Pharmacology Unit 11 Respiratory and GI Flashcards
What are the Indications of Respiratory Drugs used to treat respiratory tract irritation and control respiratory secretions?
Directed primarily at maintaining proper airflow through the respiratory secretions
What are the drugs used to treat respiratory tract irritation and control respiratory secretions?
- Antitussives
- Decongestants
- Antihistamines
- Mucolytics and Expectorants
For respiratory tract irritation and control respiratory secretions
What do Anititussives do? what is the difference between opioid and non-opioid anitussives?
What are the Adverse effects of this drug?
All Antitussive drugs suppress coughing associated with the common cold and other minor throat irritants
- Opioid antitussives (like codeine) suppress the cough reflex center in the brainstem
- Non-opioid antitussives work by inhibiting the irritant effects of histamine of the respiratoru mucuosa or by local anesthetic action on the respiratory epithelium
- Sedation
- Dizziness and upset GI
- Dependence/Tolerance (Opioids)
For respiratory tract irritation and control respiratory secretions
What do Decongestants do?
What are the Adverse effects of this drug
This stimulates vasoconstriction, drys up the mucosal vasculature and decreases local congestion in the nasal passages
- Dizziness
- Cardiovascular Irregularities (Hypertension, Palpitations)
- Headache
- Nervousness
For respiratory tract irritation and control respiratory secretions
What do Anithistamines do?
What are the Adverse effects of this drug?
The two most common applications are the treatment of respiratory symptoms caused by viral infections such as the common cold and the respiratory allergic response to seasonal allergies (e.g. hay fever) and other allergens
Decrease nasal congestion, mucosal irritation and discharge (rhinitis, sinusitis) and conjunctivitis that are caused by inhaled allergens
- Although these drugs do not reverse bronchospam associated with asthma, antihistamines may be used as an adjunct in patients with asthma to help control rhinitis and sinusitis
- Sedation
- Fatigue
- Dizziness
- Blurred Vision
- Incoordination
For respiratory tract irritation and control respiratory secretions
What do Mucolytics and Expectorants do?
What are the Adverse effects of this drug?
- Mucolytic drugs attempt to decrease the viscosity of respiratory secretions.
- Expectorant drugs facilitate the production and ejection of mucus
The intent of these drugs is to prevent the accumulation of thick, viscous secretions that can clog respiratory passages and lead to pulmonary problems
Mucolytics:
- Nausea
- Vomiting
- Inflammation of the oral mucosa
- Rhinorrhea
Expectorants:
- Upset GI
With patients taking medications for drugs for Respiratory Tract Irritation and Control Respiratory Secretions, what are the considerations for PT?
- Some of theses meds cause dizziness, sedation, and muscle coordination and changes in vision, which can increase the risk for falls.
- Maintian proper guarding and utilize the gait belt when mobilizing these patients
- Assessing blood pressure and heart rate is important secondary to changes in blood pressure and heart rhythem when taking decongestants
What are the Indications for Repiratory Drugs used to maintain airway patency in obstructive pulmonary disease?
To prevent or reverse bronchial constriction and subsequent obstruction of the airways
What are the drugs used to maintain airway patency in obstructive pulmonary disease?
- Beta-adrenergic Agonist
- Xanthine Derivatives
- Anticholinergic Drugs
- Glucocorticoids
- Cromones
- Leukotriene Inhibitors
Drugs used to maintain airway patency in obstructive pulmonary disease
What do Beta-Adrenergic Agonist do?
What are the Adverse effects of this drug?
Stimulate beta-2 receptors, this results in relaxation of bronchiole smooth muscles (brochiodilation). Can be administered orally, subcutaneously or by inhalation
- Increased brochial response to allergens and irritants (with prolonged use)
- Cardiac Irregularities
- Tremors
Drugs used to maintain airway patency in obstructive pulmonary disease
What do Xanthine Derivatives do?
What are the Adverse effects of this drug?
To produce bronchodilation
This inhibits phosphodiesterase (PDE) enzyme located in bronchial smooth muscle cells
-
Toxicity
–Nausea, confusion, irritibility, restlessness
–Cardiac arrhythmias, seizures
Drugs used to maintain airway patency in obstructive pulmonary disease
What do Anticholinergic Drugs do?
What are the Adverse effects of this drug?
Blocks muscarinic cholinergic receptors and prevents acetylcholine-induced bronchoconstriction, thus improving airflow in certain types of bronchospastic disease, such as COPD
Side note: does a lot with Vagus nerve
- Tachycardia
- Blurred Vision
- Confusion
- dry mouth
- constipation
- urinary retention
Drugs used to maintain airway patency in obstructive pulmonary disease
What do Glucocorticoids do?
