INCOMPLETE Respiratory MEDS (Grant)

Question 1

Inflammation

Answer 1

normal response to body injury

STIMULI:

• physical injury
• expos to toxic chem
• extreme heat
• invading microorganizm
• death of cells

Question 2

Chemical Mediators

Answer 2

damaged tissue releases them after injury from pathogens, Chem, Physical Trauma. Alarm that there has been an injury. Stimulate pain receptors

Question 3

Types of Chem Mediators

Answer 3

• Histamines ** (one of key chemical mediator)
• Leukotrines
• Bradychinins
• Prostoglandins

Question 4

Upper Resp System:
Nasal Decongestants (Sympathomimetic)

Answer 4

• 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)

Question 5

Upper RS:

Antihistamines

Answer 5

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)

Question 6

Upper Resp System:

Intranasal Corticosteroids/Aerosol Steroids:

Answer 6

.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.

Question 7

Upper Resp System:

Misc. Anti-Inflammatory Agent

Answer 7

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

Question 8

Rebound Effect

Answer 8

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

Question 9

URS:
Antihistamine: NI

Answer 9

• 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)

Question 10

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Answer 10

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Question 11

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Answer 11

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Question 12

.

Answer 12

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Question 13

Lower RS:

Antitussive Agents

Answer 13

Cough Suppresants

• Codeine (LT use, addictive, resp depression)
• Dextromethorphan (Delsym, non addictive nor resp depr. children)

Question 14

Lower RS:

Expectorant

Answer 14

remove mucous plugs

-Guaifenesin (Robitussin)

Question 15

Lower RS:

Potassium Iodide

Answer 15

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

Question 16

Lower RS:

Mucolytic Agents

Answer 16

DEC mucous

-Acetycysteine (Mucomyst)

Question 17

Lower RS:

Bronchodilators: (Beta-Adrenergic Agonists)

Answer 17

Short acting. Treat Broncho Spasms

• Albuterol (Proventil)
• Epinephrine (Primatine Mist)
• Metaproterenol (Alupent)
• Terbutaline (Brethine)
• Salmeterol (Serevent), LONG ACTING

Question 18

Lower RS:

BronchodilatorsL (Xanthine Derivatives)

Answer 18

taken on schedule to build UP therapeutic blood level, monitor Blood work

• Aminophylline
• Theophylline (Bronkodyl)

Question 19

Lower RS:

Anticholinergic Bronchodilators

Answer 19

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

Question 20

Lower RS:

Inhalant Corticosteroids

Answer 20

LT Asthma, DEC inflammation

• Fluticasone (Flovent)
• Triamcinolone acetonide (Azmacort)
• Fluticasone salmeterol (Advair Diskus)

Question 21

Lower RS:

Antileukotriene Agents

Answer 21

Leyukotrine chemical mediators. This is ANTI Leyukotrine
Pump/Pills
-Montelukast (Singulair)
-Zafirlukast (Accolate)

Question 22

Lower RS:

Antitubercular Agent

Answer 22

.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

Question 23

Lower RS:

Antibiotics

Answer 23

• Ciprofloxacin (Cipro)
• Penicillin
• Doxycycline (Vibramycin)
• Erythromycin (E-Mycin, many others)

Question 24

Lower RS:

Anticoagulants

Answer 24

for clot, pulmonary embolism

• Heparin
• Warafin (Coumadin)