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Lower Respiratory Flashcards

1
Q

Lower Respiratory Disorders

A

1 Chronic Bronchitis
2 Emphysema
3 Asthma

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2
Q

Chronic Bronchitis

A
  • doesn’t affect the alveolar membrane
  • productive cough 2-3mos. of year for consec yrs
  • causes pulmo HTN>Cor pulmonale
  • if PaO2 is decr then PT put on home O2
  • we want the SpO2 to be bw 88-92% on pulse ox
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3
Q

Emphysema

A
  • decr DLCO, histological patho Dx
  • occurs late in life anti-trypsin deficiency
  • almost always fr cigarette use
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4
Q

Asthma

A

-reversible disease

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5
Q

Status Asthmaticus

A
  • irreversible

- emergency

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6
Q

Lower Respiratory Drug Types

A

BAM SLAM
Beta Adrenergic Agonist
Anticholinergics
Methylxanthines

Steroids
Leukotriene Modifiers
Mast Cell Inhibitors

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7
Q

Adrenergic aka

A
  • alpha, beta agonist
  • sympathomimetics
  • catecholamines
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8
Q

adrenergic/sympathetic lung effect

A

dilates bronchioles

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9
Q

cholinergic aka

A

muscarinic agonist

  • parasympathomimetic
  • ACH-erase inhibitors
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10
Q

cholinergic/muscarinic effects on lungs

A
  • constricts bronchioles

- increases secretions

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11
Q

Beta-2 Adrenergic Agonist drugs are divided into 2 categories

A

1 Short-Acting

2 Long-Acting

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12
Q

Beta-2 Adrenergic Agonist

MOA

A

selective B2 adrenergic agonist in bronchial smooth muscles resulting in bronchodilation, block histamine release

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13
Q

Short-Acting Beta-2 Adrenergic Agonist

Tx

A

acute asthma attack

-inhaled

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14
Q

Long-Acting Beta-2 Adrenergic Agonist

Tx

A

control of chronic asthma

-PO

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15
Q

**Beta-2 Adrenergic Agonist

A/E

A
  • tachycardia/angina
  • tremors
  • insomnia…MI?
  • hypo-K
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16
Q

Beta-2 Adrenergic Agonist

CI

A
  • MI
  • tachydysrhytmias
  • angina
  • caution w hyperthyroidism
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17
Q

Beta-2 Adrenergic Agonist

RN/teaching

A
  • monitor chest pain
  • AVOID CAFFEINE
  • check pulse prior to admin
  • report HR>20-30
  • avoid using along w beta blocker meds
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18
Q

use Beta-2 Adrenergic Agonist first, wait ____ before using ____

A

5 mins

steroid inhaler

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19
Q

terbutaline

Tx

A
  • acute asthma attack
  • —rescue medication
  • to delay labor
  • –opposes oxytocin to strop pre-term labor/premature contractions
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20
Q

Anticholinergic

drug names

A

ipratropium + tiotropium

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21
Q

ipratropium + tiotropium [antichol]

MOA

A

relieve bronchospasm R2 COPD by blocking ACH

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22
Q

ipratropium + tiotropium [antichol]

Tx

A
  • COPD
  • EIB
  • off-label asthma
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23
Q

*ipratropium + tiotropium [antichol]

A/E

A
  • DRY MOUTH
  • hoarseness
  • dizziness
  • blurred vision
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24
Q

*ipratropium + tiotropium [antichol]

