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Pharmacology > Exam 2 Study Guide- Respiratory > Flashcards

Exam 2 Study Guide- Respiratory Flashcards

1
Q

Alergic Rhinitis

  • what is it
  • causes the release of what
  • relieved by what medications
A
  • “Allergies”
  • causes histamine release
  • relieved by oral/intranasal congestants and anti-histamines
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2
Q

Histamine 1 (H1)

  • locations
  • causes what
A
  • found in smooth muscle

- causes many of symptoms of allergic rhinitis

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3
Q

Histamine 2 (H2)

  • location
  • responsible for
A
  • found in the stomach

- responsible for peptic ulcers

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4
Q

What is the prototype for antihistamines (H1 antagonists)?

A

diphenhydramine (Benadryl)

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5
Q

diphenhydramine (Benadryl)

  • use
  • mechanism of action
  • adverse effects
A
  • use: allergic reactions
  • moa: histamine (h1) receptor blocker
  • adverse effects: drowsiness, photosensitivity
  • slow IV push (no more than 25 mg/min)- can send pt into shock if pushed too fast
  • anticholinergic- dries up secretions; can cause urinary retention
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6
Q

What are the 2 prototypes for intranasal corticosteroids?

A
  • fluticasone (Flonase)

- beclomethasone (Beconase)

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7
Q

Intranasal Corticosteroids

  • use
  • major complaints
  • time frame
A
  • # 1 in treating allergic rhinitis
  • major complaints: nose bleeds and burning during administration
  • must be administered 2-3 weeks prior to allergen exposure

*reduces tissue edema (in turbenence)

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8
Q

fluticasone (Flonase) & beclomethasone (Beconase)

  • route
  • mechanism of action
  • adverse effects
A
  • topical steroid that is safe for patients
  • moa: decreases local inflammation in nasal passages, thus reducing nasal stuffiness
  • adverse effects: nasal irritation, epistaxis
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9
Q

What is the prototype for intranasal sympathomimetics?

A

oxymetazoline (Afrine)

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10
Q

Intranasal & Oral Sympathomimetics

  • use
  • mechanism of action
A
  • used as decongestants

- moa: constrict blood vessels (potential issue with patients with HTN)

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11
Q

oxymetazoline (Afrin)

  • time frame
  • potential adverse effect
  • mechanism of action
A
  • can only be used for 3-5 days (if used longer can cause rebound congestion)
  • can cause blurred vision if you don’t wash your hands after administering
  • moa: causes arterioles in nasal passages to constrict; dries mucous membrane
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12
Q

What is the prototype for oral sympathomimetics?

A

pseudoephedrine (Sudafed)

*often combined with antihistamine preparation (examples: Zyrtec-D and Allegra-D)

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13
Q

What medications are used to inhibit a severe cough?

A

Opiods

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14
Q

Antitussives inhibit _________ and expectorants inhibit __________ ____________.

A

Cough; mucous production

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15
Q

What are the prototype drugs for antitussives?

A

dextromethorphan (Benylin) & Delsym

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16
Q

dextromethorphan (Benylin) & Delsym

  • mechanism of action
  • adverse effects
  • effects of large amounts
A
  • moa: acts in the medulla to inhibit cough reflex
  • adverse effects: dizziness, drowsiness, GI upset
  • very large amounts can cause euphoria type effect
17
Q

Aerosol Therapy

  • provides immediate relief of what
  • possible side effects
A
  • provides immediate relief of bronchospasm by loosening thick mucous
  • side effects can occur if pt swallows drug or doesn’t rinse mouth after inhalation
18
Q

What are the 3 devices used for aerosol therapy?

A
  1. Nebulizer
  2. Metered-dose inhaler (always shake and expel first air)
  3. Dry powder inhaler (activated by inhalation; long lasting so should last for 12 hours)
19
Q

Characteristics of Asthma (2)

A
  • inflammation coupled with mucous production

- bronchospasm (spasms in the lungs, making it difficult to breath)

20
Q

Status asthmaticus

-definition

A
  • prolonged asthma attack

* pt typically admitted to the ICU for close monitoring; can be life-threatening

21
Q

What are the 4 medications used for asthma?

A
  1. Beta-adrenergic agonists (Albuterol)
  2. Bronchodilators (Atrovent)
  3. Methylxanthines (Theophylline)
  4. Corticosteroids (Prednisone)
22
Q

Beta-adrenergic agonist

  • prototype
  • most effective against what
  • moa
  • adverse effects
  • teaching
  • normal adult dose
A
  • Proto: Albuterol
  • most effective for relieving acute broncho spasm
  • moa: activate beta2 receptors in bronchial smooth muscle to cause bronchodilation
  • adverse effects: tachycardia, increased BP
  • teaching: normal breathing, deep breath every 5th breath, shake well, expel first air
  • norm. adult dose: 2puffs/4hours as needed
23
Q

Bronchodilators-antocholinergic

  • prototype
  • moa
  • adverse effects
A
  • Proto: Atrovent
  • moa: dries up secretions
  • adverse effects: cough, drying of nasal mucosa, bitter taste

**used a lot with COPD patent because of the increased mucous production

24
Q

Methylxanthines

  • prototype
  • use
A
  • Prototype: Theophylline
  • use: primarily for long-term prophylaxis of asthma that it unresponsive to beta agonists or corticosteroids

*narrow margin of safety (8-20 mcg/mL)

25
Q

Corticosteroids

  • prototype
  • use
  • adverse effects
A
  • Proto: Prednisone
  • used to decrease frequency of asthma attacks
  • adverse effects: orpharyngeal candidiasis, weight gain, adrenal insufficient, hyperglycemia
26
Q

Leukotriene Modifiers

  • prototype
  • use
  • mechanism of action
  • adverse effects
A
  • Proto: Accolate
  • use: persistent, chronic asthma
  • moa: prevented airway edema and inflammation by blocking leukotriene receptors in airways
  • adverse effects: headache, nausea, diarrhea
  • Liver issues- use caution due to reported cases of liver failure
  • Warfarin- increases PT l
  • Erthromycin- decreases serum levels
  • Aspirin- increases levels of meds
27
Q

Contraindications in the treatment of asthma

  • Beta2 agonist (Albuterol)
  • Methylxanthines (Theophylline)
A
  • Beta2 agonist: beta blockers; shouldn’t be used if pt has hx of dysrhythmias or MI
  • Methylxanthines: CAD, angina pectoris, severe renal or liver disorders (this medication is cleared by the kidneys and liver- 50% in levels of medication), peptic ulcer, BPH, diabetes mellitus

Pharmacology (5 decks)

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