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Pharm > Chapter 6 - Respiratory Drugs > Flashcards

Chapter 6 - Respiratory Drugs Flashcards

1
Q

What is an example of a first-generation antihistamine? (H1-blocker- antagonist)

A

Diphenhydramine (Benadryl)

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2
Q

What is COPD’s pathophysiologic changes?

A

Airway obstruction with increased airway resistance to airflow

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3
Q

Major disorders of COPD?

A

Chronic bronchitis, bronchiectasis, emphysema, asthma

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4
Q

Reactive airway disease=

A

Asthma

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5
Q

Triggers of asthma

A

hypersensitivity, URI, exercise, air pollutants, resp infections, GERD

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6
Q

Side effects of asthma

A

cough, increased mucus, shortness of breath, wheezing and prolonged expiration, increased CO2 retention, chest tightness. retractions

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7
Q

If symptoms of asthma do not respond to usual treatment in 30 mins., client should….

A

seek medical attention.

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8
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disease

Chronic airflow limitation. (emphysema and chronic broncitis)

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9
Q

What happens to patients with COPD?

A

Easily fatigued, frequent resp. infections, use of accessory, muscles to breathe, orthopneic, cor pulmonale (late in disease), thin in appearance, wheezing, pursed-Lip breathing, Chronic Cough, Barrel Chest, dyspnea, prolonged expiratory time, bronchitis- increased sputum, digital clubbing

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10
Q

What is an example of a second-generation antihistamine? (non-sedating antihistamines; little to no effect on sedation)

A

Cetirizine (Zyrtec)
Fexofenadine (Allegra)
Loratadine (Claritin)

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11
Q

What should a nurse watch for when taking antihistamines?

A

Drowsiness, tachycardia, dry nose & throat, urinary frequency & hypotension

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12
Q

What is the action of Benadryl?

A

Competes with histamine for receptor sites

Reduces nasopharyngeal secretions, itching, sneezing

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13
Q

What is Benadryl is used for what?

A

Treats acute and allergic rhinitis, antitussive
Rhinitis-stuffy nose- irritation and swelling of the mucous membranes in nose
Antitussive- relieve dry cough

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14
Q

What are side effects of Benadryl?

A

Drowsiness, dry mouth, dizziness, blurred vision, wheezing, photosensitivity, urinary retention, constipation, GI distress, blood dyscrasias

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15
Q

What does Benadryl interact with?

A

Increases CNS depression with alcohol and other CNS depressants
Avoid use of MAOI’s

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16
Q

What are 3 systemic decongestants?

A

Ephedrine, Phenylephrine, Pseudoephedrine

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17
Q

Bronchodilators are

A

B2 adrenergic agonist

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18
Q

Bronchodilator side effects:

A

Tachycardia, headache, irritability, anginal, pain and tremors

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19
Q

Bronchodilator (B2 adrenergic agonist) examples

A

Salmeterol (Serevent), Terbutaline (Brethine), Albuterol (Proventil)

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20
Q

Name 5 topical decongestants

A

Ephedrine, Epinephrine, Phenylephrine, Naphazoline, Tetrahydrozoline (red-eye drops)

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21
Q

Whats the best mucolytic? (gets rid of mucous)

A

Drinking lots of water !!

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22
Q

Nasal congestion is caused by what?

A

Dilate nasal blood vessels due to infection, inflammation and allergy
Transudation of fluid into tissue spaces- leads to swelling of nasal cavity

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23
Q

Nasal decongestants stimulate alpha-adrenergic receptors to do what?

A
  • Produces nasal vascular vasoconstriction
  • Shrinks nasal mucous membranes
  • Reduces nasal secretion
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24
Q

Short acting beta2 adrenergic agonists

A

Albuterol, metaproterenol, Terbutaline (systemic)

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25
Q

Long acting beta2 adrenergic agonists

A

albuterol, salmeterol
Combination agents -Abuterol and Ipratropium
-salmeterol and fluticasone

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26
Q

Selective beta 2 adrenergic agonists- terbutaline and metaproterenol. What are there actions and administration?

A

Action: relaxes smooth muscle of bronchi
Administraiton: Oral, inhalation, subQ

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27
Q

Side effects of terbutaline and metaproterenol.

