Drugs for Lower Resp Disorders (41)

Question 1

COPD includes several respiratory disorders which are irreversible:

1. Chronic ____
2. Emphysema
3. ____

Answer 1

Bronchitis… Bronchiectasis

Question 2

Reversible COPD disorder is ____

Answer 2

Asthma

Question 3

Bronchial Asthma from environmental factors:

1. ____
2. ____ changes
3. ____
4. Emotion/Stress

Answer 3

Weather, Temperature… Exercise

Question 4

Bronchial Asthma from pollutants:

1. smoke
2. ____ - paint, thinners

Answer 4

chemicals

Question 5

Bronchial Asthma from allergens:

1. Pollens
2. Animal ____
3. ____

Answer 5

dander… foods

Question 6

Pathophysiology of Asthma

1. ____ (hypersensitivity)
2. ____ (RAD) instead of Asthma.

Answer 6

Hyperactivity… Reactive Airway Disease

Question 7

Trigger of Asthma:
Stimulates mast cells to release chemical mediators.

3 main characteristics of asthma:

1. ____
2. Bronchial ____
3. Increase bronchial ____

Answer 7

Bronchoconstriction… edema… secretions

Question 8

epinephrine (Adrenalin is a ____ sympathomimetic that treats acute ____ d/t anaphylaxis from allergic reaction –> ____, increase ____

Answer 8

nonselective… bronchospasm… bronchodilation… blood pressure

Question 9

Side effects of epinephrine:
Tremors, dizziness
Increase in ____, tachycardia, heart ____ and dysrhythmias.

Answer 9

Blood pressure, palpitations

Question 10

Sympathomimetics are ____ adrenergic receptors which control ____ smooth muscle tone.

Answer 10

Beta2… bronchial

Question 11

Sympathomimetics stimulate Beta2 adrenergic receptors, which ____ formation of cyclic adenosine monophosphate (cAMP)

Answer 11

increase

Question 12

cAMP causes smooth muscle ____ & ____

Answer 12

relaxation… bronchodilation

Question 13

Drugs affecting both Beta receptors will also have ____ cardiac side effects (____ & increase in ____).

Answer 13

cardiac… tachycardia… BP

Question 14

Other side effects of sympathomimetics:

1. CNS ____
2. ____
3. Nervousness, anxiety, ____
4. GI ____

Answer 14

stimulation… insomnia… tremor… distress

Question 15

Selective Beta2 agonist examples:
____ (Proventil)
Metaproterenol ____ (Alupent, Metaprel)

Answer 15

Albuterol… sulfate

Question 16

Side effects of Beta2 agonists:
Tremors, nervousness, ____
Increase ____ rate, palpitations
May increase ____ levels

Answer 16

HA… pulse… blood glucose

Question 17

Bronchodilating effect –> if the tolerance builds up with prolonged use, ____ the dose. If failure to respond tp previously effective dose, ____ getting worse.

Answer 17

SEE OTHER SIDE

Question 18

Sympathomimetics could be taken through p.o., inhalation, ____.

Answer 18

SEE OTHER SIDE

Question 19

Use aerosol inhaler at 1st sign of ____ or chest tightness (rescue inhalers)

Answer 19

respiratory distress

Question 20

Methylxanthine (Xanthine) Derivates interfere with enzyme that breaks down cyclic AMP –> Increase intracellular cyclic AMP (cAMP), which cause ____.

Answer 20

bronchodilation

Question 21

Mathylxanthine (Xanthine) Derivatives stimulate ____ cells in the ____ and the ____ muscle.
Diuresis –> loss of ____.

Answer 21

bronchi… heart… K+ ions

Question 22

Other side effects of Methylxanthine:

Tachycardia, GI ____, stimulation of CNS (____), potential for seizure activity.

Answer 22

distress… insomnia

Question 23

Theophylline therapeutic range is ____ mcg/mL, if you go past 20, ____.

