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pharm final > drugs for upper respiratory > Flashcards

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
Q

what kind of effect does the first generation H1 antagonists

A

anticholinergic and sedative

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26
Q

what are drug examples of first generation H1 antagonists

A

diphenhydramine (bendryl)

hydroxyzine promethazine

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27
Q

what is the MAO of second generation H1 antagonists

A

work peripherally to block the actions of histamines
fewer CNS side effects
longer duration of action (increases compliance)

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28
Q

what kind of effect does the second generation H1 antagonists

A

non sedating and fewer anticholinergic effects

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29
Q

what are the drug examples of second generation H1 antagonists

A

cetririzine
fexofenadine
loratdaine
azelastine (nasal spray)

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30
Q

what are the pharmacologic effects of H1 antagonists

A

antihistamine
antichholinergic
sedative

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31
Q

what are the peripheral effects of H1 antagonists

A

reduce localized flushing, reduce itching and pain

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32
Q

what are the Effects on the CNS of H1 antagonists

A

theraperutic dose: CNS depression (second generation negligible CNS depression)

overdose: CNS stimulation, convulstions, very young children especially sensitive to CNS stimulation

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33
Q

what are the therapeutic uses of H1 antagonists

A

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
Q

what is the action of diphenhydramine (benadryl)

A

competes with histamine for receptor sites preventing a histamine response
reduces nasopharyngeal secretions, itching, sneezing

35
Q

what are contraindications/cautions of diphenhydramine (benadryl)

A

severe liver disease
narrow angle glaucoma
urinary retention

36
Q

what age should not take diphenhydramine (benadryl)

A

children under 2

37
Q

how is diphenhydramine (benadryl) administered

A

oral
IM
IV

38
Q

what are the interactions of diphenhydramine (benadryl)

A

increases CNS depression with alcohol and other CNS depressants

39
Q

what are the therapeutic uses diphenhydramine (benadryl)

A

mild allergy -allergic rhinitis
motion sickness
insomnia (as a sleep aid)
mild symptoms of parkinsonism (for drooling)

40
Q

what are the side effects of diphenhydramine (benadryl)

A 
drowsiness
dry mouth
dizziness
blurred vision
wheezing
photosensitivity
urine retention
constipation
GI distress
blood dyscrasias (blood disease)
41
Q

what generation is diphenhydramine (benadryl)

A

1st generation

42
Q

what are the drug drug interactions with diphenhydramine (benadryl)

A

increased CNS depression with alcohol, opioids, hypnotics, benzodiazepine and antidepressants

43
Q

why do we avoid the use of MAOI with diphenhydramine (benadryl)

A

because it intensify the anticholinergic effect and increases the drying effect

44
Q

what are nursing interventions with diphenhydramine (benadryl)

A
  • 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
Q

use caution with diphenhydramine (benadryl) with patients of

A 
pregnancy
nursing mothers
newborn infants
young children
elderly
patients whose conditions may be aggravated by muscarinic blockade
46
Q

what pregnancy class is diphenhydramine (benadryl)

A

category B

47
Q

why use caution with diphenhydramine (benadryl) with nursing mothers

A

small amounts of drug pass into the breast milk

48
Q

why use caution with diphenhydramine (benadryl) with infants

A

may lead to seizures
severe respiratory depression
not to be used under age 2

49
Q

why use caution with diphenhydramine (benadryl) with young children

A

nightmares, nervousness, irritability

50
Q

why use caution with diphenhydramine (benadryl) with elderly

A

confusion, difficult, or painful urination, dizziness, drowsiness, feeling faint, dryness of mouth, throat and nose likely to occur

51
Q

what use caution with diphenhydramine (benadryl) with patients whose conditions may be aggravated by muscarinic blockade

A

narrow angle glaucoma

52
Q

what can diphenhydramine (benadryl) act as if used while pregnant

A

oxytocin

53
Q

is nasal congestion vasodilation or vasoconstriction

A

vasodilation

54
Q

dilation of nasal blood vessels is due to

A

infection, inflammation and allergy

55
Q

what leads to swelling of the nasal cavity

A

transudation of fluid into tissue spaces

56
Q

what doe nasal decongestants: systemic decongestants stimulate which receptors

A

alpha adrenergic receptors

57
Q

what do alpha adrenergic receptors do

A

produces nasal vascular vasoconstriction
shrinks nasal mucous membranes
reduces nasal secretion
rebound nasal congestion

58
Q

what is the MAO of systemic decongestants

A

sympathomimetic

generalized vasoconstriction most likely with oral decongestants

59
Q

what are systemic decongestants primarily used for

A

allergic rhinitis including hay fever and acute coryza

60
Q

what are drug examples of systemic decongestants

A

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
Q

what are some characteristics of pseduophedrine

A

associated with abuse because it causes CNS stimulation and subjective effects similar to amphetamine

62
Q

nasal decongestants examples

A 
ephedrine HCl
napazoline HCl
oxymetazoline
phenylephrine HCl
pseudoephedrine
tetrahyrozoline
63
Q

how are nasal decongestants administrated

A

nasal sprays, nasal drops, tablet, capsule, liquid

64
Q

what are the side effects of nasal decongestants

A

nervousness, restlesness, jitters, tachycardia

alpha adrenergic effect (hypertension, hyperglycemia)

65
Q

frequent use of nasal decongesants may lead to

A

tolerance

rebound nasal congestion

66
Q

nasal decongestants should not be used more than

A

5 days

67
Q

which patients should we be caution with nasal decongestants

A

cardiovascular and diabetes

68
Q

what are the interactions with nasal decongestants

A
  • 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
Q

drug examples of intranasal glucocorticoids

A 
becloclomethasone
budesonide
dexamethasone
flunisolide
fluticasone
triamcinolone
70
Q

what is the action of intranasal glucocorticoids

A

anti-inflammatory

71
Q

what is the use of intranasal glucocorticoids

A

treat allergic rhinitis (seasonal rhinitis)

may be used alone or in combination with H1 antihistamines

72
Q

dexamethasone should not be used longer than

A

30 days to avoid systemic effects

-DONT undergo rapid deactivation after absorption

73
Q

what is the MAO of antitussives

A

act on the cough control center in the medulla to suppress the cough reflex

74
Q

what are the 3 types of antitussives

A

nonopioid- dextromethorphan
opioid -codeine
combination preparations

75
Q

what are some characteristic of dextromethorphan

A

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
Q

drug example of expectorant

A

guaifenesin

77
Q

what is the action of guaifenesin

A

lossens bronchial secretions by reducing surface tension of secretions

78
Q

what are the uses of guaifenesin

A

dry nonproductive cough

79
Q

what are some patient teaching with guaifenesin

A

8 glasses of water per day to help loosen mucus

80
Q

what are side effects of guaifenesin

A

drowiness, nausea

81
Q

what are treatments of sinusitis

A 
decongestant 
acetaminophen
fluids
rest
antbiotics
82
Q

what are treatment of pharyngitis

A

saline gargles
lozenges
increaed fluid intake
acetaminophen

antibiotics with bacterial infection -strep throat

pharm final (4 decks)

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