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Respiratory Care Seminar‼️ > Ch. 14: Respiratory Medications > Flashcards

Ch. 14: Respiratory Medications Flashcards

1
Q

Drugs that break down the sputum chemically for more effective expectoration.

A

Mucolytics

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2
Q

You are having difficulty intubating a combative patient in the emergency department. The respiratory therapist should recommend the delivery of which drug to facilitate intubation?

A

Succinylcholine

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3
Q

Diluents

Normal saline solution (0.9% NaCl) INDICATION

A

Used to dilute bronchodilating agents.

May be instilled through endotracheal (ET)
tubes and tracheostomy tubes, 3 to 5 mL at a
time to clear mucus plug within the tube.

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4
Q

Diluents

Hypotonic saline solution (0.4% NaCl) INDICATION

A

Used in ultrasonic nebulizers because smaller particles are produced as a result of lower concentration.

More stable than sterile water.

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5
Q

Diluents

Hypertonic saline solution (1.8% NaCl) INDICATION

A

Used to stimulate coughing and induce sputum because it is irritating to the airway.

Larger aerosol particles are produced because of the higher concentration of the solution.

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6
Q

Diluents

Sterile distilled water INDICATION

A
  • Used to dilute other medications.
  • Used to hydrate secretions, thereby decreasing the viscosity for easier expectoration.
  • Used to humidify dry gases.
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7
Q

What is the drug class?

Acetylcysteine (Mucomyst)

A

Mucolytic

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8
Q

Acetylcysteine (Mucomyst) is available in what two concetrations?

A
  • 10%
  • 20%
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9
Q

________ breaks the disulfide bonds in the sputum, thus decreasing the sputum’s viscosity.

A

Acetylcysteine (Mucomyst)

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10
Q

Acetylcysteine (Mucomyst) is often coupled with what type of medication and why?

A

Used with bronchodilating agents because a common side effect of acetylcysteine is bronchospasm.

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11
Q

With which of the following lung disorders would acetylcysteine (Mucomyst) be indicated?

A
  • CF
  • Bronchiectasis
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12
Q

Dornase alfa (Pulmozyme, rhDNase) is used commonly for what patient population?

A

Used most commonly in patients with cystic fibrosis or other lung conditions in which thick, tenacious sputum is present.

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13
Q

MUCOLYTIC

May be nebulized (1 to 3 mL, three to four times daily) or instilled directly into the trachea.

A

Acetylcysteine (Mucomyst)

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14
Q

How should dornase alfa be stored?

A

Must be kept refrigerated and protected from light.

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15
Q

Which mucolytic should NOT be nebulized in combination with other drugs?

A

Dornase alfa (Pulmozyme, rhDNase)

Administering a bronchodilator before dornase alfa may help increase the deposition of the drug.

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16
Q

What medication works by increases the pH of the sputum, thereby
decreasing its viscosity?

A

Sodium bicarbonate (2% NaHCO3)

May be used to improve the mucolytic actions
of acetylcysteine

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17
Q

What is the indication for Mannitol (Bronchitol)?

A

CF patients

Not approved by the FDA yet, but soon. Administered by DPI (bronchodilator prior to mannitol is indicated for children who may experience bronchospasm from the powdered drug).

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18
Q

Sympathomimetic Bronchodilators

Epinephrine hydrochloride (Adrenalin Chloride, Sus-Phrine) stimulates which adrenergic receptors?

A

All three

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19
Q

Epinephrine hydrochloride (Adrenalin Chloride, Sus-Phrine)

Indication

A

Used to stimulate the heart;

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20
Q

What is the indication for Racemic epinephrine (Micronefrin, Vaponefrin)?

A

Used to decrease mucosal edema and inflammation after extubation or in pediatric patients with croup

21
Q

Indication for Metaproterenol (Alupent, Metaprel)

A

Used to decrease airway resistance

22
Q

Indication for Albuterol

A

Used to decrease airway resistance (Wheezing, bronchospasm)

23
Q

What is the first line drug for patients with COPD or
asthma?

A

Levalbuterol (Xopenex)

It’s a SABA

24
Q

Indication for Salmeterol (Serevent) - LAMA

A

Used to decrease airway resistance

Same for Formoterol

25
Q

An anticholinergic bronchodilator that acts topically in the lung instead of systemically.

A
  • Ipratropium bromide (Atrovent)
  • Tiotropium bromide (Spiriva)
26
Q

According to CLIA standards, quality control must be performed for blood gas analyzers every ____ hours.

A

8

27
Q

While counseling a patient during a smoking cessation session, the patient expresses concern about weight gain. A respiratory therapist should address the patient’s concern by explaining that this is partially the result of what?

