Chapter 2-Respiratory Flashcards
Antihistamines function (2)
- Block the release or action of histamine that increases secretions and narrows airways
- Blocks histamine 1
Decongestants function
Decrease the blood flow to the upper respiratory tract and decrease the overproduction of secretions
Expectorants function
- Increase productive cough to clear airways
- Thins mucus
Antitussives function
Block cough reflex
Antihistamine Actions (3)
- Selectively block he effects of histamine at H-1 site
- Decreases allergic response
- Anticholinergic and antipruritic effects
Antihistamine indications (4)
- Seasonal and perennial allergic rhinitis
- Allergic conjunctivitis (itchy eye)
- Uncomplicated urticaria
- Angioedema
Antihistamine Cautions (2)
- Renal or hepatic impairment
- History of dysrhythmias
Antihistamine Side Effects (2)
- Drowsiness and sedation
- Anticholinergic effects
First Generation Antihistamines (2)
- Diphenhydramine
- Hydroxyzine
Second Generation Antihistamines (3)
- Certizine
- Loratadine
- Fexofenadine
Topical Nasal Decongestants Actions (2)
- Affects SNS to cause vasoconstriction
- Causing less inflammation of the nasal membrane
Topical Nasal Decongestant Indications
-Relieve nasal congestion
Pharmacokinetics of Topical Nasal Decongestants (2)
- Not absorbed systemically
- Medication stays in nasal passage
Contraindications of Topical Nasal Decongestants
Lesion or erosion in the mucous membranes
Caution of Topical Nasal Decongestants (2)
- Any condition that might be exacerbated by sympathetic activity
- Avoid caffeine
Topical Nasal Decongestant Side Effects (2)
- Local stinging and burning
- Rebound congestion
Examples of Topical Nasal Decongestants (2)
- Oxymetazoline
- Phenylephrine
Topical Nasal Steroid Decongestant Actions
Decreases inflammatory response within the nasal area
Topical Nasal Steroid Decongestant Indications (2)
- Seasonal allergic rhinitis
- Inflammation after the removal of nasal polyps
Pharmacokinetics of Topical Nasal Steroid Decongestants
Generally not absorbed systemically
Contraindications of Topical Nasal Steroid Decongestants
Acute infection
Caution of Topical Nasal Steroid Decongestants (2)
- Active infection
- Avoid exposure to airborne infections
Side effects of Topical Nasal Steroid Decongestants (2)
- Local burning, irritation, stinging, dryness of the mucosa, and headache
- Suppression of healing can occur in a patient who has had nasal surgery or trauma
Examples of Topical Nasal Steroid Decongestants (2)
- Fluticasone
- Budesonide
Oral Decongestants Actions
Shrink the nasal mucous membrane by stimulating the alpha-adrenergic receptors in the nasal mucous membranes
Indication for Oral Decongestants
Promotion of drainage in the sinuses and improving airflow
Oral Decongestants Contraindications
Any conditions that might be exacerbated by sympathetic activity
Side Effects for Oral Decongestants (2)
- Rebound congestion
- Sympathetic effects
Drug-to-drug interactions
Use cautiously with MAOIs
Examples of Oral Decongestants
Pseudoephedrine
Expectorant functions
Loosens bronchial secretions, allowing easier movement of the secretions
Side effects for expectorants (4)
- GI symptoms (mucus in stomach)
- Headache
- Dizzy
- Prolonged use may result in masking an underlying disorder
Antitussive function
-Act directly on the medullary cough center on the brain t depress the cough reflex
Antitussive pharmacokinetics (3)
- Rapidly absorbed
- Metabolized in the liver
- Excreted in the urine
Antitussive contraindication
Patients who need to cough to maintain the airway
Caution of Antitussive (2)
- Hypersensivity
- Narcotic addiction
Side effects of Antitussives (3)
- Drying effect on the mucous membranes
- CNS side effects
- GI upset
Examples of Antitussives (3)
- Guaifenesin
- Hydrocoone (Hycodan)
- Dextromethorphan (Benylin)
