Drugs Acting on the Respiratory System Flashcards
1
Q
common cold is caused by
A
rhinovirus
2
Q
common cold is most contagious _________ before the onset of symptoms, and during the ______________ of the cold
A
1-4 days; first 3 days
3
Q
transmission of common cold:
A
touching contaminated surfaces, then touching the nose or mouth
4
Q
Drugs for common cold:
A
antihistamines, decongestants, antitussives, and expectorants
5
Q
sign and symptoms of common cold:
A
rhinorrhea, nasal congestion, cough, and increased mucosal secretions
6
Q
Inflammation of the mucuous membrane that usually accompanies the common cold
A
Acute Rhinitis
7
Q
caused by pollen or foreign substance
A
Allergic Rhinitis
8
Q
Allergic Rhinitis also called as
A
hay fever
9
Q
H1 blockers or H1 antagonists
A
Antihistamines
10
Q
Not useful in an emergency situation e.g. anaphylaxis
A
Antihistamines
11
Q
Rapidly absorbed in 15 minutes but not potent enough to combat anaphylaxis
A
Antihistamines
12
Q
First-Generation Antihistamines can cause
A
drowsiness, dry mouth, and other anticholinergic symptoms
13
Q
patient should be alerted of what when taking First-Generation Antihistamines?
A
Patient should be alerted not to drive or operate machinery when taking such medications
14
Q
Decreases secretions, nasal itching and tickling that cause sneezing
A
First-Generation Antihistamines
15
Q
Frequently combined with other ingredients in cold remedy preparations
A
DIPHENHYDRAMINE (Benadryl)
16
Q
DIPHENHYDRAMINE (Benadryl) routes:
A
Oral, IM, IV
17
Q
major side effects of Diphenydramine (Benadryl)
A
drowsiness
18
Q
should First-Generation Antihistamines be given with food?
A
yes
19
Q
avoid __________________ insertion for First-Generation Antihistamines
A
Subcutaneos
20
Q
can First-Generation Antihistamines pass on to breast milk?
A
yes
21
Q
Fewer anticholinergic effects and lower incidence of drowsiness
A
Second-Generation Antihistamines
22
Q
Second-Generation Antihistamines
A
Cetirizine, Fexofenadine, and Loratadine, Azelastine
23
Q
half life of Cetirizine, Fexofenadine, and Loratadine
A
7-15 hrs
24
Q
half life of Azelastine
A
22hrs; nasal spray
25
Stimulate the alpha-adrenergic receptors → vasoconstriction (nasal mucosa) → shrinking of the nasal mucosal membranes and reduction in fluid secretion
NASAL DECONGESTANTS
26
NASAL DECONGESTANTS can be
Nasal spray or drops, tablets, capsule, liquid
27
frequent use of Nasal Decongestants can result in
tolerance and rebound nasal congestion
28
advantage of Nasal Decongestants:
Fewer side effects than systemic decongestants
29
Systemic Decongestants can be
Tablet, capsule, liquid
30
Used primarily for allergic rhinitis including hay fever and acute coryza
Systemic Decongestants
31
Systemic Decongestants
Ephedrine, Phenylephrine, Pseudoephedrine
32
Frequently combined with antihistamine, analgesic, or antitussive in oral cold remedies
Systemic Decongestants
33
Advantage of Systemic Decongestants:
relieve nasal congestion for a longer period than nasal decongestants
34
Side Effects and Adverse Reactions of Decongestants:
increased BP and blood glucose levels
35
may decrease the effect of beta blockers
Pseudoephedrine
36
Intranasal Glucocorticoids
Beclomethasone, Budesonide, Dexamethasone, Flunisolide,
Fluticasone, Triamcinolone
37
Effective for treating allergic rhinitis
Intranasal Glucocorticoids
38
Antiinflammatory action – decrease sx of rhinorrhea, sneezing, and congestion
Intranasal Glucocorticoids
39
Chronic use – dryness of nasal mucosa
Intranasal Glucocorticoids
40
Dexamethasone should NOT be used for
more than 30 days
41
naturally protective way to clear airway of secretions or any collected material
Cough
42
Act on the cough-control center in the medulla to suppress the cough reflex
Antitussives
43
Indicated ONLY for nonproductive, irritating cough
Antitussives
44
may decrease the constant, irritating cough
Hard candy (Antitussives)
45
3 Types of Antitussives
Nonnarcotic, Narcotic, Combination
46
Antitussives
Dextrometorphan (Rubitussin), Butamirate Citrate (Sinecod)
47
Duration of action and half life of Dextrometorphan (Rubitussin), Butamirate Citrate (Sinecod)
3-6hrs; 11 hrs
48
Loosen bronchial secretions so they can be eliminated by coughing
Guaifenesin (Expectorants)
49
best natural expectorant
Hydration
50
when taking Guaifenesin (Expectorants), instruct pt to increase fluid intake to at least _________________ per day to help loosen mucus
8 glasses
51
is indicative of a bronchial infection
yellowish-greenish mucus
52
Tell pt that __________________________ may occur when dextromethorphan is taken with MAOIs
hypotension and hyperpyrexia
53
are not helpful in treating common cold viruses
Antibiotics
54
Teach pt not to take a cold remedy before or at bedtime; ______________ may occur if it contains decongestant
Insomnia
55
mode of transmission of cold and flu viruses:
hand-to-hand contact or by touching contaminated surfaces
56
Encourage pt to cough effectively. How?
