pulomonary medications Flashcards
what effects the bronchi and bronchioles
bronchcocontriciton
what plays a major role in the pathophysiology of most obstructive respiratory disorders
bronchocontrition
what is the balance of sympathetic and parasympathetic input to the smooth mm of brochi and bronchioles
bronchomotor tone q
what are the 3 main causes of abnormal bronchomotor tone
inflammation
excessive PNS activity
reduces SNS activity
bronchodilators act as ____ agents
sympathomimetics agents
(medications that mimic the SNS)
what are sympathomimetics agents (bronchiodilators) used for
anaphylaxis and acute asthma
what is used for lower respiratory disorders
sympathomimetics agents (bronchiodilators)
what drug is used during acute phase of asthmatic attacks
sympathomimetics agents (bronchiodilators)
what does sympathomimetics agents (bronchodilators) stimulate throughout the lungs
beta 2 adrenergic receptors
what drug is a sympathomimetics agent that works in 3-5 mins and effects last for 4-6 hours and acts as a rescue inhaler
short acting beta 2 agonist (SABA)
what sympathomimetics agents is given in emergent situation and what does it effect
epinephrine and affects all a drenergic receptors
why is epinephrine given in emergency situation
to promote bronchodilation and increase BP
what are some side effects of epinephrine (sympathomimetic agents)
tremors , dizziness , HTN , tachycardia , heart palapitation and angina
if someone has bronchospasm due to COPD what drug are they given via aerosol or tablet
selective beta2 adenergic agonist
what are 3 examples of selective beta 2 adrenergic agonist that are giving to patients with bronchospasm due to COPD
albuterol , salbutamol (SABA
formoterol (FABA)
salmeterol (FABA)
what drug is given to a patients with bronchospasm due to COPD with the effects beginning within 2-20 min , works up to 12 hours , used to help COPD pateints slow and used for matienance therapy
long lasting beta 2 agonist
what are some adverse reactions related to SABA
cough
tachycardia
muscle tremor
muscle contractions
what stimulate alpha-adrenergic receptor vasoconstriction of capillaries w/in nasal mucosa
shrinking of the nasal mucus membranes & reduction in fluid secretion (runny nose)
decongestants
decongestants can lead to __ in BP bc of vasoconstriction in the gut area
increase
what are side effects of decongestants
dizziness
hypertension
headaches
nausea
nervousness
insomnia
cardiovascular irregularities
what is used with anti inflammatories to treat acute moderate to severe asthma
parasympatholytics
parasympatholytics meds facilitates ____
bronchodilation
what affects the nicotinic and muscarinic receptors
acteylocholine
what are 2 muscarinic antagonist ?
ipratropium (atrovent) SAMA
tiotropium (spiriva) LAMA
what does atropine do
promote bronchodilation and decreased mucus secretions
what is used for paralysis of the respiratory system due to poisoning
atropine
is atropine used for asthma
no
what are the 8 side effects of atropine
dry mouth
headaches
tachycardia
blurred vison
rash
decreased GI activity
dizziness
confusion
what is an enzyme that reduces intracellular levels of cAMP
phosphodiesterase (PDE)
what promotes an increase in cAMP by blocking the breakdown of cAMP
methylxanthines
what is the precursor to norepinephrine and epinephrine
cAMP
what are 2 examples of methylxanthines
theophylline
aminophylline
what does phosphodiesterase inhibitors promote
bronchodilation and vasodilation of peripheral arterioles
what are the 3 things that Methylxanthines do
Promotes Prostaglandin inhibition
• Enhances catecholamine production
• Stimulates CNS and skeletal mm
what drug increase exercise tolerance via imporoved contractility and reduced fatigue of diaphragm
Methylxanthines
what is the main drug that reduces the fatigue of the diaphragm
Methylxanthines
what are some things you want to monitor for a patient taking Methylxanthines
HR
CNS effects
RR
SpO2
ABGs
chest pain or discomfort
dizziness
fainting
fast, slow, or irregular heartbeat
increase in urine volume
lightheadedness
persistent vomiting
pounding or rapid pulse
seizures
tremors’
