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drugs for upper respiratory Flashcards

1
Q

what are the 4 upper respiratory infections

A

common cold
acute rhinitis
sinusitis
acute pharyngitis

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2
Q

what is the etiology of common cold and what does it affect

A

etiology: rhinovirus

affects nasopharyngeal tract

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3
Q

what is acute rhinitis

A

inflammation of nasal mucous membranes

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4
Q

what is sinusitis

A

inflammation of mucous membrane of the sinuses

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5
Q

what is acute pharyngitis

A

inflammation of the throat

strep throat

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6
Q

when is the common cold the contagious period

A

1 to 4 days before onset of symptoms and during the first 3 days of cold

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7
Q

when is the common cold highly contagious

A

during the first 2 days

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8
Q

how is a common cold transmitted

A

touching contaminated surfaces then touching nose or mouth

viral droplets from sneezing

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9
Q

what are symptoms of common cold

A

nasal congestion
nasal discharge
cough
increased mucosal secretions

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10
Q

where is histamine found in the body

A

found in specialized cells

periphery: mast cells (tissue) and basophils (blood)
CNS: neurons

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11
Q

what is the important role of histamine

A

allergic reaction

regulation of gastric acid secretion

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12
Q

where is the distribution of histamine

A

present in all tissues
especially high in skin lungs and GI tract
low content in plasma

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13
Q

how does histamine act

A

through 2 receptors

H1 and H2

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14
Q

what is H1 receptor stimulation

A

vasodilation
increased capillary permeability
CNS effects
itching, pain, secretion of mucus

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15
Q

how does H1 receptor stimulate vasodilation

A

skin of the face and upper body (blood and WBC flow to area)

Extensive: can cause hypotension

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16
Q

how does H1 receptor stimulate increased capillary permeability

A

edema

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17
Q

how does H1 receptor stimulate CNS effects

A

on the neurons

role in cognition, memory and sleep waking cycles

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18
Q

what is H2 receptor stimulation

A

secretion of gastric acid

  • acts directly on parietal cells to promote acid release
  • dominant role in acid release
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19
Q

what are the two types of antihistamines

A

H1 antagonists

H2 antagonists

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20
Q

what do H1 antagonists produce and what treatment are they used for

A

produce selective blockade of H1 receptors

used for treatment of mild allergic disorders

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21
Q

h1 receptors antagonists are divided into what two major groups

A 
first generation (highly sedative)
second generation
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22
Q

what is the mechanism of action of H1 antagonists

A

block the actions of histamine at H1 receptors
do not block H2 receptors
some bind to muscarinic receptors (anticholinergics)

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23
Q

what is H2 antagonists produce and used for what treatment

A

produce selective blockage of H2 receptors
used for treatment of gastric and duodenal ulcers

