Chapter 18 Flashcards
Restrictive Lung Disease
Pulmonary Fibrosis Pneumonitis Lung tumors Thoracic deformities (scoliosis) Myasthenia gravis
What is Chronic Bronchitis
Constant inflammation of the lower airways, characterized by excessive secretions of mucus, hypertrophy or mucous glands and recurring infections, which progresses to narrowing or obstruction of airway
What is Asthma
Involves airway inflammation, intermittent airflow obstruction, and bronchial hyper-responsiveness
What is Emphysema
Abnormal, irreversible enlargement of air spaces distal to terminal bronchioles due to destruction of alveolar walls, resulting in decreased elastic recoil properties of lungs, characterized by air trapped in the alveoli resulting in inadequate gas exchange
How are asthma and COPD different
symptoms do not resolve with COPD
alveoli are damaged with COPD
mucus with COPD
What are drug therapies for obstructive airway diseases
Bronchodilators Anticholingergics Anti-inflammatory drugs Leukotriene Inhibitors Phosphodiesterase-4 (PDE4) Inhibitors Mucolytics
How do bronchodilators work
They dilate the bronchioles, activate beta 2 receptors in the lungs, helps get the air out, relax smooth muscle,
what are the two beta 2 antagonist Bronchodilators
SABA and LABA
What is the suffix of Methylxanthine
lline
What is significant about the Methylxanthines
They are the only bronchodilators that you take orally or by IV
What are some side effects of Methylxanthine
nervousness, insomnia, sweaty, palpitations, increased blood sugar, CNS overstimulation
What are the adverse effects of Mthylxanthine
Dysrhythmias, hypotension, can cause seizures, GI bleeding, could lead to death if therapeutic range is exceeded
What is the therapeutic range of Methlxanthine
10-20mcg
If the patient begins to have tremors or restlessness with Methylxathine, what should you do
Slow down the infusion and call provider
When do you hold a rescue inhaler
Heart rate of 120
Name the three SABA’s
Albuterol
Levalbuterol
Terbutaline
What is the suffix for SABAs
bute, buta
What is the suffix for the the LABA’s
Salmeterol
Arformoterol
What do LABA’s have to be taken with
Glucocorteriods, because bronchodilators only relax smooth muscle they do not affect inflammation
What is the Anticolenergenic (Bronchodialator)
Tiotropium (Spiriva)
Ipratroopium Bromide
Do not give Spiriva to what kind of patients
Urinary retention, Glaucoma, and Elderly
Spiriva is good for what type of patient
Heart patients because they don’t cause dysrythmias
Side affects of Spiriva
insomnia, headache, GI, depression, urinary retention, hyperglycemia, blurred vision, oral ulcerations
Adverse effects of Spiriva
Perodoxical bronchoconstriction, anaphylaxis, hyperglycemia, angiodema
What is the order of administration for bronchodilators, anticholenergenics, and steroids
bronch, 5, antichol, 5, steroid
What are you Anti-Inflammatory Drugs
Corticosteroids, mast cell stabilizers, leukotrien inhibitors
Anti-Inflammatory drugs are
Glugococorticoids
what are the inhaled glucocorticoids
Budesonide
Beclomethasone
Fluticasone
What are the oral gluc
prednisone
what are the IV gluc
dexamethasone
hydrocotisone
methylpredinsolone
What are teh Mast Cell Stabilizers
Cromolyn Sodium (INHALED)
Adverse affect of Cromolyn Sodium
Paradoxil bronchospasm,
What are the Leukotriene Inhibitors
Zileuton
Zafirlukast
What are side effects of Leukotriene Inhibitors
upper respiratory infections
What are the adverse effects of Leukotriene Inhibitors
neuro and psychiatric problems, aggression, anxiety, agitation’s, hallucinations, vivid dreams, memory impairment, increase in DEPRESSION AND SUICIDAL THOUGHTS
Leukotrienes are safe for
12 months and older
Anti-Inflammatory Drugs are for
Asthma patients
Leukotriens inhibitors
Allergy induced and sports induced asthma
Which LABA is better for asthma
Salmeterol
What is the PDE4 Inhibitor
roflumilast, for end stage COPD, watch for suicidal thoughts and depression, easier to take because you dont have to monitor blood levels
Obstructive Lung Diseases
Narrowed airways (asthma, chronic bronchitis) have trouble getting air out Destroyed alveoli (emphysema) have trouble getting air out
