Chapter 37, Respiratory drugs

Question 1

Assessments for patient taking beta agonists.

Answer 1

allergies to fluorocarbon
taking of caffeine (chocolate, tea, coffee, candy, sodas).
use of OTC medications containing caffeine (appetite suppressants, pain relievers).
educational level and readiness to learn.

Question 2

why is the intake of caffeine important to determine in patient taking beta agonists such as albuterol?

Answer 2

because of its sympathomimetic effects and possible potentiation of adverse effects such as tachycardia, hypertension, vascular headache and tremors.

Question 3

what should the nurse include in the assessments of patient taking anticholinergic drugs?

Answer 3

history of GI disorders
heart palpitations 
BPH
hyperplasia
glaucoma 
allergy to soy lecithin, peanut oils, peanuts, soybeans, other legumes.
bronchospasms

Question 4

Assessments for patients taking xanthine derivatives (eg. theophylline)

Answer 4

Cardiac and neurologic
GI reflux- assess for bowel and preexisting disease such as gastroesophageal reglux, ulcers.
results of renal and liver function test
urinary patterns (due to transient urinary frequency)
dietary questions about low-carbohydrate, high-protein, and charcoal-broiled meat.
OTC medications and caffeine containing foods.

Question 5

what are SxS of xanthine toxicity

Answer 5

N/V, restlessness, insomnia, irritability and tremors.

Question 6

what are glucocorticoids used for?

Answer 6

their antiinflammatory effects

Question 7

what are the effects of beta agonists and xanthines

Answer 7

bronchodilating effects

Question 8

what assessments should be made with patient taking corticosteroids( glucocorticoids)

Answer 8

V/s, breath sounds and heart sounds,
underlying adrenal disorders
age

Question 9

what are the indications for beta-adrenergic agonists

Answer 9

relief of bronchospasm related to bronchial asthma, bronchitis and pulmonary disease.
hypotension
shock

Question 10

what are some contraindications for the use of beta-adrenergic agonists.

Answer 10

drug allergy
uncontrolled cardiac dysrhythmias
high risk of stroke-because of the vasoconstrictive drug actions.

Question 11

what are some of the adverse effects of beta-adrenergic agonits

Answer 11

insomnia
restlessness
anorexia
cardiac stimulation
hyperglycemia
tremor 
vascular headache
anginal pain

Question 12

what are the two anticholinergic drugs used in the treatment of COPD?

Answer 12

ipratropium

tiotropium

Question 13

MOA for anticholinergics

Answer 13

The block the ACh receptors on the surface of the bronchial tree to prevent bronchoconstriction causing airway dilation

Question 14

what are anticholinergics used for?

Answer 14

prevention of bronchospasm associated with chronic bronchitis or emphysema.

Question 15

what are some contraindications for the use of anticholinergics

Answer 15

allergy to atropine
soy lecithin
peanut soils
soybeans and other legumes (beans)

Question 16

what are the most common adverse effects of anticholinergic drugs

Answer 16

dry mouth or throat
nasal congestion
heart palpitations
GI distress
urinary retention
increased intraocular pressure
headache
coughing 
anxiety

Question 17

what are xanthine derivatives used for?

Answer 17

to dilate the airways in patients with asthma
adjunct bronchodilators for 
chronic bronchitis or emphysema.
adjunct drug in the management of COPD
prevention of asthmatic symptoms
CNS stimulant to promote alertness
cardiac stimulant

Question 18

contraindications for xanthine derivatives

Answer 18

drug allergy
uncontrolled cardiac dysrhythmias 
seizure disorders
hyperthyroidism 
peptic ulcers

Question 19

what are some common adverse effects of xanthine derivatives

Answer 19

N/V
anorexia 
gastroesophageal reflux
sinus tachycardia 
extrasystole
palpitations
ventricular dysrhythmias 
urination and hyperglycemia

Question 20

what are LTRAs use for

Answer 20

the prophylaxis and long-term treatment of asthma

allergic rhinitis.

Question 21

what are the contraindications of LTRAs

Answer 21

allergy to povidone
lactose
titanium dioxide
cellulose derivatives

Question 22

list some of the adverse effects when using LTRAs

Answer 22

headaches
dyspepsia
nausea
dizziness
insomnia
diarrhea
nausea
liver dysfunction

Question 23

what are some drugs that interact with LTRAs

Answer 23

warfarin
digoxin
theophylline
prednisone 
estrogen
progestin

Question 24

what are the indications for corticosteroids

Answer 24

primary treatment of bronchospastic disorders.

Treat acute exacerbations or severe asthma (systemic)

Question 25

contraindications of corticosteroids

Answer 25

not intended as sole therapy for acute asthma attacks.
patients with hypersensitive to glucocorticoids .
patients who sputum tests positive for candida organisms.
patients with systemic fungal infections.

Question 26

what are some systemic drug effects of corticosteroid

Answer 26

adrenocortical insufficiency
increased susceptibility to infection
F and E disturbances
endocrine effects
insomnia
nervousness
seizures
brittle skin
bone loss
osteoporosis

Question 27

a patient who is taking a xanthine derivative asks the nurse about drinking coffee with the medication. what would be the nurse’s best answer?

Answer 27

coffee, tea, chocolate, cocoa and cola beverages contain xanthine.
Consumption of these beverages increase or exacerbates the CNS which may have a severe impact and could be life threatening.
The caffeine containing products should be avoided while on xanthine.

Question 28

A patient who is prescribed LTRA asks the nurse if this new medicine will help treat an asthma attack. What would be the nurse’s best answer?

Answer 28

They are used for prophylaxis in asthmatic attacks when taken on a long-term basis.
There are not used to treat acute attacks.
For best effect, patient should take the medication regularly, as ordered even if the symptoms improve and patient is feeling better.
it takes several weeks for full therapeutic effects to occur.