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Nclex Study Cards > Drugs Affecting Respiratory System > Flashcards

Drugs Affecting Respiratory System Flashcards

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1
Q

Oral Antihistamines

A

Most tested:
Fexofenadine
Diphenhydramine
Loratadine

Other:
Chlorpheniramine
Cetrizine
Levocetrizine
Deslooratadine

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2
Q

Fexofenadine (brand: Allegra)

A

Upper respiratory Drugs
Antihistamine “allergy meds”
indication: Allergies, sinusitis, hives
Safe for asthma and nasal polyps
NOT for glaucoma patients due to anticholinergic effect that increases intraocular pressure

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3
Q

Diphenhydramine (Brand: Benadryl)

A

Upper respiratory Drugs
Antihistamine “allergy meds”
Commonly used for major anaphylaxis reactions
Blocks Histamines which create mucus and secretions as well as inflammation

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4
Q

Diphenhydramine (Brand: Benadryl) Side effects

A

Side effect: sedation and sleepiness
No driving in this med

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5
Q

Contraindicated for Diphenhydramine

A

Contraindicated:
Closed angle glaucoma
Urinary retention
Peptic ulcer
Small bowel obstruction

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6
Q

Anaphylaxis from a Bee sting

A

1st Epinephrine IM
2nd Diphenhydramine IV
3rd Albuterol or steroids

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7
Q

Intra-nasal Antihistamines

A

Azelastine
Olopatadine

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8
Q

Non-sedating Antihistamines

A

Loratadine
Cetirizine
Fexofenadine

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9
Q

Loratadine (brand: Claritin)

A

Upper respiratory Drugs
Antihistamine “allergy meds”

Fewer side affects than Benadryl so patients commonly switch between Benadryl and Claritin

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10
Q

Decongestants

A

3 Groups
Adrenergic (sympathomimetics)

Antichollergics (parasympathomimetics)

Topical Corticosteroids combined with antihistamine

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11
Q

Adrenergics (sympathomimetics)

A

Ephedrine
Phenylephrine, Pseudoephedrine
Naphazoline, Oxymetazoline
Terahydrozoline
Xylometazoline

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12
Q

Antichollergics (parasympathomimetics)

A

Bronchodilators
End in “Tro-pium”
Ipratropium
Tiotropium

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13
Q

Topical Corticosteroids combined with antihistamine

A

Azelastine/fluticasone propionate

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14
Q

Antitussives

A

Codeine
Hydrocodone
Dextromethorphan
Diphenhydramine
Benzonatate

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15
Q

Codeine

A

Cough Suppressant Antitussive
Most affective antitussive
Opioid analgesic also called a narcotic/pain med

Given for mild to moderate pain to suppress the cough

Codeine doesn’t not affect
Photosensitivity
Heart Palpations
insomnia or Anxiety

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16
Q

Codeine Side effects:

A

slows down central nervous system making the vital signs low and slow

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17
Q

Codeine Key Points

A

Slow position changes, low BP can result in orthostatic hypotension - dizziness/fainting upon standing = Big fall risk
Do not give to COPD patients because lungs are low and slow
GI is also low and slow = constipation and nausea
Take with food
Increase fluid intake
8 full glasses of water (minimum)

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18
Q

2 categories of Antitussives

A

2 categories
1.Opioid—all have antitussive effects, but only codeine and hydrocodone are used for this purpose

2.Non-opiod—less effective: dextromethorphan

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19
Q

Inhaled Corticosteroids

A

Most commonly tested: Beclomethasone
Fluticasone

Other:
Budesonide
Ciclesonide
Flunisolide
Mometasone

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20
Q

Corticosteroids that reduce swelling and inflammation in the respiratory system

A

Beclomethasone
Fluticasone
Methylprednisolone (solu mederol)

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21
Q

Corticosteroids SONE Key points

A

Use spacers to prevent oral thrush (candida)
Rinse mouth after each use
Do not swallow water
Clean inhaler daily

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22
Q

Beclomethasone

A

Antinflamatory agents
Ends in “SONE”
Reduces swelling and inflammation iim the resp system - decreases bronchi

Slow onset: not a rescue drug, do not use as first sign of asthma attack

Sugar increase = Expected finding

Sores in mouth (infection)

23
Q

Who is MOST at risk for infection

A

The patient on SONE steroids
Sone steroids suppress the immune system

24
Q

What kind of onset do steroids have

A

SLOW

25
Q

Oral Corticosteriods

A

Methylprednisolone: Steroid, acts slow
Prednisolone
Prednisone

26
Q

Beta 2 Adrenergic Agonists
Inhaled short acting

A

Albuterol
Levalbuterol

End in buterol
Brutal Asthma attacks
1st drug used in asthma attacks
Fasted acting bronchodilator
The only ‘rescue inhaler”
Use BEFORE steroid inhaler

27
Q

Albuterol Side effects:

A

Tachycardia and palpitations
Tremor
Toss and Turning at Night (insomnia and Difficulty sleeping)

28
Q

Drugs too Avoid for Asthmatic patients

A

Beta blockers: Atenolol, can cause bronchospasm NSAIDS: Ibuprofen, can worsen asthma

29
Q

Beta 2 Agonist

A

Activate Beta 2 in the lungs which dilates the bronchi which results in increased airflow but it also activities beta 1 (heart) makes the heart go crazy fast

Side affect: rapid heart rate

30
Q

Beta 2 Adrenergic Agonists
Inhaled Long Acting

A

Arformoterol
Formoterol
Indacaterol
*Salmeterol

Ends in “Terol not Buterol”
Slower acting, not rescue inhalers, not used during acute asthma attacks
Used with a combination of steroids for long term control of moderate to severe asthma

