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NSG 323 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

Types of Bronchodilators

A

beta-2 agonists
anticholinergics
methylxanthines

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2
Q

types of anti-inflammatory drugs r/t oxygenation

A 
glucocorticoids
leukotriene modifiers
mast cell stabilizers
monoclonal antibodies
phosphodiesterase inhibitors
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3
Q

beta-2 agonists MOA

A

act by relaxing bronchial smooth muscle which results in dilation.

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4
Q

SABA characteristics

A

onset is immediate
via nebulizer often
for acute asthma attacks

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5
Q

SABA prototype

A

Albuterol (Proventil HFA)

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6
Q

LABA characteristics

A

prevention, maintenance.
never used as a monotherapy. instead used with a glucocorticoid.
NOT PRN, but scheduled.

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7
Q

LABA prototype

A

Salmeterol

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8
Q

SE of beta-2 agonists

A

tachy, tremors, palpitations, angina

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9
Q

Anticholinergics r/t oxygenation

A

blocks the PNS

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10
Q

anticholinergics prototype

A

Ipratropium (atrovent). typically ordered with albuterol, additive effect.

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11
Q

Ipratropium characteristics

A

onset is in 30 secs, peaks in 3 mins, 1/2 of 6 hrs.

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12
Q

SE of ipratropium

A

dry mouth, irritation of pharynx. contraindicated in pt. with a peanut allergy and with glaucoma.

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13
Q

Methylxanthines characteristics

A

not really used anymore. hard to take. narrow safety margin. chemically related to caffeine

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14
Q

Methylxanthines prototype

A

theophylline

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15
Q

Theophylline characteristics

A

oral admin, therapeutic levels 10-20 mcg/mL, NO SMOKING. 1/2 life varies, 2-15 hrs. D-D interactions!

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16
Q

aminophylline (somophyllin) admin

A

slowwww IV administration.

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17
Q

glucocorticoids (r/t oxygenation)

A

suppress inflammation

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18
Q

glucocorticoid prototype

A

beclomethasone

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19
Q

inhaled glucocorticoids

A

used as a daily prevention
little to no systemic effects
may take 1-4 wks to reach full effects
SE: adrenal suppression, candidiasis, dysphonia

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20
Q

oral/IV glucocorticoids

A

acute bronchoconstriction
prednisone (oral)
methylpredisone (solumedrol)– IV
transition from oral to IV can be tricky! may have to take both for a little while.

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21
Q

Acute asthma and glucocorticoids

A

high dose solumedrol for several days with or without oral therapy at home.

22
Q

Leukotrienes

A

important in the inflammatory response resulting in edema, inflammation and bronchoconstrictions.

23
Q

Leukotriene modifiers prototype

A

Montelukast (singulair)

ex: zafirloblast (accolate), zileuton (zyflo)

24
Q

Singulair (montelukast) characteristics

A

PO daily
used for prophylaxis of chronic asthma
NOT effective for acute attacks
maximal effects develop within 24 hrs of 1st dose
SE: neuropysch effects (depression and suicide)

25
Q

Mast Cell Inhibitors MOA

A

inhibits mast cells from releasing histamine and other chemical mediators of inflammation. prevention by decreasing inflammation.

26
Q

Mast cell inhibitors prototype

A

cromolyn (intal).

27
Q

Cromolyn characteristics

A

rebound bronchospasm if stopped abruptly. admin by nebulizer. SE: cough and broncospasm

28
Q

Monoclonal antibodies prototype

A

Omalizumab (Xolair)

29
Q

Omalizumab characteristics

A

binds to IgE in the body
for severe persistent asthma
injected subq 2-4 weeks

30
Q

Omalizumab SE

A

viral infections, URI, sinusitis, headache, injection site response. serious: Anaphylaxis

31
Q

Phosphodiesterase type 4 inhibitor MOA

A

blocks action of an enzyme that breaksdown cAMP resulting in decreased release of inflammatory mediators

32
Q

PDE4 inhibitor prototype

A

Roflomilast

33
Q

PDE4 indications

A

severe COPD with chronic bronchitis

34
Q

SE of PDE4 inhibitors

A

loss of appetite, weight loss.

Serious: psych effects– anxiety, depression, suicide

35
Q

Preventers of Allergic Rhinitis

A

Antihistamines
Intranasal glucocorticoids
Mast Cell stabilizers

36
Q

Relievers of Allergic Rhinitis

A

oral and nasal decongestants

37
Q

Antihistamines characteristics

A

1st line therapy for mild/med seasonal allergies

most effective when taken prophylactically

38
Q

antihistamine prototype 1st gen

A

diphenhydramine. will cause sedation

39
Q

antihistamine prototype 2nd gen

A

loratadine (claritin). not as much sedation.

40
Q

intranasal glucocorticoids characteristics

A

most effective for seasonal allergies
admined with a metered dose spray device
action and SE: limited to nasal passages
SE: burning/drying sensations, epistaxis

41
Q

Intranasal glucocorticoids prototype

A

Fluticasone (Flonase)

42
Q

decongestants

A

sympathomimetics. stimulate nervous system to relieve nasal congestion (alpha 1 agonist)

43
Q

decongestant oral admin

A

slower onset of action

SE: HTN, CNS stimulation. should not be used in cardiac pts.

44
Q

decongestant oral admin prototype

A

pseudoephedrine (sudafed). can make meth out of this. so use phenylephrine (Sudafed PE). not as effective

45
Q

decongestant nasal admin

A

risk for rebound congestion. causes escalating congestion requiring more drug to get the same results. don’t take more than 3-5 days

46
Q

intranasal decongestant prototype

A

oxymetazoline (afrin)

47
Q

Antitussive types

A

Opioid: codeine
nonopioid: dextromethorphan (robutussin). most frequently used form

48
Q

opioids used for coughs

A

1/10th of the level for pain mgmt

usually a combo drug

49
Q

expectorants

A

increase bronchial secretions.
stimulate flow of secretions
prototype: guaifenesin

50
Q

mucolytics

A

makes mucus more watery, more productive cough.
prototype: acetylcyestine (mucomyst)
also, 3% NS in a neb!

NSG 323 (12 decks)

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