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NRSG 106: Pharmacology > [Exam 1] Module 4 - Drug Therapy for Upper Respiratory Disorders > Flashcards

[Exam 1] Module 4 - Drug Therapy for Upper Respiratory Disorders Flashcards

1
Q

What are the two types of antihistamines?

A

Those that cause sedation (first-generation) and those that do not (second-generation)

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2
Q

First-Generation Antihistamines / Sedating Antihistamines : Use antihistamines in the management of

A

mild allergic reactions, such as season allergic rhinitis, mild transfusions, and urticaria which is referred to as hives and appears as raised, itchy welts .

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3
Q

First-Generation Antihistamines / Sedating Antihistamines : You can use antihistamines during severe allergic reactions of anaphylactic nature that cause

A

hypotension, acute laryngeal edema, and bronchospasm and can be life-threathening.

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4
Q

First-Generation Antihistamines / Sedating Antihistamines : They are noted for their

A

sedative effects and often in drugs that treat insomnia

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5
Q

First-Generation Antihistamines / Sedating Antihistamines : Prototype and Other Drugs

A

Diphenhydramine (Benadryl)

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6
Q

First-Generation Antihistamines / Sedating Antihistamines - Expected Pharmacologic Action: These bind to what? And do what?

A

Bind to H1 Receptors, and block release of histamine. This make it effective in treatment of allergies.

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7
Q

First-Generation Antihistamines / Sedating Antihistamines - Expected Pharmacologic Action: Sedating antihistamines are also mild

A

cholinergic blockers, producing actions similar to anticholinergic drugs. Dry mouth , constipation, and urinary hesitancy

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8
Q

First-Generation Antihistamines / Sedating Antihistamines - Adverse Drug Reactions: Reactions are

A

mild and consist of drowsiness and dizziness, as well as anticholinergic effects

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9
Q

First-Generation Antihistamines / Sedating Antihistamines - Interventions: Because of sedating effects and potential for dizziness, monitor clients

A

when ambulating, and advice against operating machinery

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10
Q

First-Generation Antihistamines / Sedating Antihistamines - Interventions: If experiencing excesive sedation,

A

recommend swtiching to nonsedating antihistamine

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11
Q

First-Generation Antihistamines / Sedating Antihistamines - Interventions: To combat anticholinergic effects of dry mouth… encourage client to

A

sip on water or hard candy.

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12
Q

First-Generation Antihistamines / Sedating Antihistamines - Interventions: Given the drug with food will help decrease

A

GI discomfort

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13
Q

First-Generation Antihistamines / Sedating Antihistamines - Interventions: IF acute toxicity does develop, administer

A

activated charcoal to neutralize the drug and laxatives to facilitate elimination of absorbed drug.

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14
Q

First-Generation Antihistamines / Sedating Antihistamines - Interventions: What to do with fever?

A

Administer acetaminophen for fever, adn apply ice packs or give sponge baths to reduce fever

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15
Q

First-Generation Antihistamines / Sedating Antihistamines - Administration: How is this administered?

A

Enteric Coated Drug. Don’t chew or crush

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16
Q

First-Generation Antihistamines / Sedating Antihistamines - Administration: Make sure not to take with

A

alcohol or other CNS depressants because of risk of additional CNS depression

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17
Q

First-Generation Antihistamines / Sedating Antihistamines - Administration: If given for motion sickness, give…

A

30 minutes before activity, or 1-2 hours before activity

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18
Q

First-Generation Antihistamines / Sedating Antihistamines - Client Instructions: Instruct to take when?

A

At or just before bedtime. Also suck on hard candy and increase fiber.

With difficulty urinating, notify provider.

Abdominal discomofrt? Take drug with food

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19
Q

First-Generation Antihistamines / Sedating Antihistamines - Client Contraindications and PRecautions: Contraindicated in

A

newborns and children under age of 2.

Also those with narrow-angle glucoma , prostatic hypertrophy, or acute exacerbation of asthma.

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20
Q

First-Generation Antihistamines / Sedating Antihistamines - Client Contraindications and PRecautions: Those with narrow-angle glaucoma need to be told

A

avoid taking diphenhydramine because it can potentially cause sudden and painful increase in intraocular pressure

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21
Q

First-Generation Antihistamines / Sedating Antihistamines - Indications: Interact with other

A

alcohol and CNS depressants because they increase the depressent effect of antihistamines

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22
Q

Second-Generation/Nonsedating Antihistamines: Why are these better

A

Fewer side effects and currently available as OTC.

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23
Q

Second-Generation/Nonsedating Antihistamines: Therapeutic use includes

A

Allergic Rhinitis

Treatment for Chronic Idiopathic Urticaria (which is rash and hives)

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24
Q

Second-Generation/Nonsedating Antihistamines - Prototype:

A

Cetirizine (Zyrtec)

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25
Q

Second-Generation/Nonsedating Antihistamines - Expected Pharmacologic Action: How does this work?

