Lower respiratory disorders Flashcards
What are the two major categories of lower respiratory tract disorders:
COPD, restrictive pulmonary disease
This lower respiratory disorder is caused by airway obstruction with increased airway resistance of airflow to the lung tissues is defined as:
COPD (caused by asthma and other factors)
An inflammatory disorder of the airway walls associated with varying amounts of airway obstruction is defined as:
asthma
What are the two things internally that can cause asthma:
inflamed/edematous bronchial airways; increased in mucous production all triggered by stimuli
What are the common S/S of asthma:
wheezing, coughing, dyspnea, tightness of chest early in the morning or at night
What is bronchial asthma characterized by:
bronchospasm (constricted bronchioles), wheezing, mucus secretion, dyspnea d/t resistance of airflow from obstructed airway
What occurs when allergens attach themselves to mast cells and basophils:
chemical mediators are released: histamines, cytokines, serotonin, eosinophil chemotaxis factor of anaphylaxis (ECF-A), leukotrines
What do the chemical mediators trigger:
stimulates bronchiole constriction, mucous secretion, inflammation, pulmonary congestion
Which of the chemical mediators are the most potent in bronchoconstricting:
histamine; ECF-A
What is the end result after exposure to an allergen:
bronchial hyperresponsivness, epithelial shedding, mucous hypersecretion, plasma leakage, bronchoconstriction
This type of asthmatic medication increases cAMP causing dilation of bronchioles; has nonselective (alpha-B2 adrenergic) and selective (beta-adrenergic) drugs is defined as what type of category:
sympathomimetics
What type of sympathomimetics is given for an acute bronchospasm caused by anaphylaxis and what are the examples:
non-selective (alpha-B2 adrenergic agonists); epinephrine (adrenalin)
What type of sympathomimetics is given for bronchospasm associated w/chronic asthma or COPD and what are the examples:
selective (beta-adrenergic drugs); isoproterenol, metaproterend; albuterol
What are the side/adverse effects of epinephrine:
CARDIAC DYSRHYTHMIAS (EKG), angina, palpations, HTN, dizziness, tremors
What is the first beta-adrenergic agent that’s nonselective to B1-B2; inhaled, seldom prescribed:
isoproterenol
This type of sympathominetic beta-adernergic agent reverses bronchospasm by relaxing the smooth muscle; is BEST USED FOR AN ACUTE ASTHMA ATTACK AS IT HAS A FAST ONSET is called:
metaproterenol
This beta-2 adrenergic is effective for Tx and control of asthma caused by bronchodilation ; has a long duration of action is called:
Albuterol (proventil)
What are the side effects of beta-2 adrenergics:
PALPATIONS (EKG), tremors, increased pulse rate, dilated pupils, increased glucose, HA, nervousness
What are some side effects of using an aerosol inhaler:
dry mouth, throat irritation, tremors, paradoxial airway resistance (bronchoconstriction)
What is the common name of an anticholinergic that’s often combined with abuterol (more effective combined then used on its own) and has fewer side effects compared to other anticholinergics:
Ipratropium (atrovent)
How should atrovent be administer when taking a beta-agonist aerosol:
Administer beta-agonist aerosol 5 min before giving the atrovent
How should atrovent be administer when taking an inhaled steroid:
Administer atrovent 5 min before giving the steroid so that the bronchioles are dilated and the steroid can be absorbed
What asthmatic drug category has an effect on the respiration and pulmonary vessels (dilates coronary/pulmonary vessels) and increases cAMP (dilates bronchiole vessels):
Methylxanthine derivatives
What are some examples of methylxanthine derivatives:
aminophyline, theophylline, caffeine
This methylxanthine relaxes sm muscle of the: bronchioles, pulmonary by inhibiting phosphodiesterase thus increaseing cAMP (dilation):
Theophylline
Why is theophylline not used very often in asthmatic pts:
Low therapeutic index/narrow range
What are the adverse reactions of Theophylline:
cardiac dysrhythmias, tachycardia, palpations, SZ, hyperglycemia
What effect does the chemical mediator Leukotrine cause in the lungs:
increase eosinophilmigration, mucous production, airway wall edema
This asthamtic drug reduces inflammation caused by leukotrines, used for exercised-induced asthma, NOT recommended for ACUTE ASTHMA ATTACKS:
Leukotrined antagonists (SINGULAIR)
What member of the corticosteroid family is used to treat respiratroy disorders, typically asthma:
Glucocorticoids (dexmethasone, prednisone, hydrocortisone)
When are glucocorticoids Rx:
If asthma is unresponsive to bronchodilator therapy or if pt has an asthma attack while on high doses of theophylline or adernergic drugs
When are glucocorticoids considered to have a synergistic effect:
when combined with beta-2 agonists
Why are glucocorticoids inhalation preferred over the oral route:
Oral route causes adrenal suppression
When glucocorticoids are discontinued abruptly after S/S of asthma are controlled-which also avois adrenal supression-is defined as:
short-term use
When glucocorticoids are weaned or tapered off to prevent exacerbation of S/S and adrenal suppression, it is defined as:
long-term use
What is a popular glucocorticoid combination drug that effectively controls S/S of asthma if taken BID by alleviating airway constriction and inflammation:
Advair
How can fungal infections of the mouth (candida albicans) d/t glucocorticoids be reversed or prevented:
Using a spacer, discontinue the grug and take antifungal meds, and rinsing mouth out with water after each dose
What are the side effects of glucocorticoids:
throat irritation, fungal infections, hoarshness, dry mouth, coughing
Mast cell stabalizers: suppresses the release of histamine
Cromolyn/Nedocromil; inhibits IGE from causing mast cells to release chemical mediators; NOT USED FOR ACUTE ATACKS; prevents bronchospasms and attacks; Used BEFORE exercise
What is Rx to a pt to liquefy/loosen thick mucus secretions; SHOULD NOT BE MIXED WITH OTHER DRUGS; given HHN; adjunct to bronchodilator:
Mucomysts (belongs to the mucolytics)
What are the side effects of mucolytics:
STOMATITIS, runny nose, N/V
What is the asthmatic therapy for children:
Cromolyn/nedocromil, oral glucocorticoids, oral beta-2 agonists
