Drugs for Lower Resp Disorders (41) Flashcards
COPD includes several respiratory disorders which are irreversible:
- Chronic ____
- Emphysema
- ____
Bronchitis… Bronchiectasis
Reversible COPD disorder is ____
Asthma
Bronchial Asthma from environmental factors:
- ____
- ____ changes
- ____
- Emotion/Stress
Weather, Temperature… Exercise
Bronchial Asthma from pollutants:
- smoke
- ____ - paint, thinners
chemicals
Bronchial Asthma from allergens:
- Pollens
- Animal ____
- ____
dander… foods
Pathophysiology of Asthma
- ____ (hypersensitivity)
- ____ (RAD) instead of Asthma.
Hyperactivity… Reactive Airway Disease
Trigger of Asthma:
Stimulates mast cells to release chemical mediators.
3 main characteristics of asthma:
- ____
- Bronchial ____
- Increase bronchial ____
Bronchoconstriction… edema… secretions
epinephrine (Adrenalin is a ____ sympathomimetic that treats acute ____ d/t anaphylaxis from allergic reaction –> ____, increase ____
nonselective… bronchospasm… bronchodilation… blood pressure
Side effects of epinephrine:
Tremors, dizziness
Increase in ____, tachycardia, heart ____ and dysrhythmias.
Blood pressure, palpitations
Sympathomimetics are ____ adrenergic receptors which control ____ smooth muscle tone.
Beta2… bronchial
Sympathomimetics stimulate Beta2 adrenergic receptors, which ____ formation of cyclic adenosine monophosphate (cAMP)
increase
cAMP causes smooth muscle ____ & ____
relaxation… bronchodilation
Drugs affecting both Beta receptors will also have ____ cardiac side effects (____ & increase in ____).
cardiac… tachycardia… BP
Other side effects of sympathomimetics:
- CNS ____
- ____
- Nervousness, anxiety, ____
- GI ____
stimulation… insomnia… tremor… distress
Selective Beta2 agonist examples:
____ (Proventil)
Metaproterenol ____ (Alupent, Metaprel)
Albuterol… sulfate
Side effects of Beta2 agonists:
Tremors, nervousness, ____
Increase ____ rate, palpitations
May increase ____ levels
HA… pulse… blood glucose
Bronchodilating effect –> if the tolerance builds up with prolonged use, ____ the dose. If failure to respond tp previously effective dose, ____ getting worse.
SEE OTHER SIDE
Sympathomimetics could be taken through p.o., inhalation, ____.
SEE OTHER SIDE
Use aerosol inhaler at 1st sign of ____ or chest tightness (rescue inhalers)
respiratory distress
Methylxanthine (Xanthine) Derivates interfere with enzyme that breaks down cyclic AMP –> Increase intracellular cyclic AMP (cAMP), which cause ____.
bronchodilation
Mathylxanthine (Xanthine) Derivatives stimulate ____ cells in the ____ and the ____ muscle.
Diuresis –> loss of ____.
bronchi… heart… K+ ions
Other side effects of Methylxanthine:
Tachycardia, GI ____, stimulation of CNS (____), potential for seizure activity.
distress… insomnia
Theophylline therapeutic range is ____ mcg/mL, if you go past 20, ____.
10-20…. toxicity.
Monitor for toxicity: \_\_\_\_, GI distress Restlessness Convulsions Irregular \_\_\_\_
N/V… Heartbeat
When on theophylline, avoid ____ containing beverages and foods with ____.
xanthine… caffeine
Smoking increases ____ of drug, and may need to increase ____.
metabolism… dosage
Examples of theophylline:
Theophylline (Theo-Dur, Theobid Duracaps) - time released capsules
Aminophylline - IV
Oral, Rectal, IV
SEE OTHER SIDE
Leukotriene (LT) Receptor Antagonists:
montelukast (Singulair) blocks action of ____ —> blocks s/s of ____.
leukotrine…asthma
LT Receptor Antagonists: Prophylactic/maintenance therapy for chronic asthma. NOT for ____ attacks. In regular & chewable tablet form.
acute.
Glucorticoids (Steroids) - ____ action. Given if ____ does not respond to bronchodilator therapy. ____ effect with Beta2 agonists.
anti-inflammatory… asthma… synergistic
(Glucocorticoid route) Meter Dose Inhaler (MDI) inhaler is not for severe attacks and may take ____ weeks for full effect.
1-4
MDI inhaler is more effective for controlling ____ than Beta2 agonists. More of long-term is ____ (Vanceril, Beclovent)
Beclomethasone.
(Glucocorticoid route) Tablet: Aristocort, dexamethasone (Decadron), and prednisone.
SEE OTHER SIDE
(glucocorticoids route) IV: demathasone (Decadron), hydrocortisone… ____ DOSE (all routes)
TAPER OFF
Side effects with long term use of glucocorticoids: GI \_\_\_\_ HA, confusion Sweating \_\_\_\_
irritation…. insomnia
Orally Inhaled SE:
throat irritation, hoarseness, dry mouth.
oral, laryngeal, pharyngeal fungal infections may occur… spacer may help
SEE OTHER SIDE
Cromolyn Sodium (Intal) (NO CLASSIFICATION) is taken as a ____ tx ____. DOES NOT TX ____ attacks and status ____.
prophylactic… daily… acute asthma… asthmaticus
Status Asthmaticus is a severe, prolonged, immobilizing attack of ____ that is unresponsive to normal bronchodilator treatment and should be treated as an ____.
asthma… EMERGENCY
Cromolyn Sodium (Intal) has no bronchodilator activity but inhibits the release of ____. For ____ use only.
histamines… inhalation
Serious side effect of Cromolyn Sodium is ____ bronchospasm –> DO NOT ____ abruptly.
rebound… discontinue
Mucolytics decrease thickness of pulmonary secretions and help with removal of secretions –> Increase in pulmonary ____.
ventilation
Mucolytics reduce thickness of pulmonary secretions in:
- COPD
- Cystic ____
- ____
fibrosis… pneumonia.
acetylcysteine (Mucomyst) breaks apart much-proteins contained in respiratory mucus secretions
SEE OTHER SIDE
Acetylcysteine (Mucomyst):
Nebulization directly into the ____ catheter. DO NOT mix with any other drugs!
intratracheal
Acetylcysteine (Mucomyst) may lead to large amount of liquefied secretions. Make sure the patient is able to ____ or have suction available.
cough.
