COPD and Asthma Drugs Flashcards by Eva Johnston

What is Status asthmaticus?

A medical emergency

How well did you know this?

Not at all

Perfectly

Broncholaoliater that is a glucocorticoid? What kind of mechanism/ drug is it?

B2-adrenergic agonists
salbutamol (Ventalin or Albutera)

How well did you know this?

Not at all

Perfectly

Broncholaolater that is a Anticholinergics

ipratropium bromide (Atrovent)

How well did you know this?

Not at all

Perfectly

Xanthine derivatives bronchodilator?

theophylline/aminophylline

How well did you know this?

Not at all

Perfectly

Anti-inflammatory glucocorticoid?

budesonide (Pulmicort)

How well did you know this?

Not at all

Perfectly

example of a Anti-inflammatory Leukotriene Modifier?

montelukast (Singulair)

How well did you know this?

Not at all

Perfectly

What kind of drug salbutamol? How is it used? When is it used? (Ventalin or Albutera)

It is a Selective b2 drug that Activates airway smooth muscle b2 receptors

-It is a short-acting drug relaxes smooth muscles of the airway and results in bronchial dilation

It is used for acute attacks to quickly reduce airway constriction and restore normal airflow , it is not to be used on its own or as a preventative medication! it is often combined with other medication

How well did you know this?

Not at all

Perfectly

Theraputic uses of glucocorticoids as respiratory medication?

They are a first line therapy for management of the inflammatory component of asthma, the provide significant long term control and management of symptoms and because of this they play an important role

How well did you know this?

Not at all

Perfectly

Care Implications Bronchodilators: β-Agonists ?

-Encourage measures that promote good state of health in order to prevent, relieve, or decrease symptoms of asthma/COPD

-avoid exposure to conditions that precipitate bronchospasms (smoking, allergens, stress, air pollutants)

Adequate fluid intake

How well did you know this?

Not at all

Perfectly

What Bronchodilators: Anticholinergics is used to prevent bronchoconstriction ? Compared to salbutamol how fast does it last? What kind of action does it have? What is it not used for?

ipratropium bromide (Atrovent)

Slow(er) and prolonged action
compared to salbutamol

NOT used alone for acute exacerbations!

How well did you know this?

Not at all

Perfectly

Example of oral Bronchodilators: Methylxanthines?

Theophylline

How well did you know this?

Not at all

Perfectly

Example of IV Bronchodilators: Methylxanthines? How is it different from theophylline?

Aminophylline

It is more water soluable

How well did you know this?

Not at all

Perfectly

What do Methylxanthines allow greater of? what do they provide a quick relief from?

-Quick relief of bronchospasm
greater airflow into and out of the lungs

Bronchial smooth muscle relaxation

How well did you know this?

Not at all

Perfectly

When do we use/ what are the indications if use for Xanthine Derivatives? What do they adjunctively treat?

-Used for the treatment of mild to moderate cases of acute asthma

-Adjunct agent in the management of COPD

How well did you know this?

Not at all

Perfectly

Methylxanthines: Adverse Effects on CV and GI systems?

CNS stimulation:
CV stimulation
Palpitations (increased force of contraction/fast HR)
Sinus tachycardia (increased HR)
Ventricular dysrhythmias

GI Distress:
nausea, vomiting

How well did you know this?

Not at all

Perfectly

Care Implications: Methylxanthines? what must our patients report?

Encourage to have them report to physician:
Palpitations
Nausea and/or Vomiting
Weakness or Dizziness
Chest pain
Convulsions

How well did you know this?

Not at all

Perfectly

Methylxanthines: Interactions, what happens with increased effects of theophylline? Large amounts of caffeine? What happens with Decreased effects of theophylline?

-Increased effects of theophylline:
Ciprofloxacin (fluroquinilone antibacterial)
inhibits liver CYP metabolism
many others
Large amounts of caffeine can intensify adverse effects

Decreased effects of theophylline:
increases metabolism of xanthines

How well did you know this?

Not at all

Perfectly

What do inhaled forms of glucocorticoids reduce? How long does it take to reach a therapeutic effect?

