Exam 3: Upper Respiratory Tract Disorders Flashcards

1
Q

Inflammatory process

A

Protective response of the body to harmful stimuli with the goal of removing the irritant and/or limiting its spread

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2
Q

Most common conditions that affect the upper respiratory tract involve the

A

Inflammatory response and it’s effects on the mucosal layer of the conducting airway

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3
Q

Common cold

A

Caused by a number of viruses

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4
Q

Seasonal (allergic) Rhinitis

A

Inflammation of the nasal cavity

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5
Q

Sinusitis

A

Inflammation of the epithelial cells lining the sinus cavities

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6
Q

Pharyngitis and Laryngitis

A

Infections of the pharynx and the larynx; caused by common bacteria or viruses

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7
Q

Infection

A

A contagion of the body tissues with disease causing agents that multiple and lead to a response by the immune system to their presence and the toxins they produce

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8
Q

Causes of common cold

A

Invasion of body by a cold virus such as rhinovirus or influenza

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9
Q

Symptoms of the common cold

A

Excess mucus production
Swelling or nasal and sinus mucous membranes
Redness of eyes, nose, and throat
Nasal congestion, coughing, and sneezing

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10
Q

Allergy is a reaction

A

to something from outside the body

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11
Q

The most common type of allergies

A

Type 1 hypersensitivity reactions

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12
Q

Type 1 hypersensitivity reactions occur after an

A

individual is sensitized by initial expose to an antigen (allergen)

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13
Q

Examples of antigen

A
Pollen 
Mold 
Dust mites 
Cockroaches 
Animal dander 
Foods
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14
Q

Immune system involvement for type 1 hypersensitivity

A
Antigen 
Mast cells that line upper airways 
Immunoglobin E (ig E) antibosy 
Eosinophils
Cytokines 
Chemical mediators act locally
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15
Q

What do IgE’s ?

A

IgE coats the surface of the mast cells in tissues, cause the mast cell to degranulate and release chemical mediators

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16
Q

What chemical mediators are released from a degranulated mast cell

A

Histamine

Serotonin

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17
Q

Examples of cytokines

A

Histamine
Serotonin
Leukotrienes
Prostaglandins and thomboxanes

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18
Q

Histamine effects

A
Vasodilation 
Increases capillary permeability 
Smooth muscle contraction ---> broncho constriction 
Urticaria 
Angioedema
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19
Q

Serotonin effects

A

Vasodilation
Increase capillary permeability
Smooth muscle contraction —> bronchoconstriction

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20
Q

Leukotrienes is produced during hypersensitivity rxn from

A

Arachidonic acid via LOX pathway

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21
Q

Leukotrienes effect

A

Increases capillary permeability
Smooth muscle contraction –> bronchoconstriction
Stimulates the influx of eosinophils and neutrophils into airway tissues

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22
Q

Prostaglandins and thromboxanes are synthesized at

A

the site, derived from arachidonic acid via COX pathway

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23
Q

Prostaglandins and thromboxane effects

A

Vascular dilation
Increase capillary permeability
bronchoconstriction

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24
Q

Eosinophil is a type of

A

White blood cell

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25
Q

Eosinophil sound increase with

A

Hypersensitivity reactions/diseases

Parasitic diseases

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26
Q

Are eosinophils phagocytic?

A

No! they are not phagocytic or mildly phagocytic

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27
Q

Killing mechanism of eosinophil

A

Binds to and empties its contents onto a parasite, damaging its surface and killing it

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28
Q

Eosinophils contain

A

Histaminase (degrades histamine)

Leukotrienes

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29
Q

Histaminase

A

Enzyme the degrades histamine

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30
Q

Symptoms of allergic reactions / inflammatory response

A
Local vasodilation 
Increase capillary permeability 
Leakage of fluid into extravascular space 
Smooth muscle CONTRACTION --> bronchospasm 
Itchy watery eyes 
Uticaria (hives) 
Increase secretions (mucus); rhinorrhea 
Stuffy nose 
Cough 
Sneezing
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31
Q

Goal of agents to treat upper respiratory tract disorders

A

Prevent expose to triggers that cause symptoms and to effectively manage the symptoms when they occur

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32
Q

First generation antihistamines

A

Sedating

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33
Q

Second generation antihistamines

A

Non-sedating

34
Q

Histamine-1 receptor antagonists

A

Block EFFECTS of histamine at H1 receptor sites (does not block the RELEASE of histamine)

35
Q

Histamine-1 receptor antagonists are most helpful when

A

Taken prophylactically

36
Q

Histamine-1 receptor antagonists relieves what symptoms

A

Sneezing, rhinorrhea, nasal itching; does not affect nasal congestion

37
Q

Histamine-1 receptor antagonists may also be used to treat

A

Reactions to blood/blood products (NOT hemolytic)
Urticaria
Angioedema
Adjunct to anaphylactic therapy

38
Q

1st generation antihistamines examples

A

Diphenhydramine (Benadryl)

Chlorpheniramine (Chlor-Trimeton)

39
Q

1st generation antihistamines moA

A

Binds to H1 receptor sites to block the actions of histamine, also has anticholinergic properties

