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Pharmacology Exam 2 > Drugs Affecting the Respiratory System > Flashcards

Drugs Affecting the Respiratory System Flashcards

1
Q

Bronchodilators

A

Beta-Adrenergic Agonists (albuterol & salmeterol)
Anticholinergics (ipratropium)
Xanthine Derivatives (theophylline)

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2
Q

Nonbronchodilating

A

Leukotriene Receptor Antagonists (montelukast)

Corticosteroids (methylprednisolone)

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3
Q

Antihistamines

A

diphenhydramine & loratadine

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4
Q

Decongestants

A

phenylephrine

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5
Q

Antitussives

A

Codeine & benzonatate

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6
Q

Expectorants

A

guaifenesin

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7
Q

MOA of Beta-Adrenergics

A 
Beta-2 Agonists, can be selective or non-selective
short acting (albuterol- instantaneous, rescue inhalers)
long acting (salmeterol- onset 30 minutes, asthma control)
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8
Q

Indications of Beta-Adrenergics

A

acute and chronic bronchospasms

asthma attack or control of asthma

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9
Q

Contraindications of Beta-Adrenergics

A

Allergy
HTN (even with albuterol and salmeterol because of poorly controlled HTN)
dysrhythmias and increased risk of stroke (especially with nonselective that have cardiac implications

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10
Q

Adverse Effects of Beta-Adrenergics

A

Very few with selective

Related to hyper (insomnia, restlessness, tremors, signs of cardiac stimulation)

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11
Q

Interactions with Beta-Adrenergics

A

competitive with Beta-blockers

potential for hyperglycemia, because it promotes liver to release extra glucose

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12
Q

MOA of Anticholinergics

A

Block acetylcholine from binding

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13
Q

Indication for anticholinergics

A

PREVENTION of bronchospasm

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14
Q

Contraindications of anticholinergics

A

Allergy to atropine

Glaucoma and BPH (anything that will be negatively effected by an increase in pressure)

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15
Q

Adverse Effects of anticholinergics

A

dry mouth, anxiety, coughing

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16
Q

Interactions of anticholinergics

A

additive effects with other anticholinergics

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17
Q

Nursing considerations of anticholinergics

A

Teach patient to rinse their mouth- increase compliance
Should only be applied to lungs (inhale but don’t swallow)
Monitor lung sounds, pulse ox, respiratory rate, then BP and anxiety/dizziness (HR especially with HTN and cardiac impairment)

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18
Q

MOA of Xanthine Derivatives

A

theophylline is metabolized into caffeine!

Prevents Breakdown of cAMP (which normally promotes bronchodilation, so we want to keep in around longer)

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19
Q

Indications for Xanthine Derivatives

A

Bronchospasms unrelieved by other medications- severe cases of status asthmaticus (constant bronchospasms- worried about airway patency, not about having a little buzz)

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20
Q

Contraindications for Xanthine Derivatives

A

Dysrhythmias, seizures, liver impairment

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21
Q

Adverse Effects of Xanthine Derivatives

A

buzzing around room, hyper, anxious, increased HR, insomnia

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22
Q

Interactions with Xanthine Derivatives

A

Caffeine (additive), St. John’s Wort (increases metabolism of theophylline- gets it out of the system really quick)
Antibiotics decrease metabolism of theophylline (will hang around longer

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23
Q

Nursing Considerations for Xanthine Derivatives

A

Monitor HR, respirs, BP

24
Q

MOA for Leukotriene Receptor Antagonists

A

Block inflammatory response

Leukotrienes help gear up the inflammatory response of body, montelukast blocks this

25
Q

Indications for Leukotriene Receptor Antagonists

A

Prophylactic Seasonal Allergy

Should take this no matter what- it is a preventative

26
Q

Contraindications of Leukotriene Receptor Antagonists

A

Specific Allergy to drug or components of drug

27
Q

Adverse Effects of Leukotriene Receptor Antagonists

A

Liver dysfunction

28
Q

Interactions with Leukotriene Receptor Antagonists

A

Phenobarbital and Refampin- decrease concentration of drug in system (increase metabolism so it doesn’t stay around as long)

29
Q

Nursing Considerations with Leukotriene Receptor Antagonists

A

Check liver enzymes and neuro status because it can cause liver dysfunction as well as headache, dizziness and insomnia.
Monitor other vital signs, but most importantly watch for respiratory distress.
It is given PO, so it takes longer to get into system, but sticks around longer.

