INCOMPLETE Respiratory MEDS (Grant) Flashcards
Inflammation
normal response to body injury
STIMULI:
- physical injury
- expos to toxic chem
- extreme heat
- invading microorganizm
- death of cells
Chemical Mediators
damaged tissue releases them after injury from pathogens, Chem, Physical Trauma. Alarm that there has been an injury. Stimulate pain receptors
Types of Chem Mediators
- Histamines ** (one of key chemical mediator)
- Leukotrines
- Bradychinins
- Prostoglandins
Upper Resp System: Nasal Decongestants (Sympathomimetic)
- Stimulate Symp NS
- Alpha Adrinergic decongestants: relieve SS of allergies and comm cold, congestion, easier to breath.
- Stimulate A Adrinergic receptors of nasal mucous memb –> vasoconstrictoin –> LO blood flow
MEDS
- Ephedrine
- Oxymetazoline (Afrin)
- Pseudoephedrine (Sudafed)
- ***Nasal Epinephrine (given post nasal Sx to DEC poss of bleeding)
Upper RS:
Antihistamines
block action of histamines @ H1 receptor site.
relief of allergies SS (runny eyes, itchy nose/throat, sneeze, motion sickness, insomnia)
-Certirizine (Zyrtec)
-Chlorpheniramine maleate (Chlor-Trimeton), 1ST GEN
-Diphenydramine hydrochloride (Benadryl), 1ST GEN
-Loratadine (Claritin)
-Promethazine hydrochloride (Phenergan)
-Aminophylline (Azatadine)
.1ST Generation, SE, drowsiness.
.avoid ETOH, CNS depressants. make sedated, rsk for addiction
.most effective profilactically
.does NOT stop nasal congestion
.help w runny, itchy nose
.CAUTION Hx Heart disease b.c anticholinergic effect, UP HR, LO BP. suggest EKG before starting antihistammines, COPD (anti cholinergic), Asthma (cause broncho spasms)
Upper Resp System:
Intranasal Corticosteroids/Aerosol Steroids:
.applied directly to nasal mucosa for Rhinitis (runny nose) starting to replace antihistamines d/t min SEs
.Tx Rhinitis, Asthma
-Beclomethasone dipropionate (Beconase), ASTHMA
-Budesonide (Rhinocort), ASTHMA
-Fluticasone (Flonase)
-Mometasone (Nasonex)
-Fludisolide (Nasarel)
.SE: burning sensation*, dry nasal mucosa, admin w metered spray device to allow pt to give consistent metered dose, nasal = min SEs.
Upper Resp System:
Misc. Anti-Inflammatory Agent
Cromolyn Sodium .pt on for 2-4 wks to det effectiveness. take as Rx. .prevents release of histamines .break and inhale med TX: runny nose, itching/sneezing -unknown mechanism of action -inhibits release of histamine -given w other meds -used for people w sever bronchial asthmas, allergic rhinitis
Rebound Effect
hyper secretions of mucous are worsened when using intra nasal decongestants for longer than 3-5 days
no rebound effect w ORAL use
Oral RSK: HTN, DM, Cardiac Disease b/c stim A Receptors
URS:
Antihistamine: NI
- monitor thyroid Fx (anti chili can trigger thyroid storm)
- mon visual changes
- narrow angle glaucoma
- DM (can DEC BG levels)
- Renal Toxicity (cause urinary retention)
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Lower RS:
Antitussive Agents
Cough Suppresants
- Codeine (LT use, addictive, resp depression)
- Dextromethorphan (Delsym, non addictive nor resp depr. children)
Lower RS:
Expectorant
remove mucous plugs
-Guaifenesin (Robitussin)
Lower RS:
Potassium Iodide
Expectorant by stimulating UP secretions by bronchial. LO viscosity o mucous plugs. Easier to cough up hardened dry plugs
-SSKI
TX: Bronchial Asthmas, Bronchitis, Pulmonary Emphysema
Lower RS:
Mucolytic Agents
DEC mucous
-Acetycysteine (Mucomyst)
Lower RS:
Bronchodilators: (Beta-Adrenergic Agonists)
Short acting. Treat Broncho Spasms
- Albuterol (Proventil)
- Epinephrine (Primatine Mist)
- Metaproterenol (Alupent)
- Terbutaline (Brethine)
- Salmeterol (Serevent), LONG ACTING
Lower RS:
BronchodilatorsL (Xanthine Derivatives)
taken on schedule to build UP therapeutic blood level, monitor Blood work
- Aminophylline
- Theophylline (Bronkodyl)
Lower RS:
Anticholinergic Bronchodilators
to treat COPY for over 200 yrs, limited use
SE: throat irritation, UP secretion viscosity, urinary retention, mydriasis (enl/dilated pupil)
- Ipratropium bromide (Atrovent), COPD
- Tiotropium bromide (Spiriva), therapeutic effects last longer than Atrovent
Lower RS:
Inhalant Corticosteroids
LT Asthma, DEC inflammation
- Fluticasone (Flovent)
- Triamcinolone acetonide (Azmacort)
- Fluticasone salmeterol (Advair Diskus)
Lower RS:
Antileukotriene Agents
Leyukotrine chemical mediators. This is ANTI Leyukotrine
Pump/Pills
-Montelukast (Singulair)
-Zafirlukast (Accolate)
Lower RS:
Antitubercular Agent
.If active TB, combo w this drug .Prevent, Treat TB. .If pt pos for TB, treat on 1st line profilacticaly .All TOXIC to LIVER .Pt Teach: liver toxic, no tylenol, etoh
MEDS
- *Isoniazid (INH), 6-12mos, 1st LINE (prevent active)
- Rifampin (Rifadin), 1st LINE
- *Rifapentine (Priftin), newer, 1st LINE
- Para-aminosalicylate sodium (PAS), 2nd LINE, less effective, last resort
- *Cycloserine, only ABX in this TB class of meds
Lower RS:
Antibiotics
- Ciprofloxacin (Cipro)
- Penicillin
- Doxycycline (Vibramycin)
- Erythromycin (E-Mycin, many others)
Lower RS:
Anticoagulants
for clot, pulmonary embolism
- Heparin
- Warafin (Coumadin)