40
Q

1st generation antihistamines indications

A

Management of mild reactions
Seasonal allergic rhinitis
mild transfusion reaction
Urticaria

Management of severe anaphylactic responses: Hypotension, actor laryngeal edema, bronchospasm

Treatment of motion sickness and insomnia

41
Q

1st generation antihistamines administration

A

Oral (OTC)

IM, IV (w/ prescription)

42
Q

1st generation antihistamines side effects

A
Drowsiness 
Dizziness 
Dry mouth 
Tachycardia 
Constipation
Urinary hesitancy
43
Q

1st generation antihistamines toxicity

A

Adults: Flushed face, high fever, tachycardia, dry mouth, urinary retention, pupil dilation

Children: excitation, hallucinations, seizures

44
Q

1st generation antihistamines precaution

A

Children & older adults

-Ppl with history of asthma, urinary retention, open-angle glaucoma, hypertension, impaired kidney or liver function

45
Q

1st generation antihistamines contraindications

A

Glaucoma
Prostatic hypertrophy
acute asthma exacerbation (can thicken secretion)
Increased CNS depressant effect with CNS depressants

46
Q

2nd generation antihistamines examples

A

Cetrizine
Loratadine
Dexofenadine
Deloratadine

47
Q

2nd generation antihistamines MoA

A

Bind to H2 peripherally

48
Q

2nd generation antihistamines side effects

A
Usually minor 
- headache 
- nausea 
- fatigue 
fewer than sedating antihistamines 
Mild anticholinergic effects
49
Q

2nd generation antihistamines precaution

A

ppl impaired kidney function

50
Q

2nd generation antihistamines contrindication

A

Infants under 6 months; breastfeeding women

51
Q

2nd generation antihistamines interactions

A

Theophylline can reduce clearance and lead to toxicity

Atropine may cause increased anticholinergic effects

52
Q

Drugs therapy for nasal congestion and cough

A

Nasal decongestants (sympathomimetics)
Antitussives
Expectorants
Mucolytics

53
Q

Examples of nasal decongestants

A

Phenylephrine
Pseudoephedrine
Ephedrine

54
Q

nasal decongestants moa

A

Active alpha 1 in the nose, produce vasoconstriction thus striking nasal mucosal membrane

55
Q

nasal decongestants side effects

A
CNS stimulation with oral agents 
Systemic vasoconstriction 
Tachycardia 
Heart palpitations with oral agents 
REBOUND nasal congestions with abrupt stoppage/prolonged use
56
Q

nasal decongestants precautions

A

older adults

patients w/ CAD or HTN

57
Q

nasal decongestants contraindications

A

Chronic rhinitis

Narrow - angle glaucoma; hypertension; dysrhythmia

58
Q

nasal decongestants interactions

A

MAOI antidepressants potentiate effects

Beta 2 adrenergic agonists and other stimulants increase hypertensive effects

59
Q

Antitussives-opioid example

A

Codeine

60
Q

Antitussives-opioid moA

A

Suppress cough reflex in the brain (medulla)

61
Q

nasal decongestants-opioid side effects

A
CNS depression 
Dizziness 
Light headedness 
GI discomfort 
Constipation 
Respiratory depression
62
Q

nasal decongestants-opioid precaution

A

Children and older adults
Patients with reduces respiratory reserve
History of substance abuse
Prostatic hypertrophy

63
Q

Antitussives-opioid contraindications

A
Acute asthma 
Liver disease 
Renal disease 
Acute alcoholism 
Head trauma
64
Q

Antitussives-non opioid examples

A

Dexthromethorphan (Delsym)

Benzonatate (Tessalon)

65
Q

Antitussives-non opioid moA

A

Suppress cough reflex in the brain

66
Q

Antitussives-non opioid side effects

A

CNS depression with large doses
GI discomfort
Potential for abuse

67
Q

Antitussives-non opioid precautions

A

Patients with reduced respiratory reserve
History of substance abuse
Prostatic hypertrophy

68
Q

Expectorants examples

A

Guaifenesin

69
Q

Expectorants MoA

A

Reduce surface tension of secretions, thins thick mucus

70
Q

Expectorants side effects

A

dizziness
drowsiness
GI distress
allergic rxn (rash)

71
Q

Expectorants contraindication

A

cough due to heart failure; ACE inhibitor therapy

72
Q

Expectorants precautions

A

Chronic cough, asthma

73
Q

Expectorants interactions

A

Increase risk of hemorrhage with heparin (b/c guaifenesin inhibits platelet function)

74
Q

Mucolytic example

A

Acetylcysteine

75
Q

Mucolytic MoA

A

Breaks the disulfide linkages of proteins in mucus

76
Q

Mucolytic side effects

A

Bronchospasm
Aspiration of excessive secretions
GI distress

77
Q

Mucolytic precautions

A
ppl with weak or ineffective cough 
peptic ulcer disease 
esophageal varices 
severe liver dysfunction 
asthma 
anaphylactic reaction (w/ IV administration)
78
Q

Mucolytic contraindications

A

Risk for or actual GI bleeding

79
Q

1st generation antihistamines cross

A

The blood brain barrier! Which is why it is sedating!

80
Q

Chemical mediators act

A

Locally!!