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Pnur 155 Pharmocology > Class 6 Respiratory Drugs > Flashcards

Class 6 Respiratory Drugs Flashcards

0
Q

Main action of antihistamine drugs

A

Directly compete with histamine for specific unoccupied receptor sites (histamine 1) to prevent consequences of histamine stimulation

Cannot push histamine off receptor if already bound, so take drug before exposure or when histamine isn’t at site

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1
Q

Name five drug classes used for the upper respiratory system

A

Antihistamines
Decongestants
Antitussives
Expectorants

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2
Q

Properties of antihistamines

A

Sedation
Drowsiness
Drying of mucus membranes

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3
Q

Histamine mediated disorders

A 
Allergic rhinitis (dust allergies)
Anaphylaxis
Angioedema
Drug fevers
Insect bite reactions
Urticaria
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4
Q

Define angioedema

A

Swelling around eyes

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5
Q

Define uticaria

A

Itching

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6
Q

Indications for antihistamines

A

Management of:

  • nasal allergies
  • seasonal allergies
  • allergic reactions
  • motion sickness (h2 receptors)
  • Parkinson’s drooling
  • sleep disorders
  • sneezing or runny nose
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7
Q

Antihistamine Contraindications

A 
Acute asthmatic attacks
Glaucoma
Heart disease
Kidney disease
Hypertension
Children and elderly (sedative) 
Pts who drive/operate machinery
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8
Q

Antihistamine adverse effects

A

Anticholinergic effects
Drowsiness
Changes to vision
Hypertension

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9
Q

Interactions with antihistamines

A

Alchohol
MAOIs
CNS depressants
Apple, grapefruit or orange juice

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10
Q

Two types of antihistamines

A

1) Traditional: effects CNS and PNS
- sedative & Anticholinergic effects

2) non sedating: effects PNS
- no sedative or CNS effects

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11
Q

Describe action of non sedating antihistamines

A

Works peripherally to block actions of histamine to lessen sedative side effects

Longer duration of action

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12
Q

Antihistamine implications

A
  • instruct patient to notify if excessive sedative effect
  • avoid driving
  • take with meals (reduce gi upset)
  • perform mouth care
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13
Q

Three types of decongestants

A

1) Adrenergics (sympathomimetics)
2) anticholinergics (parasympatholytics)
3) corticosteroids (intranasal)

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14
Q

Two methods of application for decongestants

A

Orally
Inhaled
Topically applied to nasal membrane

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15
Q

Action of adrenergic decongestant

A

Act in nasal by constricting blood vessels that supply upper resp tract

Results in shrinking tissues to drain nasal secretions to relieve stuffiness

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16
Q

Action of nasal corticosteroids as a decongestant

A

Act on blood vessels surrounding sinuses by decreasing inflammatory response (decreases basophils and mast cells)

Results in decreased inflammation and decreased congestion

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17
Q

Indications for nasal decongestants

A 
Nasal congestion
Acute or chronic rhinitis
Common cold
Hay fever
Allergies
Reduce swelling of nasal b4 surgery
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18
Q

Nasal decongestant contraindications

A 
Glaucoma
Uncontrolled cv disease
Hypertension
Diabetes
Prostatitis
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19
Q

Adverse effects of nasal decongestants

A

Systemic Effects (CNS) due to stimulation of heart and blood vessels

  • nervousness
  • increased HR/palpitations
  • tremors
  • dryness
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20
Q

Nasal decongestants nursing implications

A

Monitor bp and pulse
Avoid stimulants
Take at prescribed time

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21
Q

Use of antitussives

A

Drugs used to stop or reduce coughing

Only used for nonproductive cough or when coughing is harmful (after hernia surgery)

