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Pharmacology > Medications affecting the respiratory system > Flashcards

Medications affecting the respiratory system Flashcards

1
Q

For optimal gas exchange to occur what has to be functioning properly?

A

vetilation and perfusion

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2
Q

What are the advantages of a nebulizer?

A

They work much faster and allow for more administration to be administered which makes them great for emergency situations.

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3
Q

what are short acting B2 adrenergic agonists used for?

A

acute episodes! immediate onset (intravenous), considered a rescue medication

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4
Q

What are intermediate-acting B2 adrenergic agonists used for?

A

Acute episodes!

peak at 1-2 hours, but have onset of 5 minutes

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5
Q

What does B2 stimulation cause?

A

bronchodilation

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6
Q

What diseases are generally treated with the same medications?

A

COPD and Asthma

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7
Q

Does short acting B2 also affect B1?

A

YES YES YES

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8
Q

What is the longer acting B@ adrenergic agonist used for?

A

used to require less dosing

lasts 12 hours, peaks at 2 hours (MDI)

onset 10-20 minutes for PREVENTION NOT RESCUE

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9
Q

What is the therapeutic use for B2 adrenergic agonists?

A

dilation of bronchioles from B2 stimulation

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10
Q

What are some adverse effects of B2 adrenergic agonists?

A

tachycardia (b1 stimulation)

Angina (beta 1 stimulation increases HR and contractility making the heart work more)

Tremors (activation of b2 in skeletal muscle)

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11
Q

What are some nursing considerations for B2 adrenergic agonists?

A

assess HR (if it increases more than 20-30 beats/minute then treatment should be stopped… or 25%)

report chest pain (angina)

tremors usually resolve with long term use (usually seen in hospital with large dosing

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12
Q

When are B2 adrenergic agonists contraindicated?

A

non-selective beta blockers (Dont want to block beta 2 when we are trying to stimulate it)

MAOI/tricyclic antidepressants (increase the risk of tachycardia, heart disease, HTN, hyperthyroidism)

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13
Q

What is the administration technique for a MDI?

A

Shake inhaler, remove cap, attach spacer

Exhale, put inhaler to mouth, press canister and inhale

hold breath for 10 seconds (or as long as possible)

exhale through pursed lips

Wait 1 minute before repeating (allow absorption of medication before repeating exhalation and inhalation process for next dose)

clean and rinse case, put cap back on

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14
Q

What are some patient teaching points for B2 adrenergic agonists?

A

Administration techniques!

Make sure they know the difference between rescue inhaler and prevention inhaler (use short acting to terminate acute attacks)

Take beta-agonist first then take glucocorticoid inhaler!!!!!!!!!!!!! (beta agonists work faster, and opens up airways for glucocorticoid absorption)

Monitor for effects, especially in diabetics (hyperglycemia from b2 stimulation) GENERALLY NOT A PROBLEM IN NON-DIABETICS

keep a log of frequency of attacks

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15
Q

What is the therapeutic action of methylxanthines?

A

Relaxation of bronchial smooth muscle resulting in bronchial dilation

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16
Q

What are methylxanthines generally used for?

A

long term control of asthma and COPD

TAKEN PO

17
Q

What are some nursing considerations for methylxanthines?

A

toxicity - monitor serum drug levels (5-15 mcg/ml)

Avoid caffeine - can increase theophylline (methylxanthine) levels

many drug-drug interactions that can increase or decrease levels

18
Q

What are some adverse effects of methylxanthines?

A

TOXICITY:

     Mild GI symptoms

     restlessness

     dysrhythmias

     seizures
19
Q

What is the therapeutic action of inhaled anticholinergics?

A

block the vagus nerve (parasympathetic nervous system) which prevents contraction, bronchodilation occurs

by blocking the parasympathetic stimulation the sympathetic system will take over and dilate the bronchioles

20
Q

What suffix should you remember inhaled anticholinergics by?