Inhaled forms reduce systemic effects

May take several weeks for full therapeutic effect

Inhaled glucocorticoid? What is it often combined with to form a certain kind of drug>

budesonide

Budesonide + formoterol (Symbicort)

What is fluticasone? used alone what is it called? What other medication is it combined with?

-used alone (Flovent)

-used in combination Advair diskus
combo with long-acting b2- agonist salmeterol

Why should brinchodilators be used several min before glucocorticoid is administered?

bronchodilator should be used several minutes before the glucocorticoid to provide bronchodilation before administration of the glucocorticoid

What do Leukotrienes do? What can they cause?

-released in immune responses from (eg mast cells, eosinophils) in asthma
Leukotrienes cause

Leukotrienes cause:
-inflammation
-bronchoconstriction
-mucus production
-leucocyte recruitment

What are the Suppressing leukotriene effects?

-Prevent smooth muscle contraction of the
bronchial airways

-Decrease mucus secretion

-Prevent vascular permeability

-Decrease neutrophil and other leukocyte infiltration to the lungs, preventing inflammation

Example of a Leukotriene receptor antagonists? How is it tolerated?

-montelukast: it’s generally well tolerated

Example of a Leukotriene synthesis inhibitor?

zileuton

Leukotriene Modulators: Indications/ when do we use them? What are they not used for? When can improvements be seen?

Prophylaxis and chronic treatment of asthma in adults and children montelukast in children ages 2 and older (Canada) NOT for acute asthmatic attacks, they are used for chronic management of asthma on a continuous schedule, Improvement should be seen in 1 day - 1 week

H1 antagonists are? What do some also act as?

Antihistamines some also act as anticholinergic drugs

What are H2 blockers or H2 antagonists used for? What are they generally not referred to as?

-used to reduce gastric acid in PUD (peptic ulcer disease) -generally not referred to as ‘antihistamines’

Histamine-mediated disorders?

Allergic rhinitis (hay fever, mould and dust allergies) Anaphylaxis Angioedema Drug fevers- usually young children Insect bite reactions Urticaria (redness and itching)

Antihistamines: Mechanism of Action/ how do they work? Antihistamine effect

Block of H1 receptors prevents the adverse consequences of histamine receptor (increase vasodilation and capillary permeability) *Reduce dilation of blood vessels* *Reduce increased permeability of blood vessels*

Histamine action/ how does it work?

Dilation and increased permeability

What kind of effects do traditional Antihistamines have?

Have anticholinergic effects

Example of traditional histamine? Downside? What can it also be used as?

diphenhydramine (Benadryl); chlorpheniramine -Sedation/drowsiness -also used as a sleep aid

What is the Drying effect that traditional antihistamines reduce?

nasal lacrimal gland secretions (runny nose, tearing, and itching eyes) salivary

Traditional antihistamine adverse effects?

Dry mouth (reduced salivary secretions) Difficulty urinating Constipation Changes in vision (dilated pupils, blurred vision)

What kind of CNS effects do non-traditional antihistamines have?

Have fewer CNS adverse effects

Example of non-traditional antihistamines?

Loratadine (Claratin)

What do you not consume when taking traditional antihistamines?

Do not consume alcohol or other CNS depressants.

What kind of drugs are Antitussives? What are they used for? What is the most common form of them?

-Drugs used to stop or reduce coughing antitussives -most common form is in opioids

What kind of coughs are antitussives used for?

Used only for nonproductive coughs! (dry cough)

What is Dextromethorphan? What kind of drug is it? What kind of effects does it NOT have?

-It is a common OTC antitussive -it is a Synthetic opioid-like compound -does NOT produce morphine-like effects

Antitussives: Adverse Effects (codeine)

*Constipation typical opioid effects

Antitussives: Adverse Effects Dextromethorphan (Benylin)

Dizziness, drowsiness, nausea much less than CNS effects of codiene

Antitussive Agents: Nursing Implications/ what must we watch for?

*cough that lasts more than a week* -persistent headache *fever* -rash *-Antitussive agents are for nonproductive coughs *