Answer 23

10-20…. toxicity.

Question 24

Monitor for toxicity:
\_\_\_\_, GI distress
Restlessness
Convulsions
Irregular \_\_\_\_

Answer 24

N/V… Heartbeat

Question 25

When on theophylline, avoid ____ containing beverages and foods with ____.

Answer 25

xanthine... caffeine

Question 26

Smoking increases ____ of drug, and may need to increase ____.

Answer 26

metabolism... dosage

Question 27

Examples of theophylline: Theophylline (Theo-Dur, Theobid Duracaps) - time released capsules Aminophylline - IV Oral, Rectal, IV

Answer 27

SEE OTHER SIDE

Question 28

Leukotriene (LT) Receptor Antagonists: | montelukast (Singulair) blocks action of ____ ---> blocks s/s of ____.

Answer 28

leukotrine...asthma

Question 29

LT Receptor Antagonists: Prophylactic/maintenance therapy for chronic asthma. NOT for ____ attacks. In regular & chewable tablet form.

Answer 29

acute.

Question 30

Glucorticoids (Steroids) - ____ action. Given if ____ does not respond to bronchodilator therapy. ____ effect with Beta2 agonists.

Answer 30

anti-inflammatory... asthma... synergistic

Question 31

(Glucocorticoid route) Meter Dose Inhaler (MDI) inhaler is not for severe attacks and may take ____ weeks for full effect.

Answer 31

1-4

Question 32

MDI inhaler is more effective for controlling ____ than Beta2 agonists. More of long-term is ____ (Vanceril, Beclovent)

Answer 32

Beclomethasone.

Question 33

(Glucocorticoid route) Tablet: Aristocort, dexamethasone (Decadron), and prednisone.

Answer 33

SEE OTHER SIDE

Question 34

(glucocorticoids route) IV: demathasone (Decadron), hydrocortisone... ____ DOSE (all routes)

Answer 34

TAPER OFF

Question 35

``` Side effects with long term use of glucocorticoids: GI ____ HA, confusion Sweating ____ ```

Answer 35

irritation.... insomnia

Question 36

Orally Inhaled SE: throat irritation, hoarseness, dry mouth. oral, laryngeal, pharyngeal fungal infections may occur... spacer may help

Answer 36

SEE OTHER SIDE

Question 37

Cromolyn Sodium (Intal) (NO CLASSIFICATION) is taken as a ____ tx ____. DOES NOT TX ____ attacks and status ____.

Answer 37

prophylactic... daily... acute asthma... asthmaticus

Question 38

Status Asthmaticus is a severe, prolonged, immobilizing attack of ____ that is unresponsive to normal bronchodilator treatment and should be treated as an ____.

Answer 38

asthma... EMERGENCY

Question 39

Cromolyn Sodium (Intal) has no bronchodilator activity but inhibits the release of ____. For ____ use only.

Answer 39

histamines... inhalation

Question 40

Serious side effect of Cromolyn Sodium is ____ bronchospasm --> DO NOT ____ abruptly.

Answer 40

rebound... discontinue

Question 41

Mucolytics decrease thickness of pulmonary secretions and help with removal of secretions --> Increase in pulmonary ____.

Answer 41

ventilation

Question 42

Mucolytics reduce thickness of pulmonary secretions in: 1. COPD 2. Cystic ____ 3. ____

Answer 42

fibrosis... pneumonia.

Question 43

acetylcysteine (Mucomyst) breaks apart much-proteins contained in respiratory mucus secretions

Answer 43

SEE OTHER SIDE

Question 44

Acetylcysteine (Mucomyst): | Nebulization directly into the ____ catheter. DO NOT mix with any other drugs!

Answer 44

intratracheal

Question 45

Acetylcysteine (Mucomyst) may lead to large amount of liquefied secretions. Make sure the patient is able to ____ or have suction available.

Answer 45

cough.