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Cardiopulm Final > Medications > Flashcards

Medications Flashcards

1
Q

The overall goal of pulmonary medication is to:

Increase:

Decrease:

A

Sympathetic

Decrease parasympathetic

Therefore INCREASE Lumen size in lungs

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2
Q

What are side effects of most medications that enhance sympathetic output

A

Arrythmias

High HR

High BP

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3
Q

4 Mechanisms that Pulmonary meds can work?

A

Bronchodilation

Facilitation of mucociliary action

Increased alveolar ventilation/improved oxygen

Improved control of breathing pattern

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4
Q

What do sympathomimetics do

A

Immitate sympathetic NS

by stimulating Beta 2 Receptors

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5
Q

What is a SABA?

A

Short acting Beta 2 agonist

works in 3-5 mins, lasts 4-6 minutes

THIS IS FOR ACUTE ASTHMA ATTACKS

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6
Q

What is epinephrine used for?

A

Given to promote bronchodilation/increase BP

Used in emergent situations (also asthma attack)

This is not a SABA because it’s nonselective

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7
Q

What is a LABA?

A

Long acting Beta 2 Agonist

this is NOT for acute asthma attacks

-used to help patients breathe in their sleep or for maintence therapy

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8
Q

Albuterol is an example of a

A

SABA

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9
Q

LABA effects kick in how fast, and last for how long?

A

3-30 minutes after inhalation

last up to 12 hours

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10
Q

What is for chronic issues, SABA or LABA?

A

LABA

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11
Q

When a patient first starts taking SABA or LABA, what should we do?

A

Monitor for side effects

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12
Q

You should only take decongestants ____________

A

To get over the initial hump of the problem, do not use chronically!

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13
Q

What do decongestants do?

A

Stimulate alpha-adernergic receptor vasoconstriction of capillaries threfore sreducing fluid secretion in nose

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14
Q

What are side effects of decongestants

A

dizziness hypertension nausea, headache, insomnia, arrythmias

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15
Q

What is a parasympatholytic

A

Supressed parasymp nervous system

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16
Q

What nerve supplies parasympathetic input to lungs?

A

Vagus nerve

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17
Q

Parasympatholytics are used to stop ____________

A

Bronchoconstriction

They’re usually given for any kind of inflammatory lung disease

example: asbestos exposure

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18
Q

What is a S.A.M.A and a L.A.M.A

A

Short acting muscarinic antagonist or Long acting muscarinic antagonist

note: Used in outpatient

reduces secretions in mouth and airways, used to treat paralysis of respiratory system due to poisoning

Most common kind: atropine

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19
Q

Are muscarinic agents (SAMA and LAMA) used for asthma?

What are side effects of muscarinic agents?

A

NO

Dry mouth, headache, tachycardia, blurred vision

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20
Q

Caffine is an example of what

A

Methylxanthine

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21
Q

What does a Methylxanthine do?

A

-Positive inotrope

Increases sympathetic output

Blocks breakdown of cAMP

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22
Q

How do methylxanthines helpful to patients

A

Increases exercise tolerance w/ improved contractility and reduces fatigue of diaphram

note: These drugs can be preformance enhancing

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23
Q

How will a patient feel taking methylxanthines?

A

Theyll feel sick

Side effects: Chest pain, tremors, urination, insomnia, dizziness, nausea

CHECK THEIR VITALS

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24
Q

What is the good thing about corticosteroids

What is the bad thing?

A

Good: Can help open up airway indirectly

Bad: RIP Immune system

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25
Q

What are other side effects of corticosteroids

A

Myopathy

Edema

Osteopenia

Hyperglycemia

HYPOKALEMIA

THROMBUS FORMATION

26
Q

Is a corticosteroid a bronchodilator?

A

No, but it indirectly helps

27
Q

Can we do aggressive manual manipulations for patients on corticosteroids long term

A

No because their bones are wittle bitty toothpicks

28
Q

How are patients divided when deciding what drugs to administer?

A

By amount of moderate exacerbations leading to hospitalization and by dyspnea ranked on a scale of 1-10

29
Q

What is a meter dosed inhaler?

A

Delivers specific amount of meds per short burst from device

drug in aresol form

must coordinate inhalation with puff from inhaler

30
Q

What are spacers used for w/ inhalers?