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22
Q

Two ways coughing is beneficial

A

Removes excess secretions

Removes potentially harmful substances

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23
Q

Two types of antitussives

A

1) opioids

2) non opioids

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24
Action of an opioid antitussive
Suppress cough reflex by acting directly on cough center in medulla (reflex center)
25
Two examples of opioid antitussive
Codeine | Hydrocodone
26
Action of non opioid antitussive
Suppress cough reflex by numbing stretch receptors in resp tract and preventing stimulation of cough reflex
27
One example of non opioid antitussive
Dextromethorphan
28
Contraindications for antitussives
opioid Dependance | High risk for resp depression
29
Adverse effects of antitussives
``` Dizziness Resp depression Nausea Sedation Constipation Addictive qualities ```
30
Nursing implications for antitussives
Assess if cough productive or not If there's lung sounds present Don't drive or operate machinery Wait to eat 20-30 minutes
31
Action of expectorants
Drugs that aid to produce productive cough and expectoration of mucus by: - reducing viscosity of secretions - thinning secretions
32
Two types of expectorants
1) reflex stimulation | 2) direct stimulation
33
Action of reflex stimulation expectorants and give an example
Loosen and thin resp secretions by irritating gi tract Ex. Robitussin
34
Action of direct stimulation expectorants and give an example
Secretory glands are stimulated directly to increase production of resp tract fluid Ex. Iodinated glycerol
35
Expectorant indications
Relieving productive coughs from: - common cold - bronchitis - laryngitis - pharyngitis - sinusitis
36
Expectorant contraindications
Hyperkalemia (they contain potassium)
37
Name four drug classes used in lower resp tract
Bronchodialators Anticholinergics Antileukotrienes Corticosteroids
38
Two types of Bronchodialators
B adrenergic agonists | Xanthine derivatives
39
Use of beta agonist Bronchodialators
Used during acute asthma stacks to quicky reduce airway constriction and resort airflow by stimulating beta 2 receptors in lungs Either selectively or nonselectively
40
Beta agonist bronchodilators indications
- acute asthma attacks - bronchospasm - treatment of hypotension and shock
41
Beta agonist bronchodialator actions
Relaxes smooth muscle of the airway which results in bronchial dilation and increased airflow Quick and fast action
42
Beta agonist bronchodialator contraindications
- uncontrolled dysrythmias (stimulates both beta receptors) | - high risk stroke pts
43
Example of beta agonist bronchodialator
Salbutamol
44
Action of anticholinergics
Prevents acetylcholine from binding to receptors to prevent bronchial constriction and narrowing of airways Results in bronchodialation and increased airway flow ** not used for acute exacerbations
45
Two examples of anticholinergics
Atrovent | Spiriva
46
Anticholinergic adverse effects
``` Dry mouth Nasal congestion Increased HR/palpitations Gi distress Anxiety ```
47
Use of xanthine derivative bronchodialators
Inhibits enzyme that breaks down CAMP to increase CAMP levels which results in bronchodialation, smooth muscle relaxation and increased airflow
48
Function of camp
Maintains open airways by relaxing smooth muscle and inhibits release of chemical mediators thag cause inflammation
49
Effects of xanthine derivatives
Stimulation of cv system - increases cardiac output - increased blood flow to kidneys (diuretic effect) Bronchodialation Stimulation of CNS
50
Indications of xanthine derivatives
Dialation of airways in asthma, chronic bronchitis and emphysema Mild to moderate acute asthma Adjunct in managing COPD
51
Adverse effects
Nausea, vomiting Gi reflex during sleep Tachycardia and palpitations Increased urination
52
Use of antileukotrienes
Prevents leukotrienes from attaching to receptors on circulating immune cells to block inflammation in lungs and relieve asthma symptoms
53
Examples of xanthine derivatives
Theophylline | Aminophylline
54
Define leukotrienes
Substances released that cause inflammatory response - mast cells - basophils
55
Indications of antileukotrienes
Prevention/long term treatment of asthma Not used for acute attacks
56
Example of antileukotrienes
Montelukast
57
Function of basophils
Type of granual white blood cell that contains histamine and heparin which functions for inflammation and anticoagulant
58
Function of neutrophils
Granual white blood cell that functions to destroy invading organisms and also attack other WBCs
59
Function of lymphocytes
Attacks infecting microbial or cancer cells Produce antibodies against specific antigens
60
Function of monocytes
Produce macrophages to engulf large bacteria or virus infected cells
61
Use of corticosteroids
Used for chronic asthma but do not relieve acute attacks Anti-inflammatory effects by decreasing anti inflammatory substances (WBCs and Leukocytes) to increase beta adrenergic stimulation
62
Contraindications for corticosteroids
Pts with systemic fungal infection
63
Corticosteroids adverse effects
Oral fungal infections
64
Patient teaching corticosteroids
Oral care during treatment to prevent thrush Don't stop dose abruptly
65
Examples of antihistamine
Benadryl | Claritin
66
Function of a mucolytic
Breaks up mucus Ex. Acetylcysteine

Pnur 155 Pharmocology (7 decks)

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