Drugs for Upper Resp (40) Flashcards

1
Q

Cold

___ Infection that invades the respiratory tract –> ____ cell injury –> _____ response –> ____ & ____.

A

Viral…. Local… Inflammatory… Signs and Symptoms

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2
Q

Cold Signs and Symptoms:
____ blood flow to area
Local ____
Nasal ____

A

Increased… Edema… Discharge

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3
Q

Cold may develop ____ bacterial infection –> ____ of the throat –> ____ / ____ (sore throat).

A

Secondary… Irritation… Coughing/Pharyngitis

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4
Q
Allergic Rhinitis:
\_\_\_\_ (environmental):
1. \_\_\_\_
2. \_\_\_\_
3. \_\_\_\_ dander
A

Allergen… Dust… Pollen… Animal

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5
Q

Allergic Rhinitis - Immunologic Response:

____ Response –> ____ Release –> Increased secretion of ____, which leads to ____ and ____.

A

Inflammatory… Histamine… Mucus… Congestion and Sneezing.

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6
Q
Drug classifications:
\_\_\_\_ (H1 blockers)
Decongestants
\_\_\_\_ - cough relief
Expectorants
A

Antihistamines… Antitussives

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7
Q

Histamines:
H1 receptors - ____ extra-vascular smooth muscle
H2 receptors - ___ in gastric secretions –> ____ ____.

A

Constricts… Increase… Peptic Ulcer

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8
Q

Histamines ___ arterioles, which increase ____ ____ to capillaries & tissues –> ____ & itching

A

Dilate… blood supply… swelling.

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9
Q

Antihistamines ____ action of histamine at ____ receptor sites… Tx: allergic ____.

A

block… H1 Histamine… rhinitis

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10
Q

1st Generation antihistamines cause ____ symptoms:

  1. Dry ____
  2. ____
  3. Blurred Vision
A

Anticholinergic… mouth… constipation

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11
Q

1st Generation antihistamine ex: diphenhydramine (Benadryl) could be taken p.o and IM/IV. Treats allergic ____ and prevents ____ sickness. Active ingredient is in ____ .

A

Rhinitis… motion… OTC sleep aids.

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12
Q

Side Effects of 1st Gen. antihistamines (anticholinergic effects):

  1. Drowsiness
  2. ____, fatigue
  3. ____ retention & ____
  4. Dry mouth
  5. Blurred vision

___ take with ___ or other CNS depressants.

A

Dizziness… Urinary… Constipation… DO NOT… alcohol

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13
Q

Contraindications of 1st Gen. Antihistamines:

  1. Acute ____ –> ____ effect on Resp tract –> may ____ secretion –> more ____ breathing.
  2. Narrow-angle ____
  3. ____, urinary retention.
  4. ____/nursing mother (inhibits lactation)
A

Asthma… Drying… thicken… difficult… BPH… Pregnant

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14
Q

2nd Gen. Antihistamines:

  1. Little to no effect on ____.
  2. More specific to ____ receptor.
  3. Fewer ____ symptoms.
A

Sedation… H1 histamine… Anticholinergic

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15
Q
Examples of 2nd Gen. Antihistamines
cetirizine (Zyrtec)
fexofenadine (Allegra)
loratadine (Claritin)
*** \_\_\_\_ may develop over time so switch between \_\_\_\_
A

Tolerance… Drugs.

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16
Q

Nursing Diagnoses:

  1. Ineffective ____ clearance r/t ____ congestion.
  2. Sleep ____ r/t frequent ____.
A

airway… nasal…deprivation…coughing.

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17
Q
Nasal Decongestants (sympathomimetic amines):
\_\_\_\_ alpha-adrenergic receptors --> \_\_\_\_ in nasal mucosa --> Nasal mucous membranes \_\_\_\_ --> \_\_\_\_ fluid secretion (runny nose effect)
A

Stimulate… Vasoconstriction… Shrink… Decrease.

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18
Q

Nasal Decongestants:

Administer through nasal ___ / ____

A

spray / drops.

