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NSG 345 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Short Acting Beta Agonists (SABA)

A

Albuterol:
-short acting beta 2 agonist that relaxes bronchial smooth muscle

  • Used for treatment of bronchospasm
  • Onset: within 10 mins
  • Duration: 4-6 hrs
  • Adverse effects: excitement, nervousness, tremor, bronchospasm, tachycardia
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2
Q

Long Acting Beta Agonist (LABA)

A

Formoterol:
-long acting beta 2 agonist that relaxes bronchial smooth muscle

  • Used for long term prevention of bronchospasm
  • Onset: within 3 mins, but peaks within 1-3 hrs
  • Duration: 12 hrs
  • Adverse effects: excitement, nervousness, tremor, bronchospasm, tachycardia
  • SHOULD NOT BE USED FOR TREATMENT OF ACUTE ASTHMA EXACERBATIONS*
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3
Q

Short Acting Anticholinergics (SAMA)

A

Ipratropium:
-blocks the action of acetylcholine on bronchial smooth muscle which causes bronchodilation

  • Used for COPD maintenance, off-label asthma exacerbations
  • Onset: within 15 mins
  • Duration: Neb 4-5hrs, MDI 2-4 hrs
  • Adverse effects: bronchitis, headache, dizziness, anticholinergic effects
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4
Q

Long Acting Anticholinergics (LAMA)

A

Tiotropium:
-blocks the action of acetylcholine on bronchial smooth muscle which causes bronchodilation

  • Used for COPD/asthma maintenance
  • Half-life: 25-44 hrs
  • Adverse effects: bronchitis, headache, dizziness, anticholinergic effects
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5
Q

Inhaled Corticosteroids (ICS)

A

Budesonide:
-Used for COPD/asthma maintenance

  • Onset: Neb 2-8 days, Inhaler 24 hrs
  • Adverse effects: otitis media, respiratory infections, thrush, immunosuppression
  • NOT USED IN ACUTE RESPIRATORY DISTRESS*
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6
Q

Systemic IV steroid

A

Solumedrol:
-Used for COPD/asthma exacerbations

  • Onset: 1 hr
  • Adverse effects: immunosuppression, hyperglycemia
  • Monitor response and glucose
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7
Q

Oral Systemic Glucocorticoid

A

Prednisone:
-Used for long term management of severe COPD/asthma, acute asthma/COPD exacerbations

-Adverse effects: (dry mouth, throat irritation, hoarseness)
(headache, euphoria, confusion, depression) (hyperglycemia, GI distress, hypertension) (electrolyte imbalance, fluid retention) (osteoporosis, psychosis, superinfections)

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8
Q

Magnesium sulfate

A
  • Classification: Electrolyte supplement
  • Uses: off labeled treatment of severe asthma exacerbations
  • Onset: IV immediate
  • Adverse effects: flushing, hypotension
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9
Q

Epinephrine

A
  • Classification: alpha/beta agonist
  • Uses: severe bronchospasm in asthma exacerbations
  • Onset: SQ 5-10 mins
  • Adverse effects: cardiovascular effects
  • Monitor cardiopulmonary response
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10
Q

Xolair

A
  • Classification: IgG monoclonal antibody
  • inhibits IgE binding to IgE receptors on mast cells and basophils
  • for pts whose asthma is triggered by allergens
  • Onset: 12-16 weeks
  • Half-life: 26 days
  • Adverse effects: headaches, local injection site reactions
  • Monitor for anaphylactic/hypersensitivity reactions, monitor baseline IgE, monitor for signs of infection (bc it has immunosuppressant affects)
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11
Q

Leukotriene Receptor Antagonist

A

Singulair
-leukotriene receptor plays a role in promoting the associated airway edema, smooth muscle contraction and altered cellular activity associated with inflammatory process of asthma

  • Uses: asthma maintenance
  • Duration: 24 hrs
  • Adverse effects: headache, dizziness, fatigue, nausea, and neuropyschiatric events
  • Monitor mood or behavior changes including suicidal thoughts/actions
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12
Q

Mucolytics

A

Acetylcysteine
-Uses: adjunct therapy in pts with abnormal viscous secretions like COPD/bronchial asthma

  • Onset: 5 -10 mins
  • Adverse effects: chest tightness, hypotension, rash, GI symptoms, bronchospasm
  • Likely will increase bronchial secretions*
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13
Q

First generation antihistamines

A

Cause drowsiness

Ex: diphenhydramine (Benadryl)

Avoid use with MAOIs, CNS depression with use of alcohol, barbituates, hypnotics and opioids

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14
Q

Second generation antihistamines

A

Less drowsiness

Ex: cetirizine, loratadine, desloratadine, fexofenadine
Half life: 3-30 hrs

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15
Q

Decongestants

A

Stimulate alpha adrenergic receptors causing vasoconstriction of capillaries in mucosa allowing less fluid secretion

Long term use can cause rebound nasal congestion

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16
Q

Glucocorticoids

A

Prednisone, beclomethasone

Stabilization of mast cells
Anti-inflammatory action

17
Q

Antitussives

A

Act on cough control center in medulla to stop cough reflex

1) non-opioid (Benzonatate)
2) opioid (codeine, guaifenesin)
3) combination

Ex: dextromethorphan - expectorant and antitussive (non-opioid)

18
Q

Expectorants

A

Loosen bronchial secretions so they can be excreted by coughing

Ex: guaifenesin (most common), dextromethorphan can be used as expectorant

Maintain good hydration to help thin secretions (hydration is natural expectorant)

19
Q

Rapid acting insulin

A

Ex: insulin lispro, insulin aspart, glulisine

Onset: 15-30mins

Administer 10-15 mins before meal time

20
Q

Short acting insulin

A

Regular insulin

Onset: 30 mins
Peak: 90 mins-3.5 hrs
Duration: 4-12 hrs

21
Q

Intermediate acting insulin

A

NPH, Humulin N, Novolin N

Onset: 1-2 hrs
Peak: 4-12 hrs
Duration: 14-24 hrs

22
Q

Long acting insulin

A

Lantus (glargine), Levemir (detemir)

Onset: 2 hrs
Peak: NONE
Duration: 24 hrs

23
Q

Somoygi effect

A

Hypoglycemia in pre-dawn hours (2am-4am)

Indicates decrease insulin dose at bedtime

24
Q

Dawn phenomenon

A

Hyperglycemia upon awakening

Indicates need for increased insulin dose at bedtime

25
Q

Sulfonylurea

A

Oral hypoglycemic that stimulates pancreatic beta cells to produce insulin

Only used in type 2 diabetes (bc type 1 diabetics can’t make insulin)

26
Q

Biguanide

A

Metformin

Non-sulfonylurea that acts on the liver, decreasing production of glucose from stored glycogen
Also decreases absorption of glucose in the small intestine

Eliminated unchanged in urine, not metabolized by liver

May cause metallic taste in mouth

NSG 345 (1 decks)

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