Final: Respiratory Medications

Question 1

Dextromethorphan (Antitussive)

Answer 1

Suppresses cough reflex by acting directly on the medullary cough center of brain (non-productive cough)

Contraindication: PT who need to cough to maintain airway, head injury or impaired CNS

Caution: Hypersensitivity or history of narcotic addition

Adverse effects: Drying effects, CNS depression drowsiness, sedation, GI upset

Drug-drug: MAOIs

Question 2

Pseudophedrine (Oral Decongestants)

Answer 2

Decrease nasal congestion, vasoconstriction in mucous membranes

Adverse effects: Rebound congestion, sympathetic effects, anxiety, restlessness, headache, dizziness, drowsiness, seizures, hypertension

Drug-drug: Non-prescription products that contain pseudoephedrine

Obtain baseline VS, assess breath sounds, assess for urinary retention

Question 3

Diphenhydramine (Antihistamine)

Answer 3

Relieve respiratory symptoms and treat allergies; blocks effects of histamine at receptor sites

Anticholinergic and antipruritic effects

Caution: Renal or hepatic impairment, history of arrhythmias

Adverse effects: Drowsiness, sedation, anticholinergic effects, dizziness, epigastric distress, thickening of bronchial secretions, urinary retention, rash, bradycardia

Question 4

Albuterol (SABA)

Answer 4

Acute asthma; bronchospasms, prevention of attacks

Mimics effects of sympathetic nervous system, dilates bronchioles

Contraindications: Depends on severity of underlying condition (cardiac disease, vascular disease, arrhythmias, diabetes, hyperthyroidism)

Adverse effects: tachycardia, arrhythmia, hypertension, CNS stimulation, GI upset, bronchospasm, sweating, pallor, flushing

Drug-drug: General anesthetics, beta blockers

Question 5

Prednisone (Oral Glucocorticoids)

Answer 5

Bone density decreases, decreased calcium, elevated BP
Rinse mouth
Edema, monitor electrolytes, do not use K-sparing diuretics
Used for autoimmune disease
Taper slowly
Hypokalemia
Infection
Sodium increase
Glucose increase

Short term management of inflammation

Binds to receptors that inhibit inflammatory response

Adverse effects: Monitor blood glucose, WBC, infection, hypocalcemia, hypernatremia, edema, thrush

Question 6

Ipratropium (Anticholinergic)

Answer 6

Blocks vagally mediated reflexes resulting in bronchodilation

Maintenance treatment of bronchospasm in COPD

Caution: BPH, narrow angle glaucoma(aggravated by anticholinergic effects), rinse mouth after use

Adverse effects: Dizziness, headache, fatigue, nervousness, dry mouth, sore throat, palpitations, urinary retention, GI upset