A

Antagonize histamine effects at H1, witout binding to or inactivating histamine . This is what makes allergic rhinitis and idiopathic urticaria effective

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26
Q

Second-Generation/Nonsedating Antihistamines - Expected Pharmacologic Action:Dosing happens how often?

A

Once daily

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27
Q

Second-Generation/Nonsedating Antihistamines - Adverse Drug Reactions: Some clients may experience what side effects?

A

Drowsiness, as well as fatigue.

Dry mouth, nose, adn throat may occur

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28
Q

Second-Generation/Nonsedating Antihistamines - Interventions: Asses patients during

A

ambulation to determine their degree of drowsiness and fatigue. Make sure water present too

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29
Q

Second-Generation/Nonsedating Antihistamines - Interventions: Maintain fluid

A

1500 - 2000 mL per day

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30
Q

Second-Generation/Nonsedating Antihistamines - Administration: Give with food?

A

Can give with or without food

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31
Q

Second-Generation/Nonsedating Antihistamines - Administration: Do not give this with what other drug?

A

Other OTC Antihistamines

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32
Q

Second-Generation/Nonsedating Antihistamines - Administration: Dosage for someone with compromised liver or kdiney function?

A

Decreased

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33
Q

Second-Generation/Nonsedating Antihistamines - Client Instructions:

A

Take once daily

Avoid driving and activites that require mental alertness

Frequent water sips adn hard candy sucking

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34
Q

Second-Generation/Nonsedating Antihistamines - Contraindications and Precautions: Don’t go to who?

A

Those under 6 months or women breastfeeding

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35
Q

Second-Generation/Nonsedating Antihistamines - Client Instructions: Don’t give for those to allergies with

A

H1 Antihistamine receptors or hydroxyzine.

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36
Q

Second-Generation/Nonsedating Antihistamines - Client Instructions: USe cautiosly for those with

A

impaired kidney or liver function because delay in metabolism

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37
Q

Second-Generation/Nonsedating Antihistamines - Interactions

A

Theo-24 can reduce clearance of nonsedating antihistamine from body and lead to toxicity.

CNS Depression potentiate by sedative/hypnotics , opioid analgesics, or alcohol

38
Q

Antitussives: What do they do?

A

Suppress chronic, nonproductive coughing, which commonly relates to allergies or upper respiratory infections. Known as cough suppressants

39
Q

Antitussives (Opioid) - Prototype:

A

Codeine

40
Q

Antitussives (Opioid) - Expected Pharmacologic Action: Work by

A

suppresing the cough reflex in the brain

41
Q

Antitussives (Non-opioid) - Expected Pharmacologic Action:

A

suppresing the cough reflex in the brain

42
Q

Antitussives (Non-Opioid) - Prototype:

A

Dextromethorphan (Delsym)

43
Q

Antitussives (Opioid) - Adverse Drug Reactions: Common side effects are

A

Drowsiness and sedation.

Dizziness and Lightheadedness with GI Distress , N/V.

Constipation and Respiratory Depression because of depression of CNS

44
Q

Antitussives (Opioid) - Adverse Drug Reactions: There is a potential for

A

abuse, so monitor them closely.

45
Q

Antitussives (Non-opioid) - Adverse Drug Reactions: Drowsiness and Sedation are only present if

A

you give large doses, or give the doses concurrently with other CNS depressent drugs

46
Q

Antitussives (Opioid) - Interventions: Monitor patients when they

A

change positions or ambulate because they could be dizzy or lightheaded.

47
Q

Antitussives (Opioid) - Interventions: To prevent GI distress, administer

A

antitussive with either food o milk

48
Q

Antitussives (Opioid) - Interventions: When should you give this?

A

Only when needed , because of its potential for abuse.

49
Q

Antitussives (Opioid) - Interventions (Safety Alert): For clients taking opioid drugs they may experience respiratory depression. Monitor what?

A

RR. If below 12, stop drug. Give reversal drug like Naloxone (Narcan)

50
Q

Antitussives (Opioid) - Administration: Only use antitussives on a how long basis?

A

Short-term basis and at lowest effective dose possible

51
Q

Antitussives (Opioid) - Client Instructions: What to do if lightheadedness experienced?

A

Change positions gradually and to sit or lie down

52
Q

Antitussives (Opioid) - Client Instructions: If GI distress occurs..

A

Take the drug with food or milk

53
Q

Antitussives (Opioid) - Client Instructions: Increase their daily intake of

A

fluids and fiber.

54
Q

Antitussives (Opioid) - Client Instructions: Clients taking these drugs should not participate in activites that

A

require mental alertness, drink alcohol, or take any other CNS depressent drugs

55
Q

Antitussives (Opioid) - Contraindications and Precautions: Contraindicated in clients with known sensitivity to

A

Drug, and where concurrent use of MAO inhibitors and SSRIs is indicated

56
Q

Antitussives (Opioid) - Contraindications and Precautions: With this causing respiratory depression, who must look out?

