Oxygenation Flashcards

1
Q

How long between puffs

A

Bronchodilator: 1 min
Glucocorticoid: 5 min

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2
Q

An inhaler with a spacer delivers [more or less] drug to the lungs

A

more

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3
Q

Categories of bronchodilators

A
  • Beta2 Agonists
  • ## Anticholinergics
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4
Q

Beta2 Adrenergic Agonists ending

A

-terol

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5
Q

Fastest acting bronchodilators

A

sympathomimetics: beta2 adrenergic agonists

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6
Q

SABA prototype and when used

A

albuterol (Proventil HFA) used for asthma attack with immediate onset

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7
Q

LABA prototype and when used

A

Salmeterol (Servent Diskus) never used as monotherapy, on a fixed schedule, used for prevention

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8
Q

SE of Beta2 Adrenergic Agonists

A

tachycardia, tremors, palpitations, angina, tolerance (typically not SE with occasional use)

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9
Q

Anticholinergics mechanism of action

A

blocking parasympathetic nervous system

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10
Q

Anticholinergic prototype

A

Ipratropium (atrovent)

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11
Q

SE of anticholinergics like Ipratropium (Atrovent)

A

dry mouth, irritation of pharynx

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12
Q

Contraindications for anticholinergics like Ipratropium (Atrovent)

A

peanut allergy, glaucoma

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13
Q

Theophylline drug class

A

Methyxanthines

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14
Q

Are methylxanthines like theophylline used in standard therapy?

A

Nope, it’s a hard drug to take and there are better options.

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15
Q

Anti-inflammatory drug categories (respiratory)

A
  • glucocorticoids
  • leukotriene modifiers
  • mast cell stabilizers
  • monoclonal antibodies
  • phosphodiesterase inhibitors
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16
Q

glucocorticoid prototype

A

Beclomethasone (QVAR, Beclovent, Beconase, Vancenase, Vanceril)

17
Q

Inhaled glucocorticoids SE

A

adrenal suppression, candidiasis, dyphonia

18
Q

Managing candidiasis in inhaled glucocorticoids

A

take it last, rinse mouth

19
Q

Oral/IV options for glucocorticoids

A

Solumedrol (IV) and prednisone (oral) used for acute bronchoconstriction, but not a rescue!

20
Q

Leukotriene modifiers

A

Montelukast (Singulair)

21
Q

Leukotriene (montelukast-singulair) teaching points

A

prevention, not effective for acute attacks, PO daily, neuropsych effects (depression/suicide)

22
Q

Mast cell stabilizer prototype

A

cromolyn (intal)

23
Q

Monoclonal antibody prototype

A

Omalizumab (Xolair) for severe, persistent, allergic asthma not controlled by high dose steroids

24
Q

Omalizumab (Xolair) SE

A

viral infections, URI, sinusitis, headache, injection site response, anaphylaxis

25
Omalizumab (Xolair) route
subcut
26
Phosphodiasterase type 4 (PDE4) Inhibitor
Roflumilast
27
PDE4 mechanism of action
blocks PDE4 enzyme that breaks down cAMP resulting in decreased release of inflammatory mediators
28
1st gen antihistamine
diphenhydramine (Benadryl) | sedation, anticholinergic
29
2nd gen antihistamine
loratadine (clairitin)
30
intranasal glucocorticoids
flonase SE usualy in nasal passages. keep spray off septum and throat
31
sympathomimetic decongestants
alpha 1 agonist: pseudoephedrine (Sudafed)
32
Contraindications/SE of sympathomimetics
Cardiac patients. SE HTN, insomnia
33
Intranasal sympathomimetics
Oxymetazoline (Afrin)
34
Teaching for Afrin (oxymetazoline)
rebound congestion risk if used longer than 3-5 days. Can stop cold turkey, one nostril, or tapering in intranasal glucocorticoids
35
Opoid antitussive
codeine
36
Nonopoid antitussive
dextromethorphan (Robitussin) but can give euphoria if used in high doses
37
Is stopping a cough always beneficial?
No. Getting the junk out is a good thing. Reserve for sleep or if interrupting daily life.
38
Expectorants
stimulate flow of secretions: guaifenesin (Mucinex)
39
Mucolytics
make mucus more watery and cough more productive: acetylcysteine (Mucomyst) or hypertonic saline