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Pharmacy 1 > Exam 2 36 37 41 > Flashcards

Exam 2 36 37 41 Flashcards

1
Q

Two virus’ that cause the common cold

A

Rhinovirus

influenza virus

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2
Q

How does virus’ cause upper Respiratory infection

A

by invading the tissues (mucosa) of the upper respiratory tract

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3
Q

4 drug classifications that healthcare treat the common cold with

A
  1. antihistamines
  2. nasal decongestants
  3. antitussives
  4. expectorants
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4
Q

T/F when treating the common cold the treatment is generally curative

A

False it is symptomatic

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5
Q

Does symptomatic treatment eliminate the causative pathogen?

A

No it is symptomatic so it only treats the symptoms. Curative would treat the pathogen

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6
Q

What are some things to watch out for (s/s) regarding antihistamines (4)

A
  1. drowsiness
  2. dysrhythmias
  3. dry mouth
  4. hypotension
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7
Q

Antihistamines medications are (3)

A

Diphenhydramine ( Benadryl)
Hydroxyzine (Vistoril)
Cetirizine (zyrtec)

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8
Q

Benadryl (diphenhydramine) gives the pt freedom from? (3)

A
  1. allergies
  2. Nausea
  3. vomiting
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9
Q

Vistoril (Hydroxyzine) gives the pt. freedom from? (2)

A

Anxiety

pain

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10
Q

___ antagonists are commonly referred to as antihistamines

A

H1

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11
Q

2 examples of H1 antagonists antihistamine

A
  1. Diphenhydramine ( benadryl)

2. Loratadine (Claritin)

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12
Q

The definition of Antihistaminic

A

counter acts the effect of the histamine

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13
Q

A substance that blocks the neurotransmitter acetylcholine is

A

anticholinergic

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14
Q

a substance that induces sedation by reducing irritability or excitement

A

sedative

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15
Q

what percentage of the general population is sensitive to various environmental allergies

A

10 to 20%

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16
Q

5 histamine-related disorders are

A
  1. allergic rhinitis
  2. anaphylaxis
  3. drug fever
  4. insect bite reactions
  5. Urticaria
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17
Q

What is urticaria

A

itching

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18
Q

3 triggers for an allergic rhinitis

A
  1. hay fever
  2. mold
  3. dust
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19
Q
  1. block action of histamine at H1 receptor sites
  2. compete with histamine for binding at unoccupied receptors
  3. cannot push histamine off the receptor if already bound’

These 3 things are all what

A

mechanism of action for antihistamines

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20
Q

what happens in the small blood vessels to histamine (think cardio)

A

Dilation and increase permeability

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21
Q

dilation and increased permeability of the small blood vessels allows what?

A

substances to leak into tissues

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22
Q

What happens to the blood vessels when an antihistamine is given?

A

dilation and increased permeability

this allows substances to leak into the tissues

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23
Q

what happens if antihistamine is given (think cardiac)

A

reduced dilation of blood vessels

reduced increase permeability of blood vessels

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24
Q

Histamine effects on smooth muscle (exocrine glands)

A

stimulate salivary, gastric, lacrimal, and bronchial secretions

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25
Q

Antihistamine effects on smooth muscle (exocrine glands)

A

reduce salivary, gastric, lacrimal and bronchial secretions

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26
Q

Mast cells releasing histamine and other substances result in ____ in the immune system

A

an allergic reaction

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27
Q

The immune system release ____ that binds to histamine receptors, thus preventing histamine from causing a response

A

antihistamine

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28
Q

Antihistamines also effects skin… How? (3)

A

reduce capillary permeability, wheal-and-flare formation, itching

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29
Q

What is the anticholinergic effects caused by antihistamines

A

drying effect that reduces nasal, salivary, and lacrimal gland secretions

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30
Q

What are the nasal, salivary, and lacrimal gland secretions

A

runny nose, tearing, and itching eyes

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31
Q

Some antihistamines can cause __

A

sedation

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32
Q

6 adverse effects of antihistamines

A
  1. anticholinergic (drying effects)
  2. dry mouth
  3. difficulty urinating
  4. constipation
  5. changes in vision
  6. drowsiness
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33
Q

what is the most common adverse effect of antihistamines

A

anticholinergic

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34
Q

What are the two types of antihitamines

A
  1. traditional

2. nonsedating/peripherally acting

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35
Q

what is an important nursing implication when gathering data regarding antihistamines? (2)

A

gather data about the condition or allergic reaction that required treatment; also assess for drug allergies

