Drugs

Question 1

Beta 2 Agonist

Answer 1

Ends in “terol”

For Asthma - Bronchodilation

• Albuterol (Proventil): short acting, rescue med
• Formoterol: long acting, management

Side effects:
-tachycardia, tremor (norm)
-bronchospasm (chest tightness, dyspnea)

Interactions:
-avoid beta 2 agonist blockers - cause bronchospasm

Pt ed: Avoid caffeine & stimulants

Question 2

Corticosteroids

Answer 2

Ends in “sone”

• Dexamethosone (DEXPAK)
• Prednisone (PO)
• Fluticasone (inhaled)

Reduce inflammation, immunosuppression

Adverse effect:
Inhaled
- oral thrush (white patches in mouth)

PO
- adrenal suppression/ Cushing syndrome
(don’t abruptly stop, taper dose, carry extra meds)
- infection
- gastric ulcer (black/tarry stool, coffee ground emesis)
- hyperglycemia (3 P’s: polyphagia, polydipsia, polyuria)
- osteoporosis

Pt ed: rinse mouth after using inhaler

“B BEFORE C”
(always use beta 2 agonist before corticosteroid bc beta opens airway for steroid to work better)

Question 3

Anticholinergics

Answer 3

• Ipratropium (Atrovent)

Stops Bronchoconstriction & mucus

Adverse effects:
“Can’t see, cant spit, cant pee, cant poop”
- dry mouth
- urinary retention
- blurred vision
- increase intraocular pressure

Contraindication: old men w/ BPH , peanut allergies , glaucoma

Pt ed: hydrate (use sugar free gum/candy), high fiber diet, OTC stool softener, exercise

Question 4

leukotriene modifiers

Answer 4

montelukast (Singulair) - PO

For Asthma
Reduce Bronchoconstriction & inflammation

Adverse effects:
- N/V/D
- infection

BOX WARNING: mood changes, suicidal

Contraindication: St. John’s Wart

pt ed: avoid caffeine & stimulants

Question 5

Theophylline

Answer 5

• old school albuterol
• Bronchodilation
• narrow therapeutic index (causes tachy)

Adverse effects:
- toxicity (tremor, N/V, hypotension, Sz, agitation)

pt ed:
- avoid caffeine and stimulants
- take same way at same time daily
(bc narrow index so this keeps plasma lvls even)

*if toxic sx, stop meds asap

Question 6

Expectorants

Answer 6

Guaifenesin (Mucinex)
thins mucus

*use w/ productive cough

Adverse effects:
- rash
- N/V
- HA
- allergy

pt ed: hydrate

Question 7

Antitussive

Answer 7

non opioid- Dextromethorphan
suppress cough
*use w/ dry cough

Opioid- Codeine

Adverse effects:
- BOX WARNING: NARCSU (for all opioids- nausea, acute toxicity, respiratory depression, constipation, sedation, urinary retention)
- rash

Contraindication: Benzodiazepine, MAO inhibiters

pt ed:
- take as prescribed
- avoid eating/drinking 30 mins after taking
- avoid alcohol
- lock away from kids
- dont drive, sign docs, make important decisions

*Naloxone: opioid OD antidote

Question 8

Mucolytics

Answer 8

Acetylcysteine (Acetadote)
dissolves mucus (smells bad)
*Antidote for Acetaminophen OD

Adverse Effects:
- drowsiness
- N/V

pt ed: hydrate

Question 9

Decongestants

Answer 9

Pseudoephedrine (Sudafed) & Phenylephrine
vasoconstriction to reduce nasal swelling & congestion

Adverse effects:
- HBP
- tachy, jittery
- rebound congestion
(when taking 3+ days, body becomes dependent to meds, sx become worse when stop taking)

Contraindication: HTN, dysrhythmia, Glaucoma, MOA inhibitors

pt ed: avoid caffeine, green/black tea, and witch hazel

Question 10

Antihistamines

Answer 10

1st gen- Diphenhydramine (Benadryl) *more sedating
2nd gen- Loratadine (Claritin)
*less sedating

blocks histamine
for allergies, motion sickness, insomnia, urticaria/hives

Adverse effects:
- can’t see, can’t spit, can’t pee, can’t poop
- BOX WARNING: suicidal

contraindication: pregnant

pt ed: avoid alcohol