deep breaths before coughing in an upright position
57
Inflammation of the mucous membrane of one or more of the maxillary, frontal, ethmoid or sphenoid sinuses
Sinusitis
58
indicated to treat Sinusitis
Systemic or nasal decongestant
59
Inflammation of the throat
ACUTE PHARYNGITIS
60
ACUTE PHARYNGITIS a.k.a
sore throat
61
Can be caused by a virus, beta-hemolytic streptococci (strep throat), or other bacteria
ACUTE PHARYNGITIS
62
symptoms of ACUTE PHARYNGITIS
fever and cough
63
are Antibiotics effective for viral pharyngitis?
NO
64
Inflammatory disorder of the airway associated with a varying amount of airway obstruction
asthma
65
Progressive lung disease caused by smoking and chronic lung infections
Chronic Bronchitis
66
triggers for asthma
stress, allergens, and pollutants
67
stress, allergens, and pollutants → inflammation and edema of bronchial airways → constriction of air passages → wheezing, coughing, dyspnea, chest tightness
Asthma
68
Bronchial inflammation and excessive mucus secretion → airway obstruction → productive coughing, expiratory rhonchi, hypercapnia, hypoxemia
Chronic Bronchitis
69
Progressive lung disease caused by cigarette smoking, atmospheric contaminants, or lack of a1-antitrypsin protein that inhibits proteolytic enzymes that destroy alveoli
Emphysema
70
Selective B2 drug
Albuterol/Salbutamol
71
Effective for treatment and control of asthma
Albuterol/Salbutamol
72
Albuterol/Salbutamol is more rapid by ______________ (__min) than _____ (__ mins)
inhalation; 1 ; orally ; 15
73
what is the first beta adrenergic agent used for bronchospasm? and when?
First beta adrenergic agent used for bronchospasm, 1941
74
Non-selective beta agonist (B1 and B2)
Isoproterenol
75
B1 stimulation
inrease heart rate
76
B2 stimulation
bronchodilation
77
Isoproterenol duration of action, long or short?
short
78
side effects and adverse reactions of Aerosol Inhaler:
mouth dryness, throat irritation, tolerance, severe paradoxical airway resistance, tremors, nervousness, and increased heart rate
79
Side Effects and Adverse Reactions of Epinephrine
Tremors, dizziness, hypertension, tachycardia, heart palpitations, cardiac dysrhythmias, and angina
80
Side Effects and Adverse Reactions of Beta2-adrenergic drugs
Tremors, headaches, nervousness, tachycardia, palpitations
81
Used for maintenance treatment of bronchospasms associated with COPD
Tiotropium (Spiriva) (Anticholinergics)
82
Used to treat asthmatic conditions by dilating the bronchioles
Ipratropium bromide (Atrovent)
83
Anricholinergic is combined with with ______________________ to treat chronic bronchitis
albuterol sulfate
84
Administer b-agonist inhalants, _________________ using ipratropium
5 mins before
85
Administer inhaled glucocorticoids or cromolyn _________ using ipratropium
5 mins after
86
METHYLXANTHINE (XANTHINE) DERIVATIVES
Aminophylline, theophylline, caffeine
87
Group of bronchodilators used to treat asthma
METHYLXANTHINE (XANTHINE) DERIVATIVES
88
Stimulate the CNS and respiration, dilate coronary and pulmonary vessels, and cause diuresis
METHYLXANTHINE (XANTHINE) DERIVATIVES
89
what is first theophylline preparation produced? and when?