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36
Q

what is a nursing implication regarding antihistamines where it is contraindicated (2 disease process)

A
  1. acute asthma attacks

2. lower respiratory diseases IE pneumonia

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37
Q

A nursing implication, USE WITH CAUTION, for antihistamines is (9)

A
  1. intraocular pressure (glaucoma)
  2. cardiac disease
  3. renal disease
  4. HTN
  5. asthma
  6. COPD
  7. peptic ulcer disease
  8. BPH
  9. pregnancy
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38
Q

a nursing implication for antihistamines that you would instruct your pt to report to you if these should occur are? (3)

A
  1. report excessive sedation
  2. report confusion
  3. report hypotension
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39
Q

a nursing implication for antihistamines that you would instruct your pts to avoid are

A
  1. avoid driving or operating heavy machinery

2. avoid alcohol or other CNS depressants

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40
Q

Should the pt. be allowed to take over the counter or other prescribed medications while taking antihistamines.

A

No,

the nursing implication is that we are to instruct pts to not take these medications without checking with thier HCP

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41
Q

A nursing implication, should be ..when do you take antihistamines?

A

with meals to reduce GI upset

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42
Q

A nursing implication should be … if dry mouth occurs teach the pt. to (3)

A
  1. perform frequent mouth care
  2. chew gum
  3. suck on hard sugar free candy
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43
Q

3 drug classifications for cough

A
  1. antitussives
  2. expectorants
  3. mucolytics
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44
Q

what is the mechanism of action for antitussive

A

reduces coughing in nonproductive cough

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45
Q

what are some signs of caution for antitussive

A

drowsiness, GI upset and constipation

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46
Q

Mucus can be so think that ___ and ___ can grow in it

A

bacteria and virus

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47
Q

___ break the links that bind mucus together so it can be coughed up

A

Mucolytics

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48
Q

What is the mechanism of action for expectorants?

A

irritates mucous membranes to release the mucus

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49
Q

what are some signs of caution for expectorants?

A

GI upset, nausea and vomiting

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50
Q

What is the drug example for antitussive

A

dextromethorphan

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51
Q

what is the drug example for expectorant

A

guaifenesin (robitussin)

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52
Q

what is the drug example for mucolytics?

A

acetylcysteine (mucomyst)

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53
Q

what are some side effects of antitussive, mucolytics and expectorant (6)

A
  1. dizziness
  2. drowsiness
  3. vomiting
  4. bronchospasms
  5. rhinorrhea
  6. nausea
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54
Q

what are two primary causes of nasal congestion

A
  1. allergies

2. upper respiratory infections ( common cold)

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55
Q

What is the common complaint for nasal congestion

A

excessive nasal secretions

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56
Q

3 main types of decongestants

A
  1. adrenergics
  2. anticholinergics
  3. corticosteroids
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57
Q

2 key points about adrenergics

A
  1. largest group of medications for decongestants

2. is a sympathomimetic

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58
Q

2 key points about anticholinergics

A
  1. less commonly used medication for decongestant

2. is a parasympatholytic

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59
Q

2 key points about corticosteroids

A
  1. they are topical

2. they are also intranasal steroids

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60
Q

How are decongestants given? (2)

A
  1. oral

2. inhaled/topically applied to the nasal membranes

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61
Q

where is the site of action for nasal decongestants

A

blood vessels surrounding nasal sinuses

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62
Q

How do adrenergic (nasal decongestants) work

A

constrict the small blood vessels that supply URI structures

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63
Q

The result of nasal decongestants (adrenergic) are (not end result)

A

tissues shrink, and nasal secretions in the swollen mucous membranes are better able to drain

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64
Q

the end result of adrenergic a nasal decongestant is

A

nasal stuffiness is relieved

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65
Q

Nasal steroids have a ___ effect

A

antiinflammatory

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66
Q

How does nasal steroids work (mechanism of action)

A

work to turn off the immune system cells involved in the inflammatory response

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67
Q

if you decrease inflammation with nasal steroids you ___ congestion

A

decrease

yup that easy

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68
Q

End result of nasal steroid

A

nasal stuffiness is relieved

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69
Q

what are the two drug effects of nasal decongestants

A
  1. shrink engorged nasal mucous membranes

2. relieve nasal stuffiness

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70
Q

Adverse effects of adrenergics are (4) for nasal decongestant

A
  1. nervousness
  2. insomnia
  3. palpitations
  4. tremors
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71
Q

What systems can be affected by adrenergic stimulation (3) for nasal decongestant

A
  1. heart
  2. blood vessels
  3. CNS
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72
Q