CI

A
  • soy/peanut algy
  • glaucoma
  • caution in BPH + NA
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25
ipratropium + tiotropium [antichol] | RN/teaching
how to use the diskus (advair) - 2 puffs, rinse mouth after to reduce taste - at same time each day - 2 inhaled meds are prescribed, wait 5 mins in bw * DO NOT SWALLOW TIOTROPIUM CAPSULES (must inhale)
26
ipratropium + tiotropium [antichol] is often used in combination w ______
albuterol | -to incr effectiveness over just using individual med
27
peanut allergy [anaphylaxis] when there is acute bronchospasms drugs
Epinephrine -bc is beta 1 + 2 + alpha agonist Isoproterenol - beta 1 + 2 agonists so it will affect the heart - used to treat bradycardia/brady arrythmias
28
avoid the use of _____ when taking beta-2 adrenergic agonist
caffeine
29
Methylxanthines | drug names
theophylline, aminophylline, theobromine
30
A/E of theophylline, aminophylline, theobromine [methyxanthines] are unlikely below _____
20 mcg/mL
31
theophylline, aminophylline, theobromine [methyxanthines] | MOA
relaxation of bronchial smooth muscles | -bronchodilation
32
theophylline, aminophylline, theobromine [methyxanthines] | Tx
- long term control of chronic asthma | - rarely COPD
33
*theophylline, aminophylline, theobromine [methyxanthines] | A/E
* DYSRHYTHMIAS (treat w LIDOCAINE) * TACHY - GI distress - restlessness - seizure (treat w DIAZEPAM) - insomnia
34
*theophylline, aminophylline, theobromine [methyxanthines] | CI
* caffeine | - caution in liver + kidney dysfunction
35
**theophylline, aminophylline, theobromine [methyxanthines] | RN/teaching
teach to avoid caffeinated beverages, hidden sources | -smoking increases theophyline metabolism
36
theophylline, aminophylline, theobromine [methyxanthines] | therapeutic range
5-15 mcg/mL adverse effects are unlikely when below 20 mcg/mL
37
_____ increases theophylline metabolisn
smoking
38
Steroids
beclomethasone, fluticasone, budesonide
39
beclomethasone, fluticasone, budesonide [steroids] | MOA
- prevent metabolism - suppress mucous - reduce airway mucose edema
40
*beclomethasone, fluticasone, budesonide [steroids] | Tx
*short-term IV is for status asthmaticus * inhalation is for: - long term prophylacis of asthma - chronic severe asthma - in utero for bbs to improve lung function
41
*beclomethasone, fluticasone, budesonide [steroids] | A/E
*candidiasis -hoarseness suppress adrenal function -osteoperosis -hyperglycemia -infection -hypokalemia -PUD -myopathy -edema/fluid retentn -wt gain -Cushing syndrome GI ulcers
42
*beclomethasone, fluticasone, budesonide [steroids] | CI
* no recent live virus vaccines | - caution in DM
43
beclomethasone, fluticasone, budesonide [steroids] | RN/teaching
* prevent suppression of adrenal gland function by Q OD Dosing * candidiasis is treated w Nystatin prep * always taper dose esp long term tx
44
beclomethasone, fluticasone, budesonide [steroids] | candidiasis Tx + teaching
nyastatin prep aka swish + spit/swallow - swish for several minutes - avoid eating 15 min - report 3 P's, wt gain, or muscle weakness
45
Leukotriene Modifiers | drugs
monteLUKast, ziLEUton, zafirLUKast *all have leuk/luk
46
montelukast, zileukton, zafirlukast | MOA
- suppress leukotrienes | - reduce inflammation
47
montelukast, zileukton, zafirlukast | Tx
long term asthma therapy | ---adults or children 12 mos +
48
*montelukast, zileukton, zafirlukast | A/E
* depression * suicidal ideation * liver injury - headache
49
*montelukast, zileukton, zafirlukast | CI
cirrhosis
50
*montelukast, zileukton, zafirlukast | RN/teaching
* obtain baseline LFT's - monitor for NV - anorexia - abd pain
51
Short-Acting Beta-2 Adrenergic Agonist | drug names
LA is a short road trip Levabulterol Albuterol
52
Long-Acting Beta-2 Adrenergic Agonist | drug names
SF is a long road trip Salmeterol Formoterol
53
the absorption of theophylline, aminophylline, theobromine [methyxanthines] can be lowered with _____
activated charcoal
54
theophylline, aminophylline, theobromine [methyxanthines] can cause dysrhytmias but may be treated with ______
lidocaine
55
if patient is a smoker and is prescribed theophylline, their dosing will increase/decrease?
increase bc smoking increases theophylline metabolism
56
mast cell stabilizer | drug
cromolyn
57
mast cell stabilizer - cromolyn | MOA
suppresses histamine in blood vessels | which causes swelling/edema
58
mast cell stabilizer - cromolyn | Tx
prophylaxis for asthma - great for kids bc weak replacement for steroids * EIB adults
59
mast cell stabilizer - cromolyn | A/E
- metallic taste - throat burn but very safe - dry mouth
60
mast cell stabilizer - cromolyn | CI
contact lenses w eye drops
61
mast cell stabilizer - cromolyn | RN/teaching
15-30 min before exercise - drink water - gargle after inhalations - give w nebulizer or MDI
62
in kids, inhaled steroids can have systemic absorption which can ___
stunt their growth

1 Pharmacology (33 decks)

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