A

tremors, restlessness, anxiety, headaches, nervousness, tachycardia, palpitations, dysrhythmias, hyperglycemia

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28
Q

Beta2-adrenergic agonists

Pharmacokinetics

A

Minimally absorbed by the GI tract
Inhaled forms absorbed from the respiratory tract
Metabolized in the liver
Excreted in urine and stool

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29
Q

Beta2 adrenergic agonists

Pharmacodynamics and pharmacotherapeutics

A

Dynamics- bronchodilation

therapeutics- asthma and COPD

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30
Q

Decongestants can ___ ___ ___!!

A

dry you OUT

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31
Q

Intranasal Glucocorticoids

A

Fluticasone (Flonase)

Triamcinolone (Nasacort)

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32
Q

How do systemic decongestants work?

A

vasoconstriction through alpha-adrenergic receptors in blood vessels of the body

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33
Q

How do topical decongestants work?

A

Vasoconstriction through alpha-adrenergic receptors in nasal blood vessels

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34
Q

Some nasal decongestants include…

A

Oxymetazoline (Afrin)
Naphazoline (Allerest)
Pseudoephedrine (Sudafed)

Types: nasal spray, nasal drops, tablet, capsule, liquid

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35
Q

What are some drug interactions with nasal decongestants?

A

Sudafed may decrease effect of beta blockers
May increase HTN, dysrhythmias with MAOI’s
May increase restlessness, palpitations with caffeine (coffee, tea)

36
Q

Drug interaction for beta2 adrenergic agonists

A

beta adrenergic blockers

37
Q

adverse reactions for beta2 adrenergic agonists

A

brochospasm, tachycardia, palpitations, tremors

38
Q

Ipratropium is a

A

anticholinergic

39
Q

A person should not use a nasal decongestant for more than __ days

A

5

40
Q

What are the adverse reactions of systemic and topical nasal decongestants?

A

Systemic:
Nervousness, restlessness, and insomnia, nausea, palpitations, tachycardia, elevated blood pressure, difficulty urinating
Topical:
Rebound nasal congestion, burning and stinging of nasal mucosa, sneezing, mucosal dryness or ulceration

41
Q

anticholinegics: Ipratropium
Pharmacokinetics
pharmacodynamics

A 
Pharmacokinetics
Minimally absorbed by the GI tract
Inhaled forms exert effects locally
Pharmacodynamics
Bronchodilation
42
Q

anticholinergics: Ipratropium pharmacotherapeutics

A

Pharmacotherapeutics
Asthma (adjunctive therapy)
COPD

43
Q

Anticholinergics
Ipratropium bromide (Atrovent)
Ipratropium (Combivent)
What is the action and administration?

A

Action: dilates bronchioles
Administration: aerosol inhaler

44
Q

what is a caution of bronchodilators, anticholinergics?

A

Narrow-angle glaucoma- is a sudden acute type of glaucoma

45
Q

Anticholinergics: Ipratropium
Drug interactions
and adverse reactions

A 
Drug interactions
Uncommon
Adverse reactions
Paradoxical bronchospasm
Tachycardia
Nausea and vomiting
Nervousness
Dry mouth
46
Q

Inhaled corticosteroids

A

Beclomethasone dipropionate
Budesonide (Pulmacort)
Fluticasone propionate
Triamcinolone acetonide- topical

47
Q

Oral corticosteroids

A 
Prednisolone
Prednisone
IV corticosteroids
Dexamethasone 
Hydrocortisone sodium succinate
Methylprednisolone sodium succinate
48
Q

Pulmicort is for long term management of what

A

asthma

49
Q

pulmicort is

A

an anti-inflammatory and anti-allergy medication used to suppress the inflammatory response reducing bronchial hyperreactivity

50
Q

Pulmicort is contraindicated with

A

hypersensitivities to corticosteroids. DO not abruptly switch from oral corticosteroids to inhaled corticosteroids. Use with caution in clients with adrenal and liver problems.

51
Q

Intranasal Glucocoorticoids

A

Fluticasone (Flonase)

Triamcinolone (Nasacort)

52
Q

Intranasal Glucocorticoids. What is the action and use?