Sympathomimetics function
Dilation of the bronchioles
Sympathomimetics Indications (3)
- Acute asthma attack
- Bronchospasm in acute or chronic asthma
- Prevention of exercise-induced asthma
Pharmacokinetics of Sympathomimetics (2)
- Rapidly distributed
- Fast acting
Side Effects of Sympathomimetics (9)
- SNS activation
- GI upset
- Arrhythmias
- HTN
- Bronchospasm
- Sweating
- Pallor
- Flushing
- Increased blood glucose levels
Sympathomimetics drug to drug interactions
General anesthetic
Examples of Sympathomimetics (3)
- albuterol (Proventil)
- salmeterol (Serevent)
- Epinephrine (Epi-pen)
Anticholinergic functions
- Blocks vagar-mediated reflexes by antagonizing the action of acetylcholine
- Not used for acute attacks
- Dilation of airway
Indications of Anticholinergic
Maintenance treatment of bronchospasm associated COPD
Pharmacokinetics of Anticholinergic (2)
- Onset of action is 15 minutes when inhaled
- Peaks in 1-2 hours, duration of action is 3-4 hours
Caution associated with Anticholinergic
Could cause dysrhythmias
Anticholinergic side effects
- Related to the Anticholinergic effects of the drug
- Dizziness
- Headache
- Fatigue
- Nervousness
- Dry mouth
- Sore throat
Examples of Anticholinergics (2)
- ipratropium (Atrovent)
- Tiopropium (Spiriva)
Xanthine function
Relaxes the smooth muscles of the bronchi causing bronchodilation
Xanthine indications
- Symptomatic relief of chronic, stable asthma, and COPD
- When other drugs failed to show improvement
Xanthine pharmacokinetics (2)
- Narrow therapeutic margin
- Rapidly absorbed from the GI tract
Xanthine Contraindications (
- GI problems
- Coronary disease
- Respiratory dysfunction
- Renal problems
- Hepatic disease
Xanthine Side Effets (2)
- Related to theophylline levels in the blood
- GI upset, nausea, irritability
Xanthine drug to drug interaction (2)
- Nicotine increases the metabolism
- Too much can be toxic
Examples of Xanthine (2)
- Aminophylline
- Theophyline
Leukotrine Receptor Antagonists function
- Block or antagonize receptors for the production of leukotrines
- Decreases the inflammatory response to allergic ad environmental stimuli
Leukotriene Receptor Antagonists indication (2)
- Prophylaxis and chronic treatment of bronchial asthma
- Maintenance medication
Pharmacokinetics of Leukotriene Receptor Antagonists
Rapidly absorbed from GI tract
Caution of Leukotriene Receptor Antagonist
Hepatic or renal impairment
Leukotriene Receptor Antagonist Example
- montelukast (Singulair)
- Zafirlukast (Accolate)
Inhaled Steroid Function
Decrease the inflammatory response in the airway
Inhaled Steroids Indications (2)
- Prevention and treatment of asthma, COPD, emphysema
- Treat chronic steroid-dependent bronchial asthma
Pharmacokinetics of Inhaled Steroids (2)
- Well absorbed from the respiratory tract
- Not a lot of systemic side effects
Contraindication to Inhaled Steroids
Not used for emergency during an acute attack
Inhaled Steroid side effects (5)
- Sore throat
- Hoarseness
- Coughing
- Dry mouth
- Pharyngeal and laryngeal fungal infections
Examples of Inhaled steroids (2)
- beclomethasone (Beclovent)
- Budesonide (Pulmicort)
Mucolytic functions
- Works to breakdown mucus
- Aids cough
- Does not open bronchioles
Mucolytic Inidcations (3)
- Patients who have difficulty coughing up secretions
- Postoperative patients
- Patients wit tracheostomies
Pharmacokinetics of Mucolytic
-Nebulization or direct instillation into the trachea
Caution of Mucolytic (3)
- Acute Bronchospasm
- Esophageal varices
- Due to constant thoracic pressure from hard coughing due to increased mucus thickness
Example of Mucolytic
Acetylcysteine (Mucomyst)
Lower Respiratory Agents are used in children to…(
- Likely Leukotriene
- Used with beta-antagonists for acute attacks
Lower Respiratory Agents in older adults
Liver and renal impairment