blocks secretion of acid

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24
Q

what is the MAO of first generation H1 antagonists

A

work both peripherally and centrally

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25
what kind of effect does the first generation H1 antagonists
anticholinergic and sedative
26
what are drug examples of first generation H1 antagonists
diphenhydramine (bendryl) | hydroxyzine promethazine
27
what is the MAO of second generation H1 antagonists
work peripherally to block the actions of histamines fewer CNS side effects longer duration of action (increases compliance)
28
what kind of effect does the second generation H1 antagonists
non sedating and fewer anticholinergic effects
29
what are the drug examples of second generation H1 antagonists
cetririzine fexofenadine loratdaine azelastine (nasal spray)
30
what are the pharmacologic effects of H1 antagonists
antihistamine antichholinergic sedative
31
what are the peripheral effects of H1 antagonists
reduce localized flushing, reduce itching and pain
32
what are the Effects on the CNS of H1 antagonists
theraperutic dose: CNS depression (second generation negligible CNS depression) overdose: CNS stimulation, convulstions, very young children especially sensitive to CNS stimulation
33
what are the therapeutic uses of H1 antagonists
mild allergy severe allergy (adjunct only, benefits may be limited) motion sickness (promethazine) insomnia, common cold (may decrease rhinorrhea through anticholinergic properties, not H1 blockade)
34
what is the action of diphenhydramine (benadryl)
competes with histamine for receptor sites preventing a histamine response reduces nasopharyngeal secretions, itching, sneezing
35
what are contraindications/cautions of diphenhydramine (benadryl)
severe liver disease narrow angle glaucoma urinary retention
36
what age should not take diphenhydramine (benadryl)
children under 2
37
how is diphenhydramine (benadryl) administered
oral IM IV
38
what are the interactions of diphenhydramine (benadryl)
increases CNS depression with alcohol and other CNS depressants
39
what are the therapeutic uses diphenhydramine (benadryl)
mild allergy -allergic rhinitis motion sickness insomnia (as a sleep aid) mild symptoms of parkinsonism (for drooling)
40
what are the side effects of diphenhydramine (benadryl)
``` drowsiness dry mouth dizziness blurred vision wheezing photosensitivity urine retention constipation GI distress blood dyscrasias (blood disease) ```
41
what generation is diphenhydramine (benadryl)
1st generation
42
what are the drug drug interactions with diphenhydramine (benadryl)
increased CNS depression with alcohol, opioids, hypnotics, benzodiazepine and antidepressants
43
why do we avoid the use of MAOI with diphenhydramine (benadryl)
because it intensify the anticholinergic effect and increases the drying effect
44
what are nursing interventions with diphenhydramine (benadryl)
- obtain list of environmental exposures, drugs, recent foods eaten, stressors - give with food to decrease Gi distress - avoid operating motor vehicles if drowiness occurs - avoid alcohol and other CNS depressants - use sugarless candy or gum or ice chips for temporary relief of mouth dryness
45
use caution with diphenhydramine (benadryl) with patients of
``` pregnancy nursing mothers newborn infants young children elderly patients whose conditions may be aggravated by muscarinic blockade ```
46
what pregnancy class is diphenhydramine (benadryl)
category B
47
why use caution with diphenhydramine (benadryl) with nursing mothers
small amounts of drug pass into the breast milk
48
why use caution with diphenhydramine (benadryl) with infants
may lead to seizures severe respiratory depression **not to be used under age 2**
49
why use caution with diphenhydramine (benadryl) with young children
nightmares, nervousness, irritability
50
why use caution with diphenhydramine (benadryl) with elderly
confusion, difficult, or painful urination, dizziness, drowsiness, feeling faint, dryness of mouth, throat and nose likely to occur
51
what use caution with diphenhydramine (benadryl) with patients whose conditions may be aggravated by muscarinic blockade
narrow angle glaucoma
52
what can diphenhydramine (benadryl) act as if used while pregnant
oxytocin
53
is nasal congestion vasodilation or vasoconstriction
vasodilation
54
dilation of nasal blood vessels is due to
infection, inflammation and allergy
55
what leads to swelling of the nasal cavity
transudation of fluid into tissue spaces
56
what doe nasal decongestants: systemic decongestants stimulate which receptors
alpha adrenergic receptors
57
what do alpha adrenergic receptors do
produces nasal vascular vasoconstriction shrinks nasal mucous membranes reduces nasal secretion rebound nasal congestion
58
what is the MAO of systemic decongestants
sympathomimetic | generalized vasoconstriction most likely with oral decongestants
59
what are systemic decongestants primarily used for
allergic rhinitis including hay fever and acute coryza
60
what are drug examples of systemic decongestants
ephedrine pseudoephedrine --- restriction of the amount given behind the counter now for these two and sympthaomimetic, can get high on it with higher dose both of these drugs can be converted into meth phenylphrine
61
what are some characteristics of pseduophedrine
associated with abuse because it causes CNS stimulation and subjective effects similar to amphetamine
62
nasal decongestants examples
``` ephedrine HCl napazoline HCl oxymetazoline phenylephrine HCl pseudoephedrine tetrahyrozoline ```
63
how are nasal decongestants administrated
nasal sprays, nasal drops, tablet, capsule, liquid
64
what are the side effects of nasal decongestants
nervousness, restlesness, jitters, tachycardia | alpha adrenergic effect (hypertension, hyperglycemia)
65
frequent use of nasal decongesants may lead to
tolerance | rebound nasal congestion
66
nasal decongestants should not be used more than
5 days
67
which patients should we be caution with nasal decongestants
cardiovascular and diabetes
68
what are the interactions with nasal decongestants
- psuedoephredrine may decreease the effect of beta blockers - taken with MAOI may increase the possibility of hypertension or cardiac dysrhythmias - avoid large amounts of caffeine b/c it can increase restlessness and palpitations
69
drug examples of intranasal glucocorticoids
``` becloclomethasone budesonide dexamethasone flunisolide fluticasone triamcinolone ```
70
what is the action of intranasal glucocorticoids
anti-inflammatory
71
what is the use of intranasal glucocorticoids
treat allergic rhinitis (seasonal rhinitis) may be used alone or in combination with H1 antihistamines
72
dexamethasone should not be used longer than
30 days to avoid systemic effects | -DONT undergo rapid deactivation after absorption
73
what is the MAO of antitussives
act on the cough control center in the medulla to suppress the cough reflex
74
what are the 3 types of antitussives
nonopioid- dextromethorphan opioid -codeine combination preparations
75
what are some characteristic of dextromethorphan
rapidly absorbed and exerts its effect 15-30 mins after administration half life 1 hour metabolized in liver and excreted in urine changes a nonproductive cough to a less frequent productive cough
76
drug example of expectorant
guaifenesin
77
what is the action of guaifenesin
lossens bronchial secretions by reducing surface tension of secretions
78
what are the uses of guaifenesin
dry nonproductive cough
79
what are some patient teaching with guaifenesin
8 glasses of water per day to help loosen mucus
80
what are side effects of guaifenesin
drowiness, nausea
81
what are treatments of sinusitis
``` decongestant acetaminophen fluids rest antbiotics ```
82
what are treatment of pharyngitis
saline gargles lozenges increaed fluid intake acetaminophen antibiotics with bacterial infection -strep throat

pharm final (4 decks)

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