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37
Q

Intranasal glucocorticoids therapeutics:

A

Decreasing allergic rhinitis symptoms
Suppress
-congestion
-rhinorrhea
-sneezing
-nasal itching
Steroids have an anti-inflammatory action

38
Q

Intranasal Glucocorticoids initial response

A

May be seen within 2-3 hours

39
Q

Intranasal glucocorticoids maximal effect

A

May require a week

40
Q

Antitussives (Action)

A

Suppress cough reflex in the medulla

41
Q

Antitussives (therapeutics) ((BEST USE FOR))

A

Dry, non-productive cough relief

42
Q

Antitussives (opioid like)

A

Codeine

43
Q

Antitussives (Non-opioid)

A

Dextromethorphan (robitussin DM)

44
Q

Antitussives (Local anesthetic)

A

Benzonatate (Tessalon)

45
Q

Antitussives adverse effects of CNS:

A

Drowsiness
Suppress respirations (opioid)

46
Q

Antitussives GI distress (opioid) adverse effects:

A

Nausea
Constipation

47
Q

Antitussives adverse effects (possible abuse) common in which category?

A

Both
-opioid
-non opioid
-in high doses can produce euphoria “robo-tripping” or “Lean”

48
Q

Expectorants action:

A

Loosen bronchial secretions

49
Q

Expectorants example:

A

Guaifenesin (Mucinex)

50
Q

Expectorants teaching:

A

Hydration is the best expectorant!

51
Q

Mucolytics action:

A

Break down the chemical structure of the mucus molecules

52
Q

Mucolytics uses:

A

CF (cystic fibrosis)
Chronic bronchitis

Rx ONLY

53
Q

Mucolytics example

A

Acetylcysteine (mucomyst)
-Nebulizer
-Sulfer smell

54
Q

Mucolytics administration

A

Inhalation

** produces sulfur smell **

55
Q

Mucolytics off label uses

A

Tylenol overdose
Renal protection with contrast dye

56
Q

Chronic Obstructive Pulmonary Disease:

A

COPD

57
Q

COPD pathophysiologic changes:

A

Airway obstruction with increased airway resistance to airflow

58
Q

COPD root causes

A

Chronic bronchitis
Bronchiectasis
Emphysema
Asthma

59
Q

Asthma definition

A

Broncho-constriction & inflammation
(Narrow airway)

60
Q

Types of asthma:

A

Acute
Chronic

61
Q

Acute Asthma goal of therapy

A

Terminate bronchi-spasm in progress

62
Q

Chronic asthma goal of therapy:

A

Reduce the frequency of asthma attacks

63
Q

Management of A.S.T.H.M.A:

A

A- adrenergics (beta 2 agonists) (albuterol)
S- Steroids
T- Teophylline
H- Hydration (IV) (oral)
M- Mask O2
A- Anticholinergics

64
Q

Bronchodilators Beta2 adrenergic agonists

A

Inhaled short acting
- Albuterol (Proventil)
Inhaled long acting
-Salmeterol (Serevent)

65
Q

Bronchodilators (Anti-cholinerics) Parasympathetic antagonist

A

Inhaled maintenance (DRY SIDE EFFECTS)
-Ipatropium (Atrovent)
-Tiotropium (Spiriva)

** ALLERGY CAUTION (SOY, PEANUTS, ATROPINE) **

66
Q

Bronchodilators Methyl xanthine

A

Oral long acting medications (emergency occasional IV)
-theophylline (Theo-dur)

67
Q

Beta adrenergic agonists side effects:

A

Minimal when inhaled
- increased risk with more use
-tachycardia
-angina
-tremors

Pregnancy category C

68
Q

Beta Adrenergic Agonists Medication interactions

A

Beta blockers
-non selective
MAOIs, TCA
-increased risk of tachycardia and angina

69
Q

Beta adrenergic agonists teaching

A

Use of inhalers
Take adrenergic PRIOR to inhaled steroid

70
Q

Glucocorticoids Action

A

Suppress immune response
Prevents inflammation
Decreases mucous production

71
Q

Glucocorticoids help with? (Long term? Short term?)

A

Long term prophylaxis of asthma
Short term treatment after asthma attack
Not for rescue during asthma attack

72
Q

Glucocorticoids examples

A

Methylprednisolone

Prednisone (deltasone)

Triamcinolone (Azmacort)

73
Q

Glucocorticoids side effects: (what happens in the mouth? How does it effect blood glucose? Bone density? Muscles?)

A

Hoarseness
-yeast infection in mouth/throat
Hyperglycemia (diabetes?)
Infection (suppress immune system)
Bone density loss
Muscle wasting

74
Q

Glucocorticoids Teaching

A

Rinse mouth after using inhaler
Do not stop treatment abruptly
-taper dose
Monitor blood glucose
Advise to report early signs of infection
-sore throat
-weakness
-malaise

75
Q

Glucocorticoids interactions:

A

Potassium wasting diuretics
-additive K+ loss
NSAIDS
-increase risk of peptic ulcers
Insulin and oral hypoglycemic drugs

76
Q

Nursing interventions of glucocorticoid interactions

A

Monitor K+ levels and administer supplements
Advise client to avoid NSAIDS
Monitor glucose levels
-might want to increase dose of DM med

77
Q

Nursing teaching glucocorticoid interactions

A

-advise client to inhale beta 2 agonist before glucocorticoid

78
Q

Methylxanthines/Thophylline action

A

Relaxation of bronchial smooth muscle causes dilation

79
Q

Methylxanthines/Theophylline example

A

Theophylline

80
Q

Theophylline/methylxanthine therapeutics:

A

Long term control of chronic asthma

81
Q

Methylxanthines/Theophylline Narrow therapeutic range:

A

Want less than 20mcg - anything above 20mcg is toxic
Toxicity signs
-GI distress
-nervousness
-seizures

82
Q

Methylxanthines/Theophylline Interactions (increases levels of what? Decreases levels of what?)

A

Increases levels of
-caffeine
-fluoroquinolones
Decreases levels of
-Phenobarbital
-phenytoin
-Cigarette smoking

83
Q

Leukotriene Modifiers/Montelukast (singulair) ACTION (prevents effects of? What does it suppress?)

A

Prevents effects of leukotrienes
-suppressing:
-inflammation
-airway edema
-mucous production

84
Q

Leukotriene Modifiers/Montelukast (Singulair) examples:

A

Montelukast (Singulair)

85
Q

Leukotriene Modifiers/Montelukast (Singulair) Therapeutics:

A

Long term control of asthma
Exercise induced asthma
Allergic rhinitis

86
Q

Leukotriene Modifiers/Montelukast (Singulair) Side effects:

A

Headache
Drowsiness
Mood changes
Suicidal thoughts

87
Q

Antitussives

A

Codeine
Dextromethorphan

88
Q

Expectorants

A

Guaifenesin

89
Q

Antihistamines

A

Diphenhydramine (1st)
Cetirizine (2nd gen)

90
Q

N/A

A

Nursing Pharmacology (11 decks)

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