Chapter 9 - Mucus Drugs Flashcards
What are the surface epithelial cells of the mucociliary system?
Pseudo stratified columnar Ciliated
Goblet cells
Clara cells
What are the cells in the submucosal layer?
Serous
Mucous
What sputum composed of?
Mixed inflammatory cells
Cellular debris
Bacteria
What drugs are called mucoregulatory medications?
- corticosteroids
- indomethacin
- macrolide antibiotics
- anti-cholinergic agents
What are mucoregulatory drugs useful in?
Broncorrhea associated with airway inflammation.
-decreased hypersecretion
What are some therapeutic options for hypersecretion?
Remove causative factors
Optimize clearance(bronchodilators/coughing)
Use mucoactive agents when indicated
What is mucomyst used for?
2 things
- Mucolytic
- acetaminophen OD
What is the mode of action for mucomyst?
Disrupts Di-sulfide bonds
What’s a hazard of mucomyst?
Bronchodpasms
What are some secondary complications of mucomyst?
NSR
Nausea
Rhinorrhea
Stomatitis
What are you not allowed to mix with NAC?
Antifungals
Antibiotics
What is dornase Alfa used for?
- Mucoactive agent for CF pts and to preserve or improve their LUNG FUNCTION
- to reduce respiratory infections that require paraenteral antibiotics
What does dornase Alfa do to non-CF airways diseases?
No efficacy
What is the mode of action of Dornase alfa?
Decreases viscocity and adhesivity
-decreases DNA of sputum
What are the storage requirements of dornase Alfa?
Refrigerate and protect for light
What are the common side effects are of dornase Alfa?
Voice alternations
Inflammation of larynx and pharynx
Rash
Chest pain
What are some expectorants?
MSGS SSKI(iodine containing) Sodium bi-carb Guaifenesin Mannitol(oligosaccaride)
What is something you give a patient before using broncotol?
SABA
What do beta agonists do to cilia?
-Increase beat frequency, but doesn’t really effect mucous clearance
What’s an issue with using a bronchodilator for airway clearance?
It opens up the airway, but by relaxing the airway, it can cause collapse in floppy airways.
This can cause plugging
What are some mucokenetic agents?
Bronchodilators
Surface phospholipids
What is the % concentration of hypertonic saline?
7%
Which patients are too risky to give gravity postural drainage therapies to?
GERD
Muscle weakness
What is insufflation/exsufflation exercise?
Using machines to give positive pressure to inflate then negative pressure to stimulate coughing
Who would benefit from insufflation/exsufflation exercises?
- COPD
- neurological muscle weakness patients who can’t cough
What are the steps of the active cycle breathing (ACB)?
-take breath at mid-volume inhale
-squeeze are out air from chest and abdomen
(It shouldn’t be a violent huff)
What is a mucolytic agent?
An agent that breaks down mucus
What is a cause for decreased secretions in CF patients?
Defective ion transports for sodium and chloride
What 2 destructive forces do bronchial secretions stop?
- alpha 1 protease enzymes
- leukoproteases
What are some diseases involved in hypersecretion is mucus?
- chronic bronchitis
- asthma
- bronchorrhhea
What do diseased CF lung airways consist of?
DNA-rich pus
How do you describe the mucus airways of CB patients?
Excessive number of goblet and submucosal glands
Which causes hypersecretion
What is an issue with asthmatic patients who have been under constant beta agonist usage when diagnosed for hypersecretion?
Beta agonists may induce secretion of viscous mucus.
Aggressive usage may contribute to airway obstruction
What is a mucokenetic agent?
Increase cough clearance by increasing expository flow or by reducing sputum adhesivity and tenacity
What’s the mode of action for anticholenergic agents with regards to mucoregulatory treatment?
They stop production of mucous by inhibiting M3 cholinergic mechanisms.
They don’t dry secretions
What is hyperosmolar saline used for?
To induce sputum for testing
What is autogenic drainage?
Incorporating staged breathing techniques to collect sputum in central airways.
Then suppress coughs but keep building volume of breaths over time until you get to a moment where you can cough out a lot
What is a draw back to autogenic drainage?
It requires lots of coordination.
Patients over 8 years old
What is a form of PAP that people can do themselves?
Pursed lip breathing used by COPD patients