Adverse effects of steroid for nasal decongestants

A

local mucosal dryness and irritation

73
Q

____ may cause HTN, palpitations, and CNS stimulation.

A

Decongestants

74
Q

Pts with ___, ___, and ___ stimulation should avoid decongestants

A
  1. HTN,
  2. Palpitations
  3. CNS stimulation
75
Q

Pts. on medication therapy for ___ should check with their PCP before taking over the counter decongestatnts

76
Q

Main thing to check for as a nursing implication with regards to decongestants

77
Q

A nurse should teach pts. taking nasal decongestants to avoid___

78
Q

Nursing implications regarding nasal decongestants should include teaching the pt to report (3)

A

1 fever

  1. cough
  2. other symptoms lasting longer than a week
79
Q

a commonly missed nursing implication for nasal decongestant is

A

monitor for intended therapeutic effects

80
Q

Respiratory secretions and foreign objects are naturally removed by the ___ ___

A

cough reflex

81
Q

Two mechanism of actions for the cough reflex

A
  1. induces coughing and expectoration

2. initiated by irritation of sensory receptors in the respiratory tract

82
Q

what are the two basic types of cough

A
  1. Productive cough

2. nonproductive cough

83
Q

___ has congestion, and removes excessive secretions

A

productive cough

84
Q

___ is a dry cough that produces nothing

A

nonproductive cough

85
Q

Most of the time, ___ is beneficial

86
Q

Why is coughing beneficial? (2)

A
  1. removes excessive secretions

2. removes potentially harmful foreign substances

87
Q

Give an example of when it would be harmful to cough

A

after hernia repair surgery

88
Q

Drugs used to stop or reduce coughing (this is the definition)

A

antitussive

89
Q

Antitussives have two classifications, they are

A
  1. opiod

2. nonopioid

90
Q

Antitussives are used only for ___ coughs

A

nonproductive

91
Q

what is the excepting to the rule for antitussives

A

may be used in cases where coughing is harmful

92
Q

what is the adverse effects of the antitussive: Benzonatate (5)

A
  1. dizziness
  2. headache
  3. sedation
  4. nausea
  5. (others) no freakin clue what she means by that
93
Q

what is the adverse effects of antitussive: Dextromethorphan (3)

A
  1. dizziness
  2. drowsiness
  3. nausea
94
Q

What is the adverse effects of Antitussive: opioids (5)

A
  1. sedation
  2. nausea
  3. vomiting
  4. lightheadedness
  5. constipation
95
Q

what is an assessment nursing intervention for antitussives

A

perform respiratory and cough assessment, and assess for allergies

96
Q

What teaching nursing implication should be instructed to pts. regarding antitussives

A
  1. instruct pts. to avoid driving or operating heavy equipment because of possible sedation, drowsiness or dizziness
97
Q

Pts. taking chewable antitussive tablets or lozenges should be cautioned about __

A

do not drink liquids for 30 to 35 minutes afterward

98
Q

pts. taking antitussives should report what symptoms to their caregiver? (4)

A
  1. cough that lasts more than a week
  2. a persistent headache
  3. fever
  4. rash
99
Q

Antitussives drugs are for ___ cough

A

nonproductive

100
Q

what are the 3 mechanism of action for expectorants

A
  1. drugs that aid in the expectoration of mucus
  2. reduce the viscosity of secretions
  3. disintegrate and thin secretions
101
Q

what is expectoration mean

102
Q

What are the indications to use expectorants:

A

used for the relief of productive coughs

103
Q

Productive coughs are associated with: (8)

A
  1. common cold
  2. bronchitis
  3. laryngitis
  4. pharyngitis
  5. coughs caused by chronic paranasal sinusitis
  6. pertussis
  7. influenza
  8. measles
104
Q

Guaifenesin is an example of _

A

expectorant

105
Q

adverse effects of guaifenesin (expectorant)

A
  1. nausea
  2. vomiting
  3. gastric irritation
106
Q

Iodinated glycerol is an example of ___

A

expectorants

107
Q

adverse effects of Iodinated glycerol(expectorants)

A
  1. GI irritation
  2. rash
  3. enlarged thyroid gland
108
Q

An example of herbal products that reduces symptoms of the common cold and recovery time

109
Q

adverse effects of echinacea (herbal products) (4)

A
  1. dermatitis
  2. GI disturbance
  3. dizziness
  4. headache
110
Q

expectorants should be used with caution in the ___ or those with ___ or ___ ____. This would be a nursing implication