A

Decreased metabolism

28
Q

While assessing an adult male, receiving invasive, mechanical ventilation, a respiratory therapist notes breath sounds are markedly decreased, the cuff pressure is 5 cmH2O, and airflow is coming from the patient’s mouth during each positive pressure breath. The tube depth remains at 22 cmh2O. Air is added to the cuff, but the cuff pressure is not maintained. What should the RT recommend?

A

Reintubate using an endotracheal tube exchanger.

The sudden loss of cuff pressure in the air noted coming from the mouth indicates a ruptured cuff and must be addressed immediately. An endotracheal tube exchanger is a safety means to re-intubate successfully.

29
Q

Stimulates respiratory rate and depth of breathing and produces pulmonary vasodilation and bronchodilation

A

Theophylline (Theo-Dur)

30
Q

Theophylline (Theo-Dur) Indication

A

Used to decrease airway resistance, especially
in patients with asthma

31
Q

Miscellaneous Respiratory Drugs

Cromolyn sodium INDICATION

A

Used as preventive therapy for asthma (not effective during an asthma attack)

Not commonly used anymore

32
Q

Theophylline produces effects that providegreat benefits for patients with COPD

A

(1) Increased right ventricular output (improves cor pulmonale)
(2) Improves diaphragmatic function
(3) Produces pulmonary vasodilation, reducing pulmonary hypertension that results from chronic hypoxemia
(4) Stimulates breathing by altering the hypoxic response curve when partial PaO2 is elevated above 60 mm Hg

33
Q

EXAM NOTE

Another mast cell stabilizer similar to cromolyn, but 4 to 10 times stronger, is ________, which is available in MDI aerosol only.

A

nedocromil sodium (Tilade)

34
Q

Leukotriene modifiers

What are the indication for Leukotriene modifiers?

A

Leukotriene modifiers are used to prevent asthma attacks and are for long-term treatment of asthma.

35
Q

Common drugs: Leukotriene modifiers

A
  • zafirlukast (Accolate)
  • montelukast (Singulair)
  • zileuton (Zyflo)
36
Q

Neuromuscular Blocking Agents

Used as a short-term paralyzing agent to facilitate ET intubation.

A

Succinylcholine

37
Q

List long-acting paralytic agents.

A
  • Pancuronium bromide (Pavulon) (120-180 mins)
  • Vecuronium (60-90 mins)
  • Rocuronium (Zemuron) (30-60 mins)
38
Q

The paralyzing effects of the nondepolarizing agents (pancuronium, vecuronium, and rocuronium) may be reversed with the administration of what drug?

A

edrophonium (Tensilon) or neostigmine (Prostigmin)

39
Q

Antibiotics (Aerosolized)

Indication for Gentamicin

A

CF patients

Effective against Pseudomonas aeruginosa

40
Q

Antibiotics (Aerosolized)

Indication for Amoxicillin

A

Bronchiectasis

Reduces the purulence of the sputum

41
Q

Antibiotics (Aerosolized)

Indication for Tobramycin (TOBI)

A
  • Commonly used in cystic fibrosis patients
  • Effective against Pseudomonas aeruginosa and Staphylococcus aureus
42
Q

Antibiotics (Aerosolized)

Indication for Amphotericin B

A

Fungal infections

Improvement seen in treatment of pulmonary
aspergillosis and the fungus Candida albicans

43
Q

Antibiotics (Aerosolized)

Indication for Pentamidine

A
  • Used in the treatment of Pneumocystis carinii pneumonia (commonly seen in AIDS patients)
44
Q

EXAM NOTE

The primary indication for inhaled steroids is for antiinflammatory maintenance therapy of mild to moderate persistent asthma.

A

OKAY

45
Q

List some inhaled steroids

A

a. Dexamethasone
b. Beclomethasone
c. Budesonide (Pulmicort)
d. Flunisolide
e. Triamcinolone acetonide (Azmacort)
f. Fluticasone propionate (Flovent)

46
Q

What is the drug of choice to
sedate a ventilator patient for more than 24 hours?

A

Lorazepam (Ativan)

47
Q

________ are indicated for rapid sedation of acutely agitated patients because they have a 2- to 5-minute onset of action.

A

Valium and Versed

48
Q

Loop diuretics effectively treat what?

A

hypertension, pulmonary edema, and peripheral edema.

49
Q

Inhaled pulmonary vasodilators

A
  • Nitric oxide
  • Iloprost (Ventavis)
  • Treprostinil (Tyvaso)

Respiratory Care Seminar‼️ (19 decks)

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