these are all side effects of which drug
Methylxanthines
what drug is Not a “true” bronchodilator but can
promote this secondarily as a
inflammation is controlled
corticosteroids
corticosteroids ___ airflow
increase
what drug Reduces mucosal swelling, increased
bronchial lumen size via:
corticosteroids
what are side effects of corticosteroids
• Water retention
• Hyperglycemia
• Osteoporosis
• Increases susceptibility to
infections
• Muscle atrophy
• Growth retardation
- hypokalemia
what device does these things
• Delivers specific amount of meds per
short burst from device
• Device has a meter valve to deliver
precise dosage
• Drug is in aerosol form that is inhaled by
the patient:
Meter dosed inhaler (MDI):
what device Administers medication via a
mist inhaled into the lungs
nebulizer
respiratory stimulants are drugs that ___ the activity of the CNSD respiratory centers
enhance
___ and___ stimulate respiratory centers which ___ ventilation
sympathomimetics and methylxanthines
increase
what are drugs that’s specifically increase respiratory activity
analeptics (amphetamines)
what stimulates chemoreceptors in carotid arteries and cortical-spinal neurons:
dopram
can to much o2 be bad for the patient
yes
sedatives, tranquilizers, narcotic analgesics are examples of respiratory _____
depressants
pateints with a pulmonary disease should avoid respiraotry ___
depressants
what is used to control abnormal breathing patterns due to anxiety or agitation
respiratory depressants
- IV Morphine
- Midazolam (Versed)
- Propofol (Diprivan)
- Diazepram (Valium)
- Haloperidol (Haldol)
these are examples of what meds
respiratory depressants
are DVTS more worse proximal or distal and why
proximal bc vessels are larger
proximal DVTs involve the popliteal , femoral , or iliac venous system are are commonly complicated by __ __
pulmonary embolism
should the therapist mobilize the patients with a DVT when the therapeutic threshold levels of the anticoagulants have been reached ?
yes
after a IVC filter placement should a PT mobilize their patient once they are hemodynamicaaly stable
yes
when a pateint with a LE DVT below the knee is not related with anitcoauflation and does not have an IVC filter and is prescribed out of bed mobility by the physician what should the therapist do
consult with the medical team regarding mobilizing , do not just keep the patient on bed rest
does the padua prediction score for DVT include active cancer
yes
is a patients has signs or symptoms of a LE DVT therapist should assess DVT likelihood using what
wells criteria for DVT
what are the classic signs and symptoms for DVT
localized pain, tenderness , swelling and discoloration
other symptoms may include edema , fever , extermity warmth and pain
what is included in the wells DVT clinical decision criteria
active cancer
swelling
edema
what is the critieria for UE DVT
constans
when is a sonography used
if DVT UE is likely
what is the normla for D diner test
< 500
so if more then 500 bad
D-Dimer reflects the amount ofdegradation of a
protein clot from three enzymes:
thrombin
plasmin
activated factor XIIII
what is normal time for PT: prothrombin time
11-13 seconds
if prothrombin time is > ___ then it is high risk for bleeding
25
what is used to monitor effectiveness of warfarin for blood thinning
international normalized ratio
if INR have low values then risk of clots … what are u looking at
prednisone
barbiturates
vitamin K
INR: higher values increased risk of
bleeding:
• Antibiotics
• Amiodarone
• Steroids (depends on dose)
is a patient is taking Fondaparinux (anticoagulant) when si it safe to get them up?
> 3 hrs
is a patients is taking UFH (heparin) when can u walk them
> 48 hours
is a patient is taking the anticoagulant NOAC (non VKA oral anticoagulant) when can you mobilize them
> 3hours
if a patient is taking a DOAC (directing affectv anticoagulants) when can they mobilize
> 3 hours
if a patient is taking a LMWH (low molecular weight heparin) when can they mobilize
> 5 hours
will an Inferior vena cava filter work if a pateint has a UE DVT
no
what is used to diagnose pulmonary embolism
ventilation perfusion scan