A

elderly or those with asthma or respiratory insufficiency

111
Q

Nursing implication for expectorants should include ___ ___ if permitted to help loosen and liquefy secretions

A

more fluids

112
Q

what teaching nursing implication should you teach your pt. to report to you in regards to expectant

A

report fever, cough, or other symptoms lasting longer than a week

113
Q

3 methods of giving medications

A
  1. oral
  2. Topicals
  3. Parenteral
114
Q

6 examples of topical administration of drugs

A
  1. rectal
  2. Sublingual
  3. nasal
  4. eyes
  5. ears
  6. on the skin
115
Q

two assessments needed to give oral medications

A
  1. can they follow directions

2. ability to swallow

116
Q

4 ways to give parenteral medications

A
  1. IV
  2. intradermal
  3. subcutaneous
  4. IM
117
Q

two types of drugs used to treat asthma

A
  1. long-term control

2. quick relief

118
Q

3 examples of long-term control of asthma

A
  1. leukotriene receptor antagonists
  2. inhaled steroids
  3. long-acting beta2-agonists
119
Q

2 examples of quick relief drugs used to treat asthma

A
  1. intravenous systemic corticosteroids

2. short-acting inhaled beta2-agonists

120
Q

4 types of respiratory drugs (categories)

A
  1. bronchodilators
  2. anticholinergics
  3. leukotriene receptor antagonists
  4. corticosteroids
121
Q

2 types of bronchodilators used to treat respiratory issues

A
  1. beta-adrenergic agonists

2. xanthine derivatives

122
Q

This drug is:

  1. sympathomimetic, large group
  2. used during acute phase of asthmatic attacks
  3. quickly reduce airway constriction and restore normal airflow
  4. stimulate beta 2-adrenergic receptors throughout the lungs
A

bronchodilators: beta-agonists

123
Q

3 beta2-adrenergic agonist drugs

A
  1. albuterol (proventil)
  2. Terbutaline sulfate (brethine)
  3. Salmeterol (serevent)
124
Q

For Beta2-adrenergic agonist drugs what are some side effects

A
  1. tachycardia
  2. headache
  3. irritability
  4. anginal pain
  5. Tremors
125
Q

3 types of nonselective adrenergic (bronchodilator: beta agonists)

A
  1. stimulate alpha
  2. beta1 (cardiac)
  3. Beta2 (respiratory) receptors
126
Q

What does nonselective beta adrenergic (bronchodilator: beta-agonists) stimulate

A

stimulates both beta1 and beta2 receptors

127
Q

Example of nonselective beta-adrenergic drugs

128
Q

3 types of bronchodilators: Beta agonists are

A
  1. non selective adrenergic
  2. nonselective beta adrenergics
  3. selective beta 2 drugs
129
Q

example of selective beta2 drug:

A

albuterol (proventil)

130
Q

what does selective beta2 drug (bronchodilator beta-agonist) stimulate?

A

only beta 2 receptors

131
Q

What are 7 adverse effects of beta-agonists both alpha and beta (clown)

A
  1. insomnia
  2. restlessness
  3. anorexia
  4. vascular headache
  5. hyperglycemia
  6. tremor
  7. cardiac stimulation
132
Q

5 beta agonist side effects of beta1 and beta2 (metaproterenol/ alupent)

A
  1. cardiac stimulation
  2. tremor
  3. anginal pain
  4. vascular headache
  5. hypotension
133
Q

example of beta1 and beta2 beta-agonists

A

metaproterenol (alupent)

134
Q

3 adverse effects of beta agonist on beta2

A
  1. hypotension or hypertension
  2. vascular headache
  3. tremor
135
Q

example of beta 2 beta-agonist

136
Q

2 examples of anticholinergic

A
  1. ipratropium bromide (atrovent)

2. tiotropium (spiriva)

137
Q

anticholinergics are ___ and have ____ action

A

slow and prolonged action

138
Q

do you use anticholinergics for acute asthma exacerbation?