31
Q

Drugs for acute asthma attacks

A

“AIM” for acute asthma attack
A: Albuterol 1st (to bronchodialate the lungs, steroids 2nd to get all the powder deep into the lungs)

I: Ipratropium 2nd
M: Methyl-prednisolone (brand: Solu mederol)
Do not use fluticasone or salmeterol for first sign of acute asthma attack - always take steroids even if albuterol provides relief

2-4 puffs every 20minutes for 3 rounds
If it doesn’t work after 3 doses then notify HCP

Effective:
Decrease iim RR
Oxygen sat at least 90%

32
Q

Albuterol Nebulizer expected findings after treatment

A

Increase productive cough
Reports off decreased anxiety
Mild bilateral hand temors

33
Q

Albuterol Administration

A

Shake it before you take it
Shake it well
breath all the way out, push inhaler, inhale and hold for a few seconds then exhale

Clean 2 times per week with warm water not after every use. Steroids should be washed after every use

34
Q

Patient with severe asthma
Vital signs:
tachycardia
Tachypnea
O2 less than 90%
Peak exp. flow <40% predicted or best <150l/min

What medication would you give?

A

Albuterol inhaler
Nebulizer Ipratropium
IV methylprednisolone

35
Q

Beta 2 Adrenergic Agonists
Oral

A

Albuterol
Terbutaline

36
Q

Anticholinergics

A

Ipratropium
Tiotropium

37
Q

Ipratropium

A

Anticholinergic - Bronchodilators

Dries the body out
Used for moderate to severe asthma and COPD
Longer acting brochodialator that reduces secretions and commonly given in combination with albuterol
Used 2nd in an asthma attack
Blocks secretions: Cannot see, pee, spit or poop

Side effects: Dry mouth, horsiness
Treat the dry mouth and throat for all anticholinergics: use gum/candy and drink fluids

Key point: No swallowing tiotropium capsules, put the capsule in the inhaler device and then inhale

Contraindication to all anticholinergics:
Never give to patients who are already dry. Example:
Glaucoma
Urinary mention and BPH
Bowel obstructions

38
Q

Cough Expectorants

A

Guaifenesin
inIodinated glycerol
Potassium iodide

39
Q

Guaifenesin (brand mucinex)

A

Cough Expectorant
Given for cough and mucus, helps clear out excess mucus
Thins mucus - teach patients to drink fluids to help thin muscus
Drink at least 2L per day
Asthma safe

40
Q

Acetylcystine (brand: mucomyst)

A

Cough Expectorant
Helps loosen and thin serious mucus like inn cystic fibrosis

Antidote for Tylenol (acetaminophen) overdose
Blocks Acetaminophen

Also given before the cath lab to protect kidneys from contrast dye
Caution with asthmatic patients

NOT SAFE: cause or worsen bronchospasm always clarify prescriptions given for asthmatic patients

41
Q

Lower Respiratory Drugs

A

Bronchodilators
Beta 2 Agonist: Albuterol
Anticholinergics: Ipratropium
Methylxanthines: Theophylline

Anti-inflammatory Agents
Steroids: Beclomethasone

Leukotriene Inhibitor: Montelukast

Mast Cell Stabilizers: Cromolyn

42
Q

Methylxanthines

A

Brochodialators
Ends in “phylline”
*Theophylline
Aminophylline

Rapid heart rate and can be toxic
Toxic! over 20

43
Q

Theophylline Therapeutic Valus

A

Therapeutic index 10-20 = frequent blood draws
Tonic colonic seizures
#1 Sign of Severe toxicity 1st priority as the nurse report signs such as restlessness, nausea/vomiting, anorexia, insomnia
tachycardia and dysrhythmias

44
Q

Methylxanthines (Theophylline) Key points

A

Teach patients to avoid beta blockers that lower the heart rate while on Theophylline - Beta blockers can also block the affect of theophylline

Alert HCP of tachycardia before giving next dose

Take in AM
Avoid Caffeine
Stop Before Cardiac stress test

45
Q

Drugs that Increase toxicity risk Theophylline

A

Cimetidine (H2 blocker)
Ciprofloxacine (ABX)

46
Q

Which of the following prescriptions should the nurse question?

A

Naproxen for an Asthmatic Patient
Ipratropium for a patient with glaucoma
Theophylline for a patient taking cimetidine
atenolol for a patient with asthma

47
Q

What patient teaching should be included with a new prescription of albuterol, ibuprofen, tiotropium and beclomethasone?

A

Tachycardia is expected after albuterol
Report dark stool to the provider
Drink fluids to prevent dry mouth and throat

48
Q

Which medication prescribed for asthma causes of tachycardia and dysrhythmias?

A

Aminophylline

49
Q

Leukotriene Inhibitors

A

Montelukast (brand: singular)
Opens airway
Long term management of of inflammation, commonly given in combination with albuterol and steroids
Long onset (1-2 weeks to reach therapeutic range)

50
Q

Leukotriene Inhibitors Key Points

A

Given for prevention of asthma attacks - not during acute attacks
Not a rescue drug
This med will prevent inflammation that causes asthma attacks

51
Q

Patient has been conn Montelukast for 5 days and states the medication iim not working, best response by the nurse?

A

Advice 102 weeks for drug to reach the therapeutic affect

52
Q

Mast Cell stabilizers

A

Anti-inflam agents
Cromolyn
Blocks massive swelling
Prevents activity induced asthma
Take 15 minutes before exertion for maximum affects

53
Q

A client is receiving discharge instructions for a inhale corticosteroid metered dose inhaler. What teaching should the nurse include?

A

Do not swallow the water as you wash your mouth after use

54
Q

Which statement by the patient requires further teaching

A

I will take cromolyn 45 minutes before physical activity

  • take 10-15min before

Nclex Study Cards (38 decks)

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