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19
Q

With frequent use of nasal decongestants:
____.
____ Congestion ( Nasal ____ instead of ____ and shouldn’t use more than ____-____ days)

A

Tolerance… Rebound… vasodilation… vasoconstriction…

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20
Q
Examples (sprays/drops):
oxymetazoline HCl (Afrin)
phenylephrine HCl (Neosynephrine)
naphazoline HCl (Allerest)
A

SEE OTHERS SIDE

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21
Q
Systemic Decongestants (alpha-adrenergic agonists):
p.o.
Used to Tx: allergic \_\_\_\_ -->  Hay \_\_\_\_ / Acute \_\_\_\_ - profuse nasal discharge
A

Rhinitus… Fever… Coryza

22
Q

Examples of Systemic Examples:
ephedrine (Ephedrine)
phenylephrine (Neo-synephrine)
pseudoephedrine (Sudafed)

A

SEE OTHERS SIDE

23
Q

LAW OF 2006:

Bans OTC sales of cold meds containing ____. Sale limited to behind the counter and you need a photo ID

A

pseudoephdrine

24
Q

Side Effects:
Jittery, nervous (____ as tolerance develops)
alpha-____ drug –> Increase in ____ and ____ levels.

A

Disappear… adrenergic… BP and blood glucose

25
Q
Contraindications of Systemic Decongestants:
Hypertension
\_\_\_\_ Disease
\_\_\_\_
Diabetes Mellitus
A

Hypertension… Cardiac… Hyperthyroidism.

26
Q

Nasal/Systemic Decongestants are not for…

A

Infants and Young Children (<2 yrs)

27
Q

Pseudoephedrine:

  1. May ____ effect of beta blockers.
  2. ____ chance of hypertension and ____.
A

decrease… increase…. cardiac dysrhythmias.

28
Q

With decongestants you should avoid:

Large amounts of coffee / tea (____) because it increases restlessness and palpitations.

A

restlessness… palpatations.

29
Q

Intranasal Glucocorticoids (steroids): ____ action decreases symptoms of

  1. ____
  2. Sneezing
  3. ____
A

anti-inflammatory, Rhinorrea, congestion

30
Q
Examples of Decongestants:
beclomethasone (Beconase, Vanceril)
budesonide (Rhinocort)
dexamethasone (Decadron)
fluticasone (Flonase)
triamcinolone (Nasacort)
A

SEE OTHER SIDE

31
Q

Side of Effects decongestants:
Continuous use –> ____ of nasal mucosa.
Usually no ____ side effects.
Should not use for ____ days.

A

dryness… systemic… >30.

32
Q

____ act on cough control center in medulla –> ____ cough reflex

A

Antitussives… suppress

33
Q

Cough is a ____ mechanism and could be productive or non productive

A

physiological

34
Q

_____ cough should not be suppressed unless in ____ discomfort or can’t ____.

A

Involuntary… respiratory… sleep

35
Q

3 Types of antitussives

  1. ____
  2. Non-narcotic
  3. Combination
A

narcotic

36
Q

Narcotic Antitussives:

  1. codeine
  2. ____ which have a direct action on ____ center in medulla.
A

hydrocodone

37
Q

Major problems with Narcotic cough suppressants:

  1. RISK FOR ____
  2. Respiratory ____
  3. Bronchial ____
  4. ____ depression
  5. ____
A

DEPENDENCE… depression… constriction… CNS… constipation.

38
Q

Nonnarcotic Antitussives:

____ HBr which is the most common. It is a chemical derivative of ____. Acts on ____ center.

A

Dextromethorphan… opiates… cough

39
Q

Dextromethorphan HBr does NOT cause:

  1. ____
  2. Respiratory ____
  3. ____
A

Dependence… depression… analgesia

40
Q

Dextromethorphan found in…

  1. ____ DM
  2. Benylin DM
A

Robitussin

41
Q

Side effects of Dextromethorphan:

CNS ____ –> nausea, ____, drowsiness, ____.

A

depression… dizziness… sedation

42
Q

Expectorants ____ flow of secretions in ____ tract –> Decrease ____ of secretions and phlegm which easier to remove by ____.

A

stimulate… respiratory… viscosity… coughing.

43
Q

Guaifenesin is the most ____ popular expectorant. Well tolerated but may cause stomach ____ / ____.

A

popular… upset / nausea

44
Q

Nursing diagnoses for expectorants:
Ineffective airway clearance r/t nasal congestion
Sleep deprivation r/t chronic coughing

A

VERY IMPORTANT

45
Q

Goal for expectorants:
Client will be free of nonproductive cough
Client will be free of a secondary infection

A

VERY IMPORTANT

46
Q

Seek medical attention with expectorants if…

  1. Cough ____ week.
  2. High ____, rash.
  3. ____
A

> 1… fever… HA

47
Q

Asses ____ and ____ of a cough

A

frequency… productive

48
Q

Cough syrups give a local, ____ effect and should not be given water, food, ____ administration

A

soothing… after

49
Q

DO NOT suppress ____ cough and ____ clients

A

productive…post-op

50
Q

When on expectorants, encourage ____ and ____ dry air (clean regular)

A

fluids… humidify