What are the Adverse effects of this drug?
AKA corticosteroids
These are used to control inflammation-mediated bronchospam and are undoubtedly the most affective agents for controlling asthma
- They inhibit the production of proinflammatory products (cytokines, prostoglandins, leukotrienes, etc.)
- Osteoporosis
- Skin breakdown
- Muscle wasting
- Hyperglycemia
- Adrenal Suppression (Prolonged use)
Drugs used to maintain airway patency in obstructive pulmonary disease
What do Cromones do?
What are the Adverse effects of this drug?
These are taken prior to the onset of bronchoconstriction, and they must typcially be adminstered prophylactically to prevent asthma attacks
Prevents bronchoconstriction by inhibiting the release of inflammatory mediators, such as histamine and leukotriences from pulmonary mast cell
Nasal and upper respiratory passageway irritation
Drugs used to maintain airway patency in obstructive pulmonary disease
What do Leukotriene Inhibitors do?
What are the Adverse effects of this drug?
These are inflammatory compounds that are important in mediating the airway inflammation that underlies bronchoconstricive disease
Works by either inhibiting the enzyme that produces infammation or by blocking the receptor for leukotrienes on respiratory tissues
Hepatic impairment (although uncommon)
For patients taking drugs used to maintain airway patency in obstructive pulmonary disease, what considerations must PT take?
Some of the meds can cause an increase in heart rate, so assessing vitals in important for the pt safety. Blurred vision and tremors may place the patient in increased risk of falls
- Glucocorticoids can increase in blood sugar, so its important to monitor for s/s of hyperglycemia, especially for those with DMII.
What are the Indications of Gastrointestinal Drugs used to control gastic acidity and secretion?
These drugs attempt to control or prevent the detrimental effects of gastric acid
Gastrointestinal Drugs
What are the drugs used to control gastric acidity and secretion?
- Antacids
- H2 Receptor Blockers
- Proton Pump Inhibitors
GI: Drugs used to control gastric acidity and secretion
What do Antacids do?
What are the Adverse effects of this drug?
This drug is a base. It combines with excess hydrogen ions in the stomach to increase intragastric pH
- Constipation
- Diarrhea
- Electrolyte imbalance (prolonged use)
- May affect solubility of some medications
GI: Drugs used to control gastric acidity and secretion
What do H2 Receptor Blockers do?
What are the Adverse effects of this drug?
These prevent the histamine-activated release of gastric acid under basal conditions and during stimulation by food, and they can help decrease damage from gastric acid caused by NSAIDs and other factors that increase acid secretion
- Also used for both Acute and Long-term management of Peptic Ulcer and other problems such as dyspepsia and GERD
- Dizziness
- Tolerance
- Acid Rebound (withdrawal after prolonged use)
- Mild GI problems
- Headachs
GI: Drugs used to control gastric acidity and secretion
What do Proton Pump Inhibitors do?
What are the Adverse effects of this drug?
This inhibits the H+, K+ - ATPase enzyme that is ultimately responsible for secreting acid from gastric parietal cells into the lumen of the stomach
- These also have a anti-bacterial effects against H. Pylori infection and that may have some anti-inflammatory properties that help decrease gastric irritation
These may be more effective than H2 blockers and anacids in controlling acid secretion and promoting healing factors of ulcers in various conditions that cause gastric acid reproduction
- Decreased bone mineralization (prolonged use)
- Gastic polyps (prolonged use)
Patients that take drugs used to control gastric acidity and secretion, what considerations should the PT have?
- Antacids should NOT be taken within 2 hours of other orally administered drugs such as warfarin, digoxin, iron supplements and certain antibiotics
- Prolonged use of proton pump inhibitors may lead to decreased bone mineralization, this means that pts are at an increased risk of fractures. Caution should be taken when doing mobs and manipulations
- Minimizing fall risk is important since a fall can result in a signficant injury for this patient population
Gastrointestinal Drugs
What are the Indications for Antidirrheal Agents?
To decrease propulsion of food through GI tract
GI: Antidiarrheal Agents
What do Opioid Derivatives do?
What are the Adverse effects of this drug?
These drugs produce a general decrease in GI motility and they may also reduce fluid loss by increasing the absorption of salt and water or by decreasing fluid and electrolyte excretion from the GI tract
This binds to neuronal receptors on the enteric nerve plexus within the gut wall or by a direct effect of opioids on GI epithelial and smooth muscle cell
- Nausea
- abdominal discomfort
- Constipation
- Drowsiness
- Fatigue
- Dizziness
GI: Antidiarrheal Agents
What do Bismuth Salicylate do?
What are the Adverse effects of this drug?
