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1 Pharmacology > Lower Respiratory > Flashcards

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
Q

ipratropium + tiotropium [antichol]

RN/teaching

A

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
Q

ipratropium + tiotropium [antichol] is often used in combination w ______

A

albuterol

-to incr effectiveness over just using individual med

27
Q

peanut allergy [anaphylaxis] when there is acute bronchospasms
drugs

A

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
Q

avoid the use of _____ when taking beta-2 adrenergic agonist

A

caffeine

29
Q

Methylxanthines

drug names

A

theophylline, aminophylline, theobromine

30
Q

A/E of theophylline, aminophylline, theobromine [methyxanthines] are unlikely below _____

A

20 mcg/mL

31
Q

theophylline, aminophylline, theobromine [methyxanthines]

MOA

A

relaxation of bronchial smooth muscles

-bronchodilation

32
Q

theophylline, aminophylline, theobromine [methyxanthines]

Tx

A
  • long term control of chronic asthma

- rarely COPD

33
Q

*theophylline, aminophylline, theobromine [methyxanthines]

A/E

A
  • DYSRHYTHMIAS (treat w LIDOCAINE)
  • TACHY
  • GI distress
  • restlessness
  • seizure (treat w DIAZEPAM)
  • insomnia
34
Q

*theophylline, aminophylline, theobromine [methyxanthines]

CI

A
  • caffeine

- caution in liver + kidney dysfunction

35
Q

**theophylline, aminophylline, theobromine [methyxanthines]

RN/teaching

A

teach to avoid caffeinated beverages, hidden sources

-smoking increases theophyline metabolism

36
Q

theophylline, aminophylline, theobromine [methyxanthines]

therapeutic range

A

5-15 mcg/mL

adverse effects are unlikely when below 20 mcg/mL

37
Q

_____ increases theophylline metabolisn

A

smoking

38
Q

Steroids

A

beclomethasone, fluticasone, budesonide

39
Q

beclomethasone, fluticasone, budesonide [steroids]

MOA

A
  • prevent metabolism
  • suppress mucous
  • reduce airway mucose edema
40
Q

*beclomethasone, fluticasone, budesonide [steroids]

Tx

A

*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
Q

*beclomethasone, fluticasone, budesonide [steroids]

A/E

A

*candidiasis
-hoarseness
suppress adrenal function
-osteoperosis
-hyperglycemia
-infection
-hypokalemia
-PUD
-myopathy
-edema/fluid retentn
-wt gain
-Cushing syndrome
GI ulcers

42
Q

*beclomethasone, fluticasone, budesonide [steroids]

CI

A
  • no recent live virus vaccines

- caution in DM

43
Q

beclomethasone, fluticasone, budesonide [steroids]

RN/teaching

A
  • prevent suppression of adrenal gland function by Q OD Dosing
  • candidiasis is treated w Nystatin prep
  • always taper dose esp long term tx
44
Q

beclomethasone, fluticasone, budesonide [steroids]

candidiasis Tx + teaching

A

nyastatin prep aka swish + spit/swallow

  • swish for several minutes
  • avoid eating 15 min
  • report 3 P’s, wt gain, or muscle weakness
45
Q

Leukotriene Modifiers

drugs

A

monteLUKast, ziLEUton, zafirLUKast

*all have leuk/luk

46
Q

montelukast, zileukton, zafirlukast

MOA

A
  • suppress leukotrienes

- reduce inflammation

47
Q

montelukast, zileukton, zafirlukast

Tx

A

long term asthma therapy

—adults or children 12 mos +

48
Q

*montelukast, zileukton, zafirlukast

A/E

A
  • depression
  • suicidal ideation
  • liver injury
  • headache
49
Q

*montelukast, zileukton, zafirlukast

CI

A

cirrhosis

50
Q

*montelukast, zileukton, zafirlukast

RN/teaching

A
  • obtain baseline LFT’s
  • monitor for NV
  • anorexia
  • abd pain
51
Q

Short-Acting Beta-2 Adrenergic Agonist

drug names

A

LA is a short road trip

Levabulterol
Albuterol

52
Q

Long-Acting Beta-2 Adrenergic Agonist

drug names

A

SF is a long road trip

Salmeterol
Formoterol

53
Q

the absorption of theophylline, aminophylline, theobromine [methyxanthines] can be lowered with _____

A

activated charcoal

54
Q

theophylline, aminophylline, theobromine [methyxanthines] can cause dysrhytmias but may be treated with ______

A

lidocaine

55
Q

if patient is a smoker and is prescribed theophylline, their dosing will increase/decrease?

A

increase

bc smoking increases theophylline metabolism

56
Q

mast cell stabilizer

drug

A

cromolyn

57
Q

mast cell stabilizer - cromolyn

MOA

A

suppresses histamine in blood vessels

which causes swelling/edema

58
Q

mast cell stabilizer - cromolyn

Tx

A

prophylaxis for asthma

  • great for kids bc weak replacement for steroids
  • EIB adults
59
Q

mast cell stabilizer - cromolyn

A/E

A
  • metallic taste
  • throat burn but very safe
  • dry mouth
60
Q

mast cell stabilizer - cromolyn

CI

A

contact lenses w eye drops

61
Q

mast cell stabilizer - cromolyn

RN/teaching

A

15-30 min before exercise

  • drink water
  • gargle after inhalations
  • give w nebulizer or MDI
62
Q

in kids, inhaled steroids can have systemic absorption which can ___

A

stunt their growth

1 Pharmacology (33 decks)

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