oxygenation Flashcards

1
Q

respiratory meds are broken down into which 2 categories? (MOA)

A

bronchodilators + anti-inflammatory

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2
Q

what kind of drugs are beta 2 adrenergic agonists?

A

sympathomimetics (emergency drugs!!)

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3
Q

Beta 2 adrenergic agonists end in what?

A

“____terol”

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4
Q

what is the drug of choice for bronchoconstriction/asthma attack?

A

SABA (short acting) - think, emergency, so has to work quickly!!

ALBUTEROL

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5
Q

what are the 2 subcategories of beta 2 adrenergic agonists? which of those is considered a “rescue med?” and which is a “maintenance med?”

A

LABA (long acting) + SABA (short acting)

  • SABA is rescue med - emergency drug!!*
  • LABA is maintenance med, for prevention*
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6
Q

what is the prototype for SABA?

A

albuTEROL

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7
Q

onset of albuterol

A

IMMEDIATE (think: it’s a SHORT ACTING beta adrenergic agonist)

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8
Q

what is the prototype for LABA?

A

salmeTEROL

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9
Q

which drug within the bronchodilators is NEVER to be used as monotherapy due to increased risk of death?

A

salmeterol (usually combined with glucocorticoid)

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10
Q

possible SE of beta 2 adrenergic agonists in HIGH DOSES

A

tachycardia, palpitations, tremors, angina

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11
Q

describe proper administration of MDI (ex: albuterol)

A

start to inhale –> activate inhaler –> hold breath 10 seconds –> wait 1 MINUTE before next inhalation

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12
Q

what is the MOA of anticholinergics?

A

blocking the PNS

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13
Q

anticholinergics are CONTRAINDICATED in patients with which condition? also, which allergy?

A

glaucoma (can increase IOP) // peanut allergy

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14
Q

re: bronchodilators/oxygenation, what is the prototype for anticholinergics?

A

ipratropium

“you can’t Pee with ‘UM”

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15
Q

SE of ipratropium

A

dry mouth

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16
Q

what will you often see ipratropium ordered with? why?

A

ipratropium + albuterol

(works on PNS + works on SNS)

ADDITIVE

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17
Q

prototypes for methylxanthines (don’t really focus/worry about these) :)

A

theophylline (PO)

aminophylline (IV)

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18
Q

review: MOA of glucocorticoids (simple)

A

inhibit immune + inflammatory response

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19
Q

re: anti-inflammatory drugs/oxygenation, what is the prototype for glucocorticoids?

A

beclomethaSONE

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20
Q

how long can it take for beclomethasone to “kick in”/full effect?

A

1-4 weeks
…NOT a life-saving med! takes too long!
is a PREVENTION med

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21
Q

SE of beclomethasone

A

candidiasis

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22
Q

how can we combat the SE of candidiasis with beclomethasone?

A

use this inhaler LAST + rinse/spit

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23
Q

name of oral and IV glucocorticoid for acute bronchoconstriction, COPD

A

prednisone (PO)

solumedrol (IV) - methylprednisolone

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24
Q

describe what the transition from oral to inhaled glucocorticoids would look like, and why?

A

done SLOWLY. meds must overlap.

to avoid adrenal insufficiency

25
Q

re: oxygenation, what is the prototype for LEUKotriene modifier

A

monteLUKast (Singulair)

26
Q

MOA for monteLUKast

A

blocks inflammation –> less edema, inflammation, bronchoconstriction

27
Q

what is monteLUKast used for?

A

prevention/maintenance of chronic asthma

NOT a rescue drug!!

28
Q

re: oxygenation, what is the prototype for monoclonal antibodies?

A

omalizumab (Xolair)

“Oma is allergic to Liz”

29
Q

what is omalizumab used for? and when is it used?

A

allergy-related asthma (severe, persistent)

used when high dose steroids haven’t worked (last resort)

30
Q

what is the severe SE of omalizumab?

what are standards for observation after this drug is administered?

A

anaphylaxis

observe 2 hours after 1st dose 3x, then 30 mins q dose after

31
Q

describe route and frequency of omalizumab admin

A

Subcutaneous q 2-4 weeks

32
Q

re: oxygenation, what is the prototype for phosphodiesterase type 4 (PDE4) inhibitor?

A

roflumilast

33
Q

when would we use phosphodiesterase inhibitor? what is the prototype?

A

severe COPD w/chronic bronchitis (END STAGE)

roflumiLAST

34
Q

serious SE of roflumilast

A

psychiatric effects :(

35
Q

allergic rhinitis drugs can be broken down into which 2 categories?

A

preventers + relievers

36
Q

prototype for 1st generation antihistamine

A

diphenhydramine (Benadryl)

37
Q

prototype for 2nd generation antihistamine

A

loratidine (Claritin)

38
Q

antihistamines work BEST if taken ______?

A

prophylactically

-with loratidine, ideally, several weeks before allergies start kicking in

39
Q

between 1st and 2nd generation antihistamines, which produce LESS sedation? what is the prototype for that one?

A

2nd gen - loratidine (Claritin)

40
Q

which drug is MOST effective for seasonal allergies?

A

fluticasone (Flonase)

41
Q

re: allergic rhinitis, what is the prototype for intranasal glucocorticoids?

A

fluticasone

42
Q

SE of fluticasone

A

specific to nasal passages: burning, drying, epistaxis

43
Q

tips / tricks to avoid SE of fluticasone

A

nose to toes, avoid placing tip near septum, GENTLY sniff in

44
Q

re: allergic rhinitis, another name for sympathomimetics is what?

A

decongestants

45
Q

prototype for PO decongestant

A

pseudoephedrine (Sudafed)

46
Q

prototype for intranasal decongestant (sympathomimetic)

A

oxymetazoline (Afrin)

47
Q

re: allergic rhinitis, how are decongestants (sympathomimetics) working?

A

alpha 1 agonist –> acting on vessels –> constricting –> decrease secretions –> decrease congestion

48
Q

SE of pseudoephedrine

A

HTN, insomnia

49
Q

which patients should we NOT use pseudoephedrine with?

A

cardiac patients - stimulating the SNS system so this drug impacts the heart!

50
Q

with oxymetazoline (Afrin), what is that patient at risk for? how can we combat this?

A

rebound congestion w/cessation

USE NO MORE THAN 3-5 DAYS

51
Q

anti-tussive drugs can be _____ or ____-______

A

opioid or non-opioid

52
Q

prototype for opioid anti-tussive drug

A

codeine (often combo drug)

53
Q

prototype for non-opioid anti-tussive drug

A

dextromethorphan (Robitussin)

54
Q

stopping a cough isn’t always beneficial. T/F? under which circumstances would we want to stop a cough?

A

TRUE.

tx if disrupting sleep or daily life

55
Q

what do expectorants or mucolytics do?

A

increase bronchial secretions

make cough more productive

56
Q

expectorant prototype

A

guaifenesin (Mucinex)

57
Q

mucolytic prototype

A

acetylcystine (Mucomyst)

58
Q

what is another non-pharmacological example of a mucolytic?

A

hypertonic saline in a neb