This stimulates water and electrolyte absorption from lower GI, decreasing fluid loss. The salicyate component may inhibit the production of prostaglandins that irritate the intestinal lining; the comination of these make this effective in treating mild-to-moderate diarrhea
- Also decreases gastric acid secretion and exerts anacid effects; hence its used in stomach upset and minor gastric irritation
Active ingredient in Pepto-Bismol
This drug is free from serious adverse affects
Patients that take Antidiarrheal Agents, what considerations should the PT take?
Drowsiness, fatigue, and dizziness may place the patient at an increased risk for falls, so caution must be taken during gait training and transfers to maximize patient safety.
Gastrointestinal Drugs
What are the Indications for Laxatives and Catartics?
- Laxatives promote evacuation of the bowel and defecaion when normal bowel movements are impaired, but no obstruction exist in the GI system.
- Cathartics or purgatives are also used to promote lower GI evacuation, but in a somewhat more rapid fashion than with typical laxatives
GI: Laxatives and Cathartics
What do Bulk forming Laxatives do?
What are the Adverse effects of this drug?
This absorbs water and swells within the lower GI tract. The increased size of the water-laden laxative stretches the bowel, thus stimulating intestinal movement (peristalsis)
- Nausea
- Stomach Cramps
GI: Laxatives and Cathartics
What do Hyperosmotic Laxatives do?
What are the Adverse effects of this drug?
Increase stool fluid content and stimulates peristalsis
- Nausea
- Stomach Cramps
GI: Laxatives and Cathartics
What do Stimulant Laxatives do?
What are the Adverse effects of this drug?
They may activate peristalsis by a direct irritant effect on the intestinal mucosa or by stimulating the nerve plexus within the gut wall
- Nausea
- Stomach Cramps
GI: Laxatives and Cathartics
What do Stool Softeners and Lubricants do?
What are the Adverse effects of this drug?
This facilitates the entry of water into the fecal mass, thus softening the stool and permitting easier defecation
- Nausea
- Stomach Cramps
Gastrointestinal Drugs
What are the Miscellaneous GI Drugs?
- Digestants
- Emetics
- Antiemetics
- Choletholytic Agents
GI: Miscellaneous GI Drugs
What do Digestants do?
Aid in the digestion of food.
- Digestants preparations can replace digestive constituents in the stomach and upper small intestine whenever then endogenous production of these constituents is impaired. Commonly used by individuals with cystic fibrosis
GI: Miscellaneous GI Drugs
What do Emetics do?
These medications induce vomiting, usually used to empty stomach contents after ingested toxins or poisoning
- The two primary emetics are apomorphine and ipecac
GI: Miscellaneous GI Drugs
What do Antiemetics do?
This helps decrease nausea and vomiting associated with motion sickness, post-op, or other medical treatments such as chemotherapy and radiation therapy
GI: Miscellaneous GI Drugs
What do Cholelitholytic Agents do?
These are used to dissolve gallstones that are supersaturated with cholesterol
- These drugs decrease the cholesterol content of bile and may help dissolve gallstones that are supersaturated with cholesterol; however do not appear effective in the treatment of calcified gallstones
What is the primary role of bronchodilators in obstructive pulmonary disease?
To relieve acute bronchospasm
Bronchodilators are essential in managing symptoms of obstructive pulmonary diseases such as asthma and COPD.
What are the two administration routes for bronchodilators and their effects?
Inhaled: rapid with little systemic toxicity; Oral: longer duration but side effects
Common side effects of oral administration include tachycardia and tremor.
What are inhaled glucocorticoids used for?
Long term prevention of asthmatic attacks
What are oral glucocorticoids used for?
Short term management of asthma
What are the most effective drugs for the prevention of acute asthmatic episodes?
Glucocorticoids
Name the primary classifications of antacids.
- Aluminum-containing
- Magnesium-containing
- Calcium carbonate-containing
- Sodium bicarbonate-containing
- A combination of any of these classifications
Each classification has different properties and side effects.
What is the most common side effect associated with aluminum-containing antacids?
Constipation
This side effect is due to the aluminum component in the antacids.
What side effect is often associated with magnesium-containing antacids?
Diarrhea
Magnesium can have a laxative effect, leading to this side effect.
What conditions are H2 blockers commonly used to treat?
- Dyspepsia
- Gastroesophageal reflux (GERD)
These medications help reduce symptoms associated with excess stomach acid.
What type of bacterium is Helicobacter pylori?
Gram-negative bacterium
Where is H. pylori often present in individuals with gastric ulcer disease?
Upper gastrointestinal tract
What are the main treatment options for H. pylori infection in gastric ulcer disease?
Antibacterials, PPI, bismuth or a combination
