Exam 3: Respiratory Meds Flashcards
What is the action of a mucolytic?
breaks bonds of mucus to be less viscous and smaller
What is the prototype drug for mucolytic class?
Acetylcysteine/Mucomyst
What drug is acetylecysteine the antidote for?
Acetaminophen
What pt diagnosis would mucomyst be contraindicated in?
Pt with asthma
explanation: Bronchospasm may occur in asthmatics; nebulized solution
What effects could Mucomyst have on a patient?
N/V due to rotten egg odor
sticky coating on face after nebulization
What is the action of an expectorant or bronchomucotropic?
helps to liquify (reduce viscosity)/increase volume of secretions by irritating GI system and stimulates nerve endings AKA gastropulmonary reflex
What is the prototype drug for expectorant class?
guaifenesin/Robitussin/Mucinex
What teaching should the nurse give a patient taking an expectorant?
increase water intake because the medication draws fluid from body
T/F:Guaifensin causes GI ulcers.
False
side effects are rare and has occasional GI irritation but not enough to cause ulcers
Which of the following is a sympathomimetic non selective bronchodilator?
A: epinephrine
B: Isoproterenol
C: Albuterol
D: Ipratropium
Epinephrine
non-selective does all sympathetic things
stimulates Alpha, Beta 1 and 2
Which of the following best describes how Epinephrine is administered?
1: IM
2: breathing tube
3: SQ
4: Oral
A) 1 and 2
B) 1,2,3
C) 1
D) None of the above
B
Cannot be given orally because it will be destroyed by enzymes
What effects does epinephrine have on the body?
1: vasoconstricttion to reduce edema
2: Stimulates HR and force of contraction
3: induces bronchial smooth muscle relaxation
4: none of the above
1, 2, 3
Alpha: vasconstriction
Beta 1: heart
Beta 2: lungs
What are side effects the nurse may expect from their patient after using their epi pen?
A: headache
B: Tachycardia
C: tremors
D: Dyspnea
E: All of the above
E
A pt with what diagnosis would epi administration be contraindicated? Select all that apply.
A: liver failure
B: Kidney problems
C: HTN
D: CAD
E: Hyperthyroidism
C, D, E
What medication should be avoided when using epi?
MAO Inhibitors
will cause severe HTN
Which of the following is a sympathomimetic non-selective Beta stimulator bronchodilator?
A: Epinephrine
B:Isoproterenol
C: Albuterol
D: Ipratropium
B
What action does Isoproterenol have on the body?
stimulates Beta 1 and 2
heart and causes bronchodilation and decreases tone and motility of GI tract and uterus
Which of the following are side effects of Isoproterenol?
A: tachycardia and palpitations
B: headache
C: Nausea
D: tremors
E: insomnia
F: All of the above
F
How is isoproterenol administered?
IV and inhalation
T/F: The nurse can expect her patient to be discharged with isoproterenol.
F
only seen in inpatient settings, commonly ICU and long term use decreases efficacy
What is the classification of albuterol?
sympathomimetic selective beta 2 stimulator
beta 2 only stimulates the lungs
What effects can the nurse observe in her patient after the administration of albuterol?
opens airways
relaxation of smooth muscles
What type of inhaler is albuterol?
Short acting, used for acute treatment of episode
“rescue inhaler” “inhaler” lasts longer than epi but onset is slower
Which type of inhaler should be administered first: SABA or LABA
SABA
give fastest acting first to open airways and LABA to prevent constriction
What is ipratropium?
Anticholinergic bronchodilator, an inhlaed short acting muscarinic antagonist (SAAMA)
Which patient would the provider prescribe ipratropium (Atrovent)?
A) COPD
B) Asthma
C) SOB
COPD
What is the action of ipratropium?
blocks cholinergic receptors, reducing bronchial tone
cholinergic=constrict/ rest and digest
What are the side effects of Atrovent?
dry mouth, pharyngeal irritation
What is the prototype for methylated xanthine?
Aminophylline (Theophylline)
What is the action of aminophylline?
directly affects smooth muscle for relaxation through inhibition of phosphodiesterase allowing increased cAMP
phosphodiesterase is needed to make cAMP
What is another drug in the category of methylated xanthine?
caffeine
What parts of the body does the methylated xanthine class stimulate?
heart, CNS, renal excretion, and medullary respiratory center
What are the ADRs of Aminophylline?
GI: anorexia, N/V (stimulates vomiting center), abdominal discomfort
CNS: nervousness, insomnia, irritability, headache, severe convulsions, and coma
CV: tachy, severe– hypotension and arrhythmias
Urinary frequency
T/F The half life of aminophylline is shorter in non smokers than smokers.
F