A

NO because they are slow to act

139
Q

5 adverse effects of anticholinergics

A
  1. dry mouth
  2. constipation
  3. urinary retention
  4. blurred vision
  5. tachycardia
140
Q

3 examples of plant alkaloid (bronchodilators: xanthine derivatives)

A
  1. caffeine
  2. theobromine
  3. theophylline
141
Q

The only plant alkaloid that is actually used as a bronchodilator

A

theophylline

142
Q

2 synthetic xanthine (bronchodilators)

A
  1. aminophylline

2. dyphilline

143
Q

xanthine derivatives have a ___ ___ on the kidneys

A

diuretic effect

144
Q

xanthine derivatives cause ____ stimulation

A

cardiovascular

145
Q

increasing cardiovascular stimulation is the increase force of ___ and increased __ ___, resulting in increased ___ output and increased ___ flow to the ___

A

contraction, heart rate, cardiac output, blood flow to the kidneys

146
Q

xanthine derivatives cause bronchodilation by ___ smooth muscle in the airways

147
Q

what is the result of xanthine derivatives

A

relief of bronchospasm and greater airflow into and out of the lungs

148
Q

what is the additional effect of xanthine deriatives

A

cns stimulation

149
Q

xanthine derivatives adverse effects: (9)

A
  1. nausea
  2. vomiting
  3. anorexia
  4. gastroesophageal reflux during sleep
  5. sinus tachycardia
  6. extrasystole,
  7. palpitations
  8. ventricular dysrhythmias
  9. transient increased urination
150
Q

what is leukotriene modifiers

A

newer class of asthma medications

151
Q

examples of asthma medications (3)

A

1, montelukast (singulair)

  1. zafirlukast (accolate)
  2. zileuton (zyflo)
152
Q

define leukotrienes

A

substances released when a trigger, such as cat hair or dust, starts a series of chemical reactions in the body

153
Q

leukotriene can cause 3 things. They are?

A

inflammation, bronchoconstriction and mucus production

154
Q

what assessment findings would you find with a leukotriene reaction

A

coughing wheezing and sob

155
Q

what prevents leukotrienes from attaching to receptors on cells in the lungs and in circulation

156
Q

LRTAs ____ inflammation in the lungs during an asthma episode

157
Q

an example of a leukotriene is

A

an allergen

158
Q

LRTAs drug effects block leukotrienes that does 4 things:

A
  1. prevent smooth muscle contraction of the bronchial airways
  2. decrease mucus secretion
  3. prevent vascular permeability
  4. decrease neutrophil and leukocyte infiltration to the lungs, preventing inflammation
159
Q

3 examples of LRTA

A
  1. zileuton (zyflo)
  2. Zafirlukast (accolate)
  3. Montelukast (singulair)
160
Q

What are the adverse effects of zileuton (zyflo) (6)

A
  1. headache
  2. dyspepsia
  3. nausea
  4. dizziness
  5. insomnia
  6. liver dysfunction
161
Q

What are the adverse effects of zafirlukast (accolate) (4)

A
  1. headache
  2. nausea
  3. diarrhea
  4. liver dysfunction
162
Q

what are the adverse effects of montelukast (singulair)

A
  1. nausea
  2. liver dysfunction

*key is fewer than zyflo and accolate

163
Q

corticosteroids have what type of properties

A

antiinflammatory

164
Q

what is corticosteroids used for

A

chronic asthma

165
Q

do you take corticosteroids to relieve acute asthmatic attack

A

NO to slow takes many weeks before full effects are seen

166
Q

type of forms that corticosteroids can be administered

A

oral or inhaled forms

167
Q

in corticosteroids which form reduces systemic effects

168
Q

stabilize membranes of cells that release harmful bronchoconstriction substances is the mechanism of action for what drug

A

corticosteroids

169
Q

what are the cells that corticosteroids stabilize?

A

leukocytes

170
Q

corticosteroids increase responsiveness of bronchial smooth muscle to __-__ __

A

beta-adrenergic stimulation

171
Q

3 inhaled corticosteroids are

A
  1. beclomethasone dipropionate (QAR)
  2. fluticasone (Flovent)
  3. budesonide (plumicort)
172
Q

2 oral corticosteroids are

A
  1. prednisolone

2. prednisone

173
Q

indications to use inhaled corticosteroids:

A
  1. treatments of bronchospastic disorders that are not controlled by conventional bronchodilators.
174
Q

what is a bronchospastic disorder

175
Q

is an inhaled corticosteroids is not indicated as

A

a first line drug for acute asthmatic attacks or status asthmaticus

176
Q

what is status asthmaticus

A

uncontrolled asthma attack not treatable by the normal drugs

177
Q

adverse effects of inhaled corticosteroids are (5)

A
  1. pharyngeal irritation
  2. coughing
  3. dry mouth
  4. oral fungal infections
  5. systemic effects are rare because low doses are used for inhalation therapy
178
Q

2 freedoms that zyrtec (cetirizine) can give the pt.

A
  1. sneezing

2. running nose

179
Q

3 properties of antihistamines:

A
  1. antihistaminic
  2. anticholinergic
  3. sedative

Pharmacy 1 (6 decks)

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