drugs affecting respiratory system

Question 1

long acting beta 2 agonist

Answer 1

salmeterol

Question 2

salmeterol black box warning

Answer 2

should not be used by itself bc inv risk for asthma related intubation and death; either use albuterolor use long acting with steroid!

Question 3

beta agonists drug interactions with which other drugs:

Answer 3

digitalis–> can cause dysrythmias
beta blockers-> both compete for sites, this includes beta blocker eye drops
TCAs and MAOIs: causes beta agonists to have more of a vascular effect

Question 4

albuterol meter dosed inhaler amount dose frequency, how often can be repeated

Answer 4

2 puffs every 4 to 6 hours.
Dose via nebulizer is 2.5 mg/dose
May be repeated twice after 5 to 10 minutes
May be combined with ipratropium

Question 5

what can be given for exercise induced bronchospasm?

Answer 5

albuterol puff : 2 puffs 15 min before exercise

or salmeterol : 2 puffs 30 min to an hour before exercise.

Question 6

which 2 responses drugs are approved for use in children younger than 4 years of age.

Answer 6

albuterol and metaproteronol; albuterol safest on infants and cheapest

Question 7

meter dosed inhaler education

Answer 7

return demonstration

spacer with all patients

Question 8

Second- or third-line drug for asthma and COPD

Answer 8

theophylline; absorbed in GI tract completely

Question 9

theophylline warnings

Answer 9

monitor in patients who have heart issues; preg category c; monitor for theophylline toxicity

Question 10

theophylline toxicity:

Answer 10

occurs over 20

cns irritablity, palps, tachycardia, hypotension

Question 11

things that increase clearance of theophylline and dec its half life:

Answer 11

phenobarbital use, dilantin, smoking cigs, being less than 12

Question 12

things that increase half life, decrease clearance in theophyline

Answer 12

inc age, liver and kidney disease, chf

Question 13

theophylline pt teaching

Answer 13

clearance is affected by diet

• monitor for toxicity
• avoid large amount of caffeine containing products

Question 14

what drugs can be given for apnea of maturity

Answer 14

theophylline and caffeine citrate

theophylline:Loading dose of 4 mg/kg per dose
Maintenance dose of 4 mg/kg per day in the premature infant or newborn up to age 6 weeks

caffeine citrate:10 to 20 mg/kg is given in the treatment apnea of prematurity.
Maintenance dose of 5 mg/kg per day

Question 15

this drug Blocks muscarinic cholinergic receptors

Answer 15

inhaled anticholinergic: ipratropium bromide (atrovent)

Question 16

Inhibits muscarinic M3 receptors in lungs

Answer 16

Tiotropium and aclidinium bromide

Question 17

what do inhaled anticholinergics cause and what do they primary treat

Answer 17

cause brachial smooth muscle relaxation

and treat cops

Question 18

inhaled anticholinergics ADRs

Answer 18

cough and dry mouth mostly

Question 19

leukotriene modifier antagonists (-lukast) singulair

Answer 19

when mast cells are broken down, luekotriene and histamine are released, causing the constriction, these meds in turn block the contraction from happening

Question 20

precautions of leukotriene antagonists

Answer 20

do not suddenly stop and use oral or inhaled steroids; do not give to lactating women

-zafirlukast: don’t give to someone with hepatic insufficiency

Question 21

rare side effect of leukotriene inhibitor

Answer 21

new onset neuro condition: adhd

Question 22

most common singulair side effect

Answer 22

headache

Question 23

this drug class:Inhibit the release of arachidonic acid through phospholipase A2 inhibition, thereby producing direct anti-inflammatory properties in the airways.

Answer 23

inhaled corticosteroids

Question 24

ics precautions

Answer 24

don’t give to someone for acute bronchospasm

don’t give to immunocompromised pts

Question 25

corticosteroids can also be used to manage

Answer 25

allergic rhinitis

Question 26

ics adrs

Answer 26

altered taste: dysgeusia
tongue and mouth irritation
flushing

Question 27

pt teaching with ics use

Answer 27

use spacer with each use; rinse mouth with water with each use

Question 28

first generation vs second generation antihistamines

Answer 28

1st: diphenhydramine (Benadryl)–> causes drowsiness
2nd: non sedating antihistamines: loratadine, allegra, zyrtec

Question 29

mast cell stabilizers

Answer 29

prevent breakdown of mast cells; cromolyn and nedocromil

Question 30

decongestants examples

Answer 30

pseudoephedrine and phenyl ephedrine (pseudo more effective)

Question 31

decongestants do what

Answer 31

promote vasoconstriction; not used for kids under 6 yrs

Question 32

contraindications for decongestant use

Answer 32

its using MAOIs or those with severe HTN

Question 33

afrin nasal spray

Answer 33

rebound nasal congestion if used more than 2-3 days

Question 34

agent that is in all antitussives

Answer 34

dextramethorphan

Question 35

the only expectorant/mucolytic approved by fda

Answer 35

guafenisin: not more effective than fluids