A

Action:
Antiinflammatory
Use:
Treat allergic rhinitis
May be used alone or in combination with H1 antihistamines
Dexamethasone should not be used longer than 30 days to avoid systemic effects.
Prescription in USA

53
Q

Corticosteroids

Pharmacokinetics

A 
Pharmacokinetics
Oral forms: Readily absorbed and metabolized in the liver
Inhaled forms: Minimally absorbed 
(DOES NOT mean not effective)
IV forms: Rapid onset
54
Q

Corticosteroids pharmacodynamics

A

Pharmacodynamics

Cytokine, leukotriene, and prostaglandin inhibition; recruit eosinophils; release other inflammatory mediator

55
Q

Corticosteroids pharmacotherapeutics

A

Pharmacotherapeutics

Asthma

56
Q

advair and spiriva do what

A

keep the air moving

57
Q

what should you do to the advair tablets?

A

Crush the tablet in the diskus

58
Q

what should you do to the spiriva capsule?

A

puncture the capsule in the handihaler

59
Q

Advair contains what?

A

contains a corticosteroid to decrease inflammation.

60
Q

spiriva prevents what?

A

brochospasm

61
Q

Corticosteroids

Drug interactions

A 
Drug interactions
Hormone contraceptives
Ketoconazole
Macrolide antibiotics
Barbiturates
Cholestyramine
Phenytoin
62
Q 
corticosteroids 
Adverse reactions          (inhaled forms)
A 
Adverse reactions          (inhaled forms)
Mouth irritation
Oral candidiasis
Upper respiratory infection (URI)
Cough and hoarseness
63
Q

corticosteroids
Adverse reactions
(oral forms)

A 
(oral forms)
Nausea and vomiting
Headache, insomnia
Hyperglycemia
Growth suppression in children
64
Q

What is the most common antitussive? (anti-cough)

A

Nyquil - dextromethorphan hydrobromide

65
Q

Dextromethorphan is one of the most active ingredients in many OTC ____ _______?

A

Cough medicines
Ex: Mucinex DM, Robitussin, Nyquil, Vicks, TheraFlu, etc.

Forms: syrup, tablet, spray and lozenge

66
Q

Due to this, detromethorphan degrades over time and loses its purity

A

Is unstable

67
Q

A type of mucolytic, acetylcysteine (Mucomyst) does what?

A

Liquifies and loosens thick mucus secretions

68
Q

How should Mucomyst be administered?

A

5 min. after a bronchodilator, should not be mixed with other drugs

69
Q

This is an antidote for acetaminophen overdose if given within 12-24 hours

A

Acetylcysteine (Mucomyst)

-given orally, diluted in juice or soft drink

70
Q

A type of Expectorant

A

Guaifenesin (Mucinex)

71
Q

What does Mucinex do?

A

Loosens bronchial secretions by reducing surface tension of secretions, soothes mucous membranes, resp tract fluid production increases

72
Q

What is Mucinex used for and what are possible side effects?

A

Dry, nonproductive cough

SE: drowsiness, nausea

73
Q

You would not want to take the expectorant- Guaifenesin if you have what?

A

Right-sided HF or fluid in the lungs

74
Q

Methylxanthines are used for what conditions?

A

Asthma, chronic bronchitis, emphysema

75
Q

What do methylxanthines do?

A

Bronchodilation, inflammatory mediator reduction, bronchospasm reduction

76
Q

Name 2 drugs that are methylxanthines

A

Aminophylline (Somophyllin)

Theophylline (SloBid)

77
Q

What is the action of methylxanthines?

A

Relaxes smooth muscle of bronchi, bronchioles increase cAMP (chemical that helps relax smooth muscle) PROMOTING BRONCHODILATION

78
Q

Name two leukotriene receptor antagonists:

A

Zafirlukast (Accolate)

Montelukast (Singulair)

79
Q

What are leukotriene receptor antagonists used for?

A

prophylactic and maintenance for chronic asthma

80
Q

How do leukotriene receptor antagonists work?

A

reduce inflammatory process and decrease bronchoconstriction

81
Q

Why aren’t leukotriene receptor antagonists used in emergencies?

A

Because they are highly protein bound when taken orally

82
Q

leukotriene receptor antagonists side effects:

A

Dizziness, HA, GI distress, abnormal liver enzymes, nasal congestion, cough, pharyngitis

83
Q

Name two types of aerosol inhalers:

A

Metered-dose inhaler (MDI)

Dry powdered inhaler (DPI)

84
Q

What should we teach our patient about using bronchodilators (inhalers)?

A

use inhaler correctly and take care of equipment correctly

85
Q

Frequent dosing of inhalers can cause what?

A

tremors, nervousness, tachycardia

Pharm (9 decks)

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