A

troprium

21
Q

What are inhaled anticholinergics used for?

A

long-term control

exercise induced asthma

NOT A RESCUE INHALER, DOESNT DIRECTLY DILATE BRONCHIOLES, IT IS A PREVENTER

IT IS AN MDI

22
Q

When are inhaled anticholinergics contraindicated?

A

glaucoma (decreases outflow of viscous humor increas IOP)

BPH (causes bladder contractions which further aggrevates problem)

23
Q

What are some nursing considerations for inhaled anticholinergics?

A

administration techniques
rinse mouth to reduce bad taste (sour metallic taste)
if used with other inhalers wait 5 minutes before
dosing

Monitor for adverse effects (dry mouth, hoarseness)

USE ONLY FOR PREVENTION NOT FOR ACUTE ATTACKS

24
Q

What is the therapeutic action of glucocorticoids?

A

decrease inflammation in airways, suppress airway mucous, increase effect of b2 agonists

NOT FOR IMMEDIATE RELIEF BUT DECREASE FREQUENCY AND SEVERITY OF ATTACKS

25
Q

What is a suffix to remember glucocorticoids by?

A

one

26
Q

What are some adverse effects of glucocorticoids?

A

pharyngeal and laryngeal fungal infections
MDI increases risk (beclomethasone)
look for sore throat, hoarseness, coughing

adrenal gland suppression (long-term use of prednisone PO… greater than 10 days)
medication is doing some of what the kidneys do so they stop functioning (release of cortisol)

bone loss (long-term prednisone PO)

hyperglycemia/glucosuria

27
Q

What are some nursing considerations for glucocorticoids?

A

rinse mouth out after using inhaler (help prevent fungal infections)

monitor for symptoms of pharyngeal or laryngeal fungal infections (sore throat, hoarseness, coughing)

do not stop abruptly, taper dose (decreased adrenal gland function and abrupt stop can cause adrenal crisis)
can cause electrolyte imbalances, water retention, weakness, fatigue, depression, ect…

use alternate day dosing (prevents adrenal gland suppression and bone loss)

increase calcium and vitamin D (bone loss)

monitor BG levels (prednisone PO and solu-medrol IV)
YOU WILL SEE THIS PROFOUNDLY (especially in diabetics)

28
Q

What are some more adverse effects and nursing considerations for glucocorticoids?

A

Peptic ulcer disease (long term prednisone PO) - avoid NSAIDs/aspirin (increase risk for bleeding and ulcers), report black tarry stools, administer with food

Infection (long-term prednisone PO) - monitor for and report signs of infection from systemic suppression of inflammation (sore throat,weakness, malaise, decreased wound healing)

Fluid/electrolyte imbalances (prednisone PO) - weight gain, hypokalemia

29
Q

When are glucocorticoids contraindicated?

A

Live virus vaccines and systemic fungal infections

30
Q

What are some patient teaching points for glucocorticoids?

A

Administration techniques for inhalers
take B2 agonist inhaler first then glucocorticoid inhaler
rinse mouth after use - reduces oral fungal infections

monitor for signs of adverse effects (sings of infection, black tarry stools, hyperglycemia)

May need to increase dose during times of stress

dont prednisone suddenly, taper off

Avoid taking aspirin/NSAIDs

Avoid live virus vaccines

31
Q

what is the therapeutic action of leukotriene modifiers?

A

blocks the release of leukotrienes to suppress airway edema, bronchconstriction, mucous production, airway inflammation

32
Q

What are leukotriene modifiers used for?

A

long term control of asthma and to prevent exercise-induced bronchospasms

VERY COMMONLY USED IN CHILDREN WITH ASTHMA

33
Q

what is an adverse effect of leukotriene modifiers?

A

liver injury

34
Q

What are some nursing considerations for patients taking leukotriene modifiers?

A

use cautiously in patients with liver dysfunction

monitor labs for liver function

Pharmacology (13 decks)

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