Aminophylline, 1936
90
Inhibition of phosphodiesterase → increased cAMP → relaxation of
smooth muscles of bronchi, bronchioles, and pulmonary blood vessels
→ bronchodilation
Theophylline
91
therapeutic range of Theophylline
10-20 mcg/mL
92
Once used as a first-line drug for pts with chronic asthma and other COPDs
Theophylline
93
serious adverse efects of Theophylline
dysrhythmias, convulsions, cardiorespiratory collapse
94
decrease the liver metabolism rate and increase the half-life and effects of theophylline
Beta blockers, cimetidine, propranolol, and erythromycin
95
decreases the effects of theophylline
Barbiturates and carbamazepine
96
theophylline decreases the effects of?
lithium
97
theophylline has a decreased risk of
digitalis toxicity
98
decreases theophylline levels
phenytoin
99
theophylline has a synergistic effect when given with
B-adrenergic agonist
100
should bronchodilators be administered before or after meals?
after meals
101
what type of diet increases theophylline elimination?
high-protein, low-carbohydrate diet
102
LEUKOTRIENE RECEPTOR ANTAGONISTS AND SYNTHESIS INHIBITORS
Zafirlukast, Montelukast sodium, Zileuton
103
LEUKOTRIENE RECEPTOR ANTAGONISTS AND SYNTHESIS INHIBITORS
Leukotriene
104
Promote an increase in eosinophil migration, mucus production, and airway wall edema → bronchoconstriction
Leukotriene
105
Effective in reducing inflammatory symptoms of asthma triggered by allergic and environmental stimuli
Leukotriene
106
Leukotriene is not recommended for the treatment of?
acute asthmatic attack
107
Leukotriene is safe for (age range)
6 years old and above
108
GLUCOCORTICOIDS (STEROIDS)
Beclomethasone, dexamethasone, prednisone, prednisolone, methylprednisone, hydrocortisone
109
Indicated if asthma is unresponsive to bronchodilator therapy or if the pt has an asthmatic attack while on maximum doses of theophylline or adrenergic drug
GLUCOCORTICOIDS (STEROIDS)
110
indicated for Acute asthma exacerbations
Systemic glucocorticoids
111
should Glucocorticoids (Steroids) be taken with food?
YES
112
Short Acting Bronchodilator
Short Acting B2 Agonist Agent (SABA) = Salbutamol, Terbatuline
Short Acting Anti-Muscarinic Agent (SAMA) = Ipratropium Bromide
113
Long Acting Bronchodilator
Long Acting B2 Agonist Agent (LABA) = Salmeterol, Folmoterol, Indacaterol
Long Acting Anti-Muscarinic Agent (LAMA) = Tiotropium
114
Inhaled Corticosteroid (ICS)
Fluticasone, Budesonide, Beclomethasone
115
Fungal infections may be prevented by using a
spacer
116
Used for prophylactic treatment of bronchial asthma and must be taken daily
Cromolyn sodium
117
Acts by inhibiting histamine release to prevent an asthma reaction
Cromolyn sodium
118
Has anti-inflammatory effects and suppress the release of histamine, LTs, and other mediators from the ,ast cells
Nedocromil sodium
119
More effective than cromolyn
Nedocromil sodium
120
DRUG THERAPY FOR ASTHMA ACCORDING TO AGE
Young children
Cromolyn and nedocromil
Oral glucocorticoids
Oral b2-adrenergic agonist
121
inflammatory effects of asthma
Cromolyn and nedocromil
122
control a moderate to severe asthmatic state
Oral glucocorticoids
123
dose and frequency of Oral Glucocorticoids for Young Children with asthma
1-2 inhalations 3-4x a day or 40-80mcg 2x/day
124
drug for severe asthma attacks in young children
Oral b2-adrenergic agonist
125
DRUG THERAPY FOR ASTHMA ACCORDING TO AGE
Older adults
B2-adrenergic agonist and methylxanthines
Frequent glucocorticoids
126
can cause tachycardia, nervousness, and tremors in older adults esp those with cardiac conditions
B2-adrenergic agonist and methylxanthines
127
increased risk of developing cataracts, osteoporosis, and DM
Frequent glucocorticoids
128
Liquefy and loosen thick mucus secretions so they can be expectorated
MUCOLYTICS
129
should Acetylcysteine be mixed with other drugs?
NO
130
Antidote for acetaminophen overdose of given within 12-24h after overdose inegestion
Acetylcysteine
131
Enzyme that digests DNA in thick sputum secretions of patients with cystic fibrosis
Dornase alfa
132
Hep reduce respiratory infections and improves pulmonary function
Dornase alfa
133
Used ONLY if a bacterial infection results from retained mucus secretions
ANTIMICROBIALS
134
Trimethoprim-sulfamethoxazole a.k.a
Co-trimoxazole
135
Effective for mild to moderate acute exacerbations of chronic bronchitis from infectious causes
Trimethoprim-sulfamethoxazole (Co-trimoxazole)
136
work primarily by stimulating alpha-adrenergic receptors in the smooth muscles of blood vessels in the nasal mucosa. This stimulation causes vasoconstriction, or the narrowing of blood vessels.
Nasal Decongestants
137
Beta-2 adrenergic receptors: It causes bronchodilation, which relaxes the smooth muscles of the airways, improving airflow and making it essential in treating bronchospasm.
Epinephrine
138