A

Used to reduce speed of meds into mouth so you dont have to time it perfectly

31
Q

What is the most common breathing treatment method of delivery

A

Jet Nebulizer

Tubing connected to compressed air soruce

connected to patient w/ nose piece or face mask

32
Q

What is bad about Respiratory stimulant drugs?

A

These medications can reduce the natural drive to breathe by the CNS

note: too much oxygen can damage lungs

These drugs are usually used to combat excessive use of drugs like narcotics that depress respiratory center

33
Q

Can a PT put someone on oxygen if they feel the patient needs it

what about turn up their current level of oxygen

A

NO, oxygen is a medication given in a specific amount by the doctor

no touchy touchy you dumb PTs!

34
Q

Respiratory depressants like Morphine, Midazoam, Propofol, and Diazepram are often used as a mild sedative for surgical procedures, are these appropriate for patients w/ respiratory disease?

A

NO AVOID THESE

35
Q

What is the typical path that a DVT follows?

A

Lower extremity -> RA -> RV -> Pulmonary Trunk -> gets stuck in lung somewhere

36
Q

Whats more dangerous, a DVT in the thigh or in the calf?

A

Thigh

Proximal DVTs are more dangerous

37
Q
A
38
Q

What should a PT do during a patient interview

A

Screen for risk of DVT

39
Q

Is screening for risk the same thing as screening for DVTs

A

NO!

40
Q

What can PTs recommend to individuals at high risk of DVT

A

Mechanical compression

Example: Compression stockings

41
Q

What criteria is used to establish the likihood of a DVT

A

Wells Criteria

42
Q

Is Wells criteria diagnostic for a DVT?

A

no

43
Q

Physical therapist should verify patients with a DVT are ___________

and initiate mobilization when _____________________

A

Patient is on anticoagulant

Therapeutic levels of anticoagulant have been reached

44
Q

Can we mobilize patients with an IVC?

(inferior vena cava filter)

A

Yes, when hemodynamically stable

talk to physician first

45
Q

What are 4 ways a PT can decrease risk of DVT

A

Encourage mobility

use mechanical compession

consult physican about medication

provide education about prevention

46
Q

What is the Padua Prediction score

A

Assesses RISK of DVT, not SYMPTOMS

47
Q

What should you use if you want to establish the likelihood a patient has a DVT

A

Wells Criteria

48
Q

What are classic signs of a DVT

A

Localized pain, swelling, discoloraton, warmth

Symptoms cannot diagnose a DVT!

Physical Exam findings are not sensitive or specific and in 50% of DVTs there are none of these symptoms

49
Q

Wells Criteria and other scoring algorthms are HIGHLY SENSITIVE, what does this mean?

A

Very sensitive to what theyre suppose to pick up, but can produce many false positives

50
Q

What is Homan’s sign

A

USELESS

51
Q

How is a DVT usually diagnosed

A

With a D-dimer test followed by a Doppler Ultrasound

52
Q

What is prothrombin time?

A

The average time it takes for a clot to form

53
Q

A D Dimer test will typically show what?

A

Under 500 ng/ML firinogen in blood.

If there is OVER 500, this is positive for potential clots

54
Q

What is normal pro-thrombin time?

If this time is increased what happens?

A

Normal 11-13

Helps prevent clots, however too much of an increase puts you at risk of bleeding

55
Q

What is INR

A

International Normalized Ratio

Used to monitor affectiveness of warfarin for blood thinning

56
Q

Too low INR means what?

Too high INR means what?

A

too low: risk of clots

too high: risk of bleeding

57
Q
A
58
Q

INR helps you determine if it’s safe to get a patient up when they’re taking anti-coagulants, but before this you should…

A

check w/ medical team

59
Q

What is diagnostic test is used first for patients w/ high chance of DVT

For patients w/ low chance?

A

High chance: Bedside ultrasound (doppler)

Low chance: D-Dimer

60
Q

If a patient took anticoagulants less than _____ hours ago do not get them up

A

2 hours

However all meds are different, check w/ physician before mobilizing

The algorthm seems to go:

Under 2: NO mobility

3-5: check w/ physician

Over 5: Mobilize

61
Q

Will an IVC help w/ a DVT in your arm?

A

No

62
Q

left off on slide 54

A

Cardiopulm Final (8 decks)

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