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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
Q

Action of an opioid antitussive

A

Suppress cough reflex by acting directly on cough center in medulla (reflex center)

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25
Q

Two examples of opioid antitussive

A

Codeine

Hydrocodone

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26
Q

Action of non opioid antitussive

A

Suppress cough reflex by numbing stretch receptors in resp tract and preventing stimulation of cough reflex

27
Q

One example of non opioid antitussive

A

Dextromethorphan

28
Q

Contraindications for antitussives

A

opioid Dependance

High risk for resp depression

29
Q

Adverse effects of antitussives

A 
Dizziness
Resp depression
Nausea
Sedation
Constipation
Addictive qualities
30
Q

Nursing implications for antitussives

A

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
Q

Action of expectorants

A

Drugs that aid to produce productive cough and expectoration of mucus by:

  • reducing viscosity of secretions
  • thinning secretions
32
Q

Two types of expectorants

A

1) reflex stimulation

2) direct stimulation

33
Q

Action of reflex stimulation expectorants and give an example

A

Loosen and thin resp secretions by irritating gi tract

Ex. Robitussin

34
Q

Action of direct stimulation expectorants and give an example

A

Secretory glands are stimulated directly to increase production of resp tract fluid

Ex. Iodinated glycerol

35
Q

Expectorant indications

A

Relieving productive coughs from:

  • common cold
  • bronchitis
  • laryngitis
  • pharyngitis
  • sinusitis
36
Q

Expectorant contraindications

A

Hyperkalemia (they contain potassium)

37
Q

Name four drug classes used in lower resp tract

A

Bronchodialators
Anticholinergics
Antileukotrienes
Corticosteroids

38
Q

Two types of Bronchodialators

A

B adrenergic agonists

Xanthine derivatives

39
Q

Use of beta agonist Bronchodialators

A

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
Q

Beta agonist bronchodilators indications

A
  • acute asthma attacks
  • bronchospasm
  • treatment of hypotension and shock
41
Q

Beta agonist bronchodialator actions

A

Relaxes smooth muscle of the airway which results in bronchial dilation and increased airflow

Quick and fast action

42
Q

Beta agonist bronchodialator contraindications

A
  • uncontrolled dysrythmias (stimulates both beta receptors)

- high risk stroke pts

43
Q

Example of beta agonist bronchodialator

A

Salbutamol

44
Q

Action of anticholinergics

A

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
Q

Two examples of anticholinergics

A

Atrovent

Spiriva

46
Q

Anticholinergic adverse effects

A 
Dry mouth
Nasal congestion
Increased HR/palpitations
Gi distress
Anxiety
47
Q

Use of xanthine derivative bronchodialators

A

Inhibits enzyme that breaks down CAMP to increase CAMP levels which results in bronchodialation, smooth muscle relaxation and increased airflow

48
Q

Function of camp

A

Maintains open airways by relaxing smooth muscle and inhibits release of chemical mediators thag cause inflammation

49
Q

Effects of xanthine derivatives

A

Stimulation of cv system

  • increases cardiac output
  • increased blood flow to kidneys (diuretic effect)

Bronchodialation

Stimulation of CNS

50
Q

Indications of xanthine derivatives

A

Dialation of airways in asthma, chronic bronchitis and emphysema

Mild to moderate acute asthma

Adjunct in managing COPD

51
Q

Adverse effects

A

Nausea, vomiting
Gi reflex during sleep
Tachycardia and palpitations
Increased urination

52
Q

Use of antileukotrienes

A

Prevents leukotrienes from attaching to receptors on circulating immune cells to block inflammation in lungs and relieve asthma symptoms

53
Q

Examples of xanthine derivatives

A

Theophylline

Aminophylline

54
Q

Define leukotrienes

A

Substances released that cause inflammatory response

  • mast cells
  • basophils
55
Q

Indications of antileukotrienes

A

Prevention/long term treatment of asthma

Not used for acute attacks

56
Q

Example of antileukotrienes

A

Montelukast

57
Q

Function of basophils

A

Type of granual white blood cell that contains histamine and heparin which functions for inflammation and anticoagulant

58
Q

Function of neutrophils

A

Granual white blood cell that functions to destroy invading organisms and also attack other WBCs

59
Q

Function of lymphocytes

A

Attacks infecting microbial or cancer cells

Produce antibodies against specific antigens

60
Q

Function of monocytes

A

Produce macrophages to engulf large bacteria or virus infected cells

61
Q

Use of corticosteroids

A

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
Q

Contraindications for corticosteroids

A

Pts with systemic fungal infection

63
Q

Corticosteroids adverse effects

A

Oral fungal infections

64
Q

Patient teaching corticosteroids

A

Oral care during treatment to prevent thrush

Don’t stop dose abruptly

65
Q

Examples of antihistamine

A

Benadryl

Claritin

66
Q

Function of a mucolytic

A

Breaks up mucus

Ex. Acetylcysteine

Pnur 155 Pharmocology (7 decks)

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