oxygenation Flashcards
respiratory meds are broken down into which 2 categories? (MOA)
bronchodilators + anti-inflammatory
what kind of drugs are beta 2 adrenergic agonists?
sympathomimetics (emergency drugs!!)
Beta 2 adrenergic agonists end in what?
“____terol”
what is the drug of choice for bronchoconstriction/asthma attack?
SABA (short acting) - think, emergency, so has to work quickly!!
ALBUTEROL
what are the 2 subcategories of beta 2 adrenergic agonists? which of those is considered a “rescue med?” and which is a “maintenance med?”
LABA (long acting) + SABA (short acting)
- SABA is rescue med - emergency drug!!*
- LABA is maintenance med, for prevention*
what is the prototype for SABA?
albuTEROL
onset of albuterol
IMMEDIATE (think: it’s a SHORT ACTING beta adrenergic agonist)
what is the prototype for LABA?
salmeTEROL
which drug within the bronchodilators is NEVER to be used as monotherapy due to increased risk of death?
salmeterol (usually combined with glucocorticoid)
possible SE of beta 2 adrenergic agonists in HIGH DOSES
tachycardia, palpitations, tremors, angina
describe proper administration of MDI (ex: albuterol)
start to inhale –> activate inhaler –> hold breath 10 seconds –> wait 1 MINUTE before next inhalation
what is the MOA of anticholinergics?
blocking the PNS
anticholinergics are CONTRAINDICATED in patients with which condition? also, which allergy?
glaucoma (can increase IOP) // peanut allergy
re: bronchodilators/oxygenation, what is the prototype for anticholinergics?
ipratropium
“you can’t Pee with ‘UM”
SE of ipratropium
dry mouth
what will you often see ipratropium ordered with? why?
ipratropium + albuterol
(works on PNS + works on SNS)
ADDITIVE
prototypes for methylxanthines (don’t really focus/worry about these) :)
theophylline (PO)
aminophylline (IV)
review: MOA of glucocorticoids (simple)
inhibit immune + inflammatory response
re: anti-inflammatory drugs/oxygenation, what is the prototype for glucocorticoids?
beclomethaSONE
how long can it take for beclomethasone to “kick in”/full effect?
1-4 weeks
…NOT a life-saving med! takes too long!
is a PREVENTION med
SE of beclomethasone
candidiasis
how can we combat the SE of candidiasis with beclomethasone?
use this inhaler LAST + rinse/spit
name of oral and IV glucocorticoid for acute bronchoconstriction, COPD
prednisone (PO)
solumedrol (IV) - methylprednisolone
describe what the transition from oral to inhaled glucocorticoids would look like, and why?
done SLOWLY. meds must overlap.
to avoid adrenal insufficiency
re: oxygenation, what is the prototype for LEUKotriene modifier
monteLUKast (Singulair)
MOA for monteLUKast
blocks inflammation –> less edema, inflammation, bronchoconstriction
what is monteLUKast used for?
prevention/maintenance of chronic asthma
NOT a rescue drug!!
re: oxygenation, what is the prototype for monoclonal antibodies?
omalizumab (Xolair)
“Oma is allergic to Liz”
what is omalizumab used for? and when is it used?
allergy-related asthma (severe, persistent)
used when high dose steroids haven’t worked (last resort)
what is the severe SE of omalizumab?
what are standards for observation after this drug is administered?
anaphylaxis
observe 2 hours after 1st dose 3x, then 30 mins q dose after
describe route and frequency of omalizumab admin
Subcutaneous q 2-4 weeks
re: oxygenation, what is the prototype for phosphodiesterase type 4 (PDE4) inhibitor?
roflumilast
when would we use phosphodiesterase inhibitor? what is the prototype?
severe COPD w/chronic bronchitis (END STAGE)
roflumiLAST
serious SE of roflumilast
psychiatric effects :(
allergic rhinitis drugs can be broken down into which 2 categories?
preventers + relievers
prototype for 1st generation antihistamine
diphenhydramine (Benadryl)
prototype for 2nd generation antihistamine
loratidine (Claritin)
antihistamines work BEST if taken ______?
prophylactically
-with loratidine, ideally, several weeks before allergies start kicking in
between 1st and 2nd generation antihistamines, which produce LESS sedation? what is the prototype for that one?
2nd gen - loratidine (Claritin)
which drug is MOST effective for seasonal allergies?
fluticasone (Flonase)
re: allergic rhinitis, what is the prototype for intranasal glucocorticoids?
fluticasone
SE of fluticasone
specific to nasal passages: burning, drying, epistaxis
tips / tricks to avoid SE of fluticasone
nose to toes, avoid placing tip near septum, GENTLY sniff in
re: allergic rhinitis, another name for sympathomimetics is what?
decongestants
prototype for PO decongestant
pseudoephedrine (Sudafed)
prototype for intranasal decongestant (sympathomimetic)
oxymetazoline (Afrin)
re: allergic rhinitis, how are decongestants (sympathomimetics) working?
alpha 1 agonist –> acting on vessels –> constricting –> decrease secretions –> decrease congestion
SE of pseudoephedrine
HTN, insomnia
which patients should we NOT use pseudoephedrine with?
cardiac patients - stimulating the SNS system so this drug impacts the heart!
with oxymetazoline (Afrin), what is that patient at risk for? how can we combat this?
rebound congestion w/cessation
USE NO MORE THAN 3-5 DAYS
anti-tussive drugs can be _____ or ____-______
opioid or non-opioid
prototype for opioid anti-tussive drug
codeine (often combo drug)
prototype for non-opioid anti-tussive drug
dextromethorphan (Robitussin)
stopping a cough isn’t always beneficial. T/F? under which circumstances would we want to stop a cough?
TRUE.
tx if disrupting sleep or daily life
what do expectorants or mucolytics do?
increase bronchial secretions
make cough more productive
expectorant prototype
guaifenesin (Mucinex)
mucolytic prototype
acetylcystine (Mucomyst)
what is another non-pharmacological example of a mucolytic?
hypertonic saline in a neb