A

Clients who have reduced respiratory reserve

57
Q

Antitussives (Opioid) - Contraindications and Precautions: Inform men with prostatic hypertrophy that

A

antissives may cause urinary retention

58
Q

Antitussives (Opioid) - Interactions: If combined with alcohol and other CNS depresents, will increase

A

CNS depressent efects

59
Q

Antitussives (NonOpioid) - Interactions: Increase the analgesic effects of

A

opioids prescribed for pain

60
Q

Antitussives (Opioid) - Interactions: Fever and hypotension may occur if

A

nonopoid antitussives taken with MAOI antidepressent.

St John wart may increase sedation

61
Q

Expectorants: What do they do?

A

Drugs to treat colds adn other upper respiratory infections that produce mucus as part of disease process

Can also give them bronchitis to facilitate removal of secretions

62
Q

Expectorants - Prototype:

A

Guaifensein (Mucinex)

63
Q

Expectorants - Expected Pharmacologic Action: REaction is

A

reduction in the surface tension of secretions. Thins the thick mucus, making it easier to cough out.

64
Q

Expectorants - Adverse Drug Reactions:

A

May experience dizziness, drowsiness, headache, GI Distress and allergic reaction

65
Q

Expectorants - Interventions: Because of dizziness and drowsiness, monitor them as

A

they change positions or ambulate

66
Q

Expectorants - Interventions: Avoid GI Distress by

A

giving the drug with food or 8 oz of water

67
Q

Expectorants - Administration: When giving, make sure client…

A

increases their fluid intake to help the expectorant liquefy secretions

68
Q

Expectorants - Administration: If worsening of cough or high fever, notify pprovider because

A

may be development of pneumonia

69
Q

Expectorants - Administration: Give expectorants only when

A

needed and not with combination products for colds that also contain guaifenesin.

70
Q

Expectorants - Administration: Available in

A

tablets and sustained-release formulations

71
Q

Expectorants - Client Instructions: Avoid

A

driving or engaging in activities that require mental alertness.

72
Q

Expectorants - Client Instructions: If experiecing GI Distress…

A

instruct them to take the drug with fofod or 8 oz of water.

73
Q

Expectorants - Contraindication and Precautions: Contraindicated for clients with

A

known sensitivity and in clients with phenylketonura (aspartame content)

74
Q

Expectorants - Contraindication and Precautions: USe incaution for those who have

A

cough lasting more than one week

diabetes

Clients receiving disulfiram

75
Q

Expectorants - Interactions

A

No significant drug-drug interactions

76
Q

Mucolytics: What are these?

A

inhalants drugs client need to decrease viscosity of mucous secretions.

77
Q

Mucolytics: This can reverse what overdose?

A

Acetylcysteine (Acetadote) and can be administerd orally or intravenously

78
Q

Mucolytics - Prototype:

A

Acetylcysteine (Acetadote)

79
Q

Mucolytics - Expected Pharmacologic Action: Work by

A

breakign disulfide linkages of proteins in mucus, subsequently decreasing viscosity of mucus. Allows client to expectorate the mucus

80
Q

Mucolytics - Adverse Drug Reactions: Side effect is

A

Bronchospasm and GI Distress.

81
Q

Mucolytics - Adverse Drug Reactions: Drugs rotten-egg smell can precipitate

A

nausea in clients, along with ingestion of copious amounts of secretions

82
Q

Mucolytics - Interventions: Closely monitor

A

clients respiratory status on a regular basis. Includes auscultation.

83
Q

Mucolytics - Interventions: Clients may need bronchodilator along with

A

the mucolytic to enhance its effectiveness in removing secretions

84
Q

Mucolytics - Interventions (Safety Alert): If trouble managing teh increase in secretions, give

A

suction equipment and have readily available

85
Q

Mucolytics - Administration: For those with bronchopulmonary disease, you give by

A

inhalation throuhg a nebulizer or by direct instillation through a tracheotomy tube

86
Q

Mucolytics - Administration: When giving acetylcysteine, its important to ensure

A

that the equipment you use does not contain metal or rubber parts

87
Q

Mucolytics - Client Instructions: Tell them to report any

A

difficulty breathing or worsening cough. Encourage them to expectorate secretions

88
Q

Mucolytics - Client Instructions (Safety Alert): Instruct clients on proper cleaning of

A

nebulizer equipment they use during respiratory treatments.

89
Q

Mucolytics - Contraindications and Precautions: Dont use oral mucolytics in clients who have

A

risk of or have actual gastric bleeding

90
Q

Mucolytics - Contraindications and Precautions: Use in caution in clients who have

A

asthma, history of bronchospasm, or severe respiratory insufficiency.

91
Q

Mucolytics - Interactions: No

A

No known drug or food interactions

NRSG 106: Pharmacology (14 decks)

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