30
Q

MOA for Corticosteroids

A

Stabilize cell wall and increase smooth muscle response to beta stimulation (make smooth muscle more receptive to beta stimulation by decreasing cell wall’s irritation)

31
Q

Indications for Corticosteroids

A

Bronchospasm

32
Q

Contraindications to Corticosteroids

A

Fungal Infections (increased risk to develop fungal infections and if they already have one, you can make it worse) and hypersensitivity to corticosteroids (some people become CRAZY with steroids- steroid psychosis)

33
Q

Adverse Effects of Corticosteroids

A

oral infections, adrenal suppression, Cushing’s syndrome (too much cortisol), CNS stimulation (steroid psychosis)

34
Q

Interactions with Corticosteroids

A

Systemic, hyperglycemia (corticosteroids promote the release of blood sugar- careful with diabetics), hypokalemia, immunosuppressants, antifungals, antidiabetics

35
Q

Nursing considerations for Corticosteroids

A

BP, glucose, CNS, respirations

36
Q

MOA of antihistamines

A 
H1 Antagonists (compete for histamine receptors)
Histamine is part of body's natural immune response when something foreign is sensed-- it binds with H1 receptors which causes BV in nose to vasodilate and become more permeable to fluid (nasal congestion, mucous, red nose)

diphenhydramine is sometimes used as a sleep aid because it has a sedative quality
loratadine is nonsedative and it stops congestion and drainage

37
Q

Indications for antihistamines

A

allergies and colds

38
Q

Contraindications for antihistamines

A

allergy, glaucoma and HTN (nondrowsy)

39
Q

Adverse effects of antihistamines

A

Sedative (diphenhydramine)- drowsy, should not drive

Nonsedative (loratadine)- increased HR, HTN

40
Q

Interactions with antihistamines

A

additive- other antihistamines

competitive- vasodilators

41
Q

MOA of Decongestants

A

shrink mucosal membranes- vasoconstriction (adrenergic agonist)
Most frequently used is phenylephrine

42
Q

Indications of Decongestants

A

Nasal Congestion

43
Q

Contraindications of Decongestants

A

Glaucoma, HTN, CV issue (related to increase of pressure b/c of overall vasoconstriction)
Diabetes (liver effect to increase blood sugar)

44
Q

Adverse Effects of Decongestants

A

Alpha-Adrenergic- stimulating aspects

45
Q

Interactions of decongestants

A

Few mainly HTN effects- mainly OTC b/c of this potential for causing increase in BP

46
Q

Nursing Considerations for Decongestants

A

monitor CV status

47
Q

MOA for Antitussives

A

Suppress cough center in the CNS
Codeine is the most effective, but can cause opiate related side effects– they are CNS depressants that target the cough center, but opioids effect pain center and can cause respiratory distress

48
Q

Indications for Antitussives

A

Non productive cough– May have stuff in chest, but airway is so irritated that they can’t get anything up– the antitussive makes cough more productive.

49
Q

Contraindications for Antitussives

A

Decreased LOC, Respiratory Suppression, HTN

50
Q

Adverse Effects of Antitussives

A

CNS depression vs cardiac stimulation

51
Q

Interactions of Antitussives

A

CNS Depressants (additive with codeine)

52
Q

Nursing Considerations of Antitussives

A

possible effects on CNS– assess LOC and respiratory status

53
Q

MOA of Expectorants

A

Loosen and thin secretions- thick secretions need to be thinned so it is easier to get out

54
Q

Indications of Expectorants

A

Relief of cough associated with non-chronic coughs

55
Q

Contraindications of Expectorants

A

Drug allergy

56
Q

Adverse Effects of Expectorants

A

nausea, vomiting, gastric irritation- if taken on an empty stomach

57
Q

Nursing Considerations of Expectorants

A

Don’t give on an empty stomach!

Pharmacology Exam 2 (4 decks)

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