Oxygenation/Respiratory

Question 1

antitussives

Answer 1

dextromethorphan

• suppress cough reflex in medulla

Contraindications: MAOIs (increase risk of serotonin syndrome)

Adverse Effects: nervousness, irritability, stomach pain

Question 2

decongestants

Answer 2

pseudoephedrine

• reduces blood flow to mucosa which decreases prod. of mucosa

Contraindications: severe hypertension, coronary artery disease, antihypertensives, MAOIs

Adverse effects: palpitations, tachycardia, transient hypertension, insomnia

• can cause insomnia; patient shouldn’t take within 2 hours of bedtime

Question 3

antihistamine

Answer 3

diphenhydramine

• inhibits release of histamine, reduces inflammation

Contraindications: MAOIs (increase risk of serotonin syndrome), alcohol use (increase CNS depression), excess sun exposure (photosensitivity reactions)

adverse effects: anxiety, nervousness, irritability, drowsiness, palpitations, tachycardia, hypotension

Question 4

expectorants

Answer 4

guaifenesin

• liquefies secretions

adverse effects: dizziness

• fluid intake should be increased
• drug shouldn’t be used for chronic/persistent cough; smoking, asthma, emphysema

Question 5

xanthine

Answer 5

theophylline

• inhibits enzyme (phosphodiesterase) which results in dilation of bronchial airway and pulmonary blood vessels
• used for acute bronchospasm

adverse effects: insomnia, tremors, palpitations, hypotension, arrhythmias

toxicity: tachycardia, restlessness, seizures, anorexia
- smoking will increase drug elimination
- Alcohol, caffeine will decrease drug elimination

Question 6

sympathomimetics

Answer 6

albuterol

• increase bronchodilation by mimicking effects of sympathetic NS
• Used for bronchospasm (COPD, asthma, emphysema)

adverse effects: insomnia, tremors, palpitations, hypertension, tachycardia, hypokalemia

Question 7

anticholinergics

Answer 7

ipratropium

• inhibits muscarinic receptors resulting in bronchodilation
• Treats bronchospasm in chronic bronchitis or emphysema

adverse effects: palpitations, hypertension, bitter taste

• drug isn’t effective for treating acute episodes of bronchospasm

Question 8

inhaled steroids

Answer 8

fluticasone

• decreases inflammation by reducing mast cell and leukotriene response
• Prevent asthmatic bronchospasm

adverse effects: palpitations, hypertension, hyperglycemia, oral candidiasis (patient should rinse mouth to reduce risk of thrush)

• not effective for treating acute episodes of bronchospasms (Not a rescue drug)
• can stunt child growth

Question 9

leukotriene receptor antagonists

Answer 9

montelukast

• Causes bronchodilation by reducing response to antigens
• prevents asthmatic bronchospasm

adverse effects: dizziness, headache, abdominal pain. nausea, diarrhea

• monitor for signs of psychosis, thoughts of suicide
• drug needs to be taken daily, even if asymptomatic