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Pharmacology > Repiratory > Flashcards

Repiratory Flashcards

1
Q

reversible airway obstruction causing inflamed, narrow and swollen bronchi and bronchioles, excessive mucus production

A

asthma

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2
Q

symptoms of asthma

A

cough
wheeze
chest tightness
SOB

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3
Q

triggers of asthma

A

viral infections
air pollutions
strong odours
physical activity (SOB)
allergies

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4
Q

if asthma is left untreated it could lead to

A

COPD

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5
Q

main cause of COPD

A

smoking
environmental factors: pollution, dust chemical fumes and gas
genetics

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6
Q

symptoms of COPD

A

SOB
productive cough
increased phlegm or mucus production
fatigue
chest infections

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7
Q

forms of COPD

A

emphysema and chronic bronchitis

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8
Q

2 main asthma treatments

A

bronchodilators and corticosteroids

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9
Q

2 types of bronchodilators

A

adrenoceptor agonist (selective beta-2 agonist) and antimuscarinic bronchodilators

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10
Q

2 types of selective Beta-agonists and indications

A

short-acting (SABA) - (reliever)mild and acute asthma or exercise induced asthma with quick onset 5-15 mins
long-acting (LABA) - (preventer) chronic asthma and COPD. long therapeutic effect (12 hours)

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11
Q

SABA pharmacodynamics

A

beta-2 receptor agonist in smooth muscles of bronchi > stimulation of adenyl cyclase >increasing cAMP which relaxes smooth muscles >bronchodilation effect

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12
Q

SABA meds

A

salbutamol
terbutaline

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13
Q

SABA contraindications

A

medications that inhibit beta-1 receptors which inhibits sympathetic nerves (since beta-2 agonist induces sympathetic nerves)
hyperthyroidism
cardiovascular disease and arrhythmias
HTN
diabetes

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14
Q

LABA pharmacodynamics

A

same as SABA but act as a preventer
MUST use with inhaled corticosteroids or ICS

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15
Q

LABA meds

A

salmeterol
formoterol
eformoterol
indacaterol
olodaterol

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16
Q

LABA contraindications

A

hyperthyroidism
hypersensitivity

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17
Q

LABA adverse effects

A

palpitation
peripheral vasodilation - hypotension
headache
fine muscle tremor

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18
Q

tolerance in beta-2 agonist drugs can

A

downregulate beta-2 receptors over time
high doses can make the receptors unresponsive

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19
Q

sympathomimetics treatment for asthma - used in emergency situations

A

ephedrine and adrenaline - promote bronchodilation by activating beta receptors
reduce oedema through pulmonary vasoconstriction by stimulating alpha receptors

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20
Q

SABA and LABA nursing considerations

A

ALWAYS take bronchodilator FIRST - to dilate airways
WAIT 5 mins
THEN use corticosteroids
RINSE mouth with water after using inhaled bronchodilators or corticosteroids to PREVENT THRUSH (yeast infection)

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21
Q

sodium cromoglycate pharmacodynamics

A

inhibits inflammatory mediators during inhaled allergens such as histamine and leukotrienes from mast cells

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22
Q

sodium cromoglycate meds

A

cromolyn

23
Q

mast cell stabilizers (leukotriene receptor antagonist) pharmacodynamics

A

inhibits leukotrienes which is produced by the immune system which promotes bronchoconstriction, inflammation, microvascular permeability and mucus secretion in asthma and COPD

24
Q

anticholinergic pharmacodynamics

A

blocks parasympathetic nerves which causes the airways to constrict, therefore allows airways to remain open

25
Q

anticholinergic meds

A

aclidinium
umeclidinium
ipatropium
tiotropium

26
Q

anticholinergics indications

A

bronchospasms in COPD

27
Q

anticholinergics adverse effects

A

blurred vision
dysuria
dry mouth
constipation

28
Q

asthma and COPD treatment that mainly inhibits inflammatory mediators of the immune system

A

corticosteroids

29
Q

corticosteroids MoA

A

suppress recruitment and activation of eosinophils and mast cells in airways > reduce inflammatory response
suppress antibody synthesis and receptor production
inhibits prostaglandin synthesis > reducing oedema, mucus production and inflammation
upregulates beta-receptors > increased therapeutic benefits from beta-2 agonist meds

30
Q

corticosteroids must be used with ___________ to achieve therapeutic effects and further reduce exacerbations and need of higher doses

A

beta-2 agonist

31
Q

inhaled corticosteroids adverse effects

A

sore throat
hoarse voice
oral candidiasis or thrush
risk of chest infections

32
Q

inhaled corticosteroids meds

A

budesonide

33
Q

smart inhalers are

A

combination of LABA and inhaled corticosteroids > short term relief

eg. formoterol + budesonide (symbicort)

34
Q

oral or systemic corticosteroids meds

A

oral: prednisolone, prednisone, hydrocortisone

IV: methylprednisolone

35
Q

oral corticosteroids adverse effects

A

cushing syndrome
hyperglycaemia
osteoporosis
sepsis
depression
HTN
decreased libido
oedema
weight gain
risk of cataracts

36
Q

excessive use of corticosteroids can cause

A

cushing syndrome

37
Q

chronic use of oral corticosteroids can inhibit the function of HPA axis or hypothalamic-pituitary adrenal axis (ACTH) by negative feedback resulting in

A

adrenal insufficiency - sever fatigue, weakness, weight loss, postural hypotension, low BP, nausea, vomiting, painful muscles and joints

38
Q

treatment for adrenal suppression and insufficiency

A

hydrocortisone replacement therapy

39
Q

nursing consideration for long-term corticosteroid replacement

A

monitor signs of infection (since corticosteroids are immunosuppressants)
increase Ca diet (corticosteroids can deplete bone density)
increase dose in time of stress (cortisol is decreased)
slowly taper off medications DO NOT STOP ABRUPTLY - it may cause adrenal insufficiency symptoms

40
Q

antimuscarinic meds MoA

A

blocks parasympathetic receptors such as ACh and muscarinic to promote smooth muscle relaxation
inhibits cholinergic (Ach) mediated bronchoconstriction and cholinergic production of mucus

41
Q

antimuscarinic meds should be used with _________ to promote synergistic bronchodilator effects

A

beta-2 agonists drugs

42
Q

2 types of antimuscarinics

A

short-acting muscarinic antagonist (SAMA)
long-acting muscarinic antagonist (SAMA)

43
Q

indications for SAMA

A

used for COPD only
symptom relievers (cough, wheezing and SOB)
can be used with salbutamol for severe asthma

44
Q

SAMA meds

A

Ipratropium

45
Q

LAMA indications

A

persistent COPD
long term treatment for bronchospasm and excessive mucus secretion

46
Q

LAMA meds

A

Tiotropium

47
Q

antimuscarinics adverse effects

A

dry mouth
urinary retention
pupil dilation
glaucoma

48
Q

antimuscarinics contraindicated with

A

glaucoma
prostatic hyperplasia
bladder obstruction

49
Q

a condition caused by viral infection causing inflammation and swelling of the lining of voice box and windpipe becoming narrowed

A

croup

50
Q

croup treatment

A

mild- oral corticosteroids
severe - hospital treatment, nebulised adrenaline

51
Q

sympathomimetic medicines that binds to alpha-1 receptors causing blood vessels to constrict

A

decongestants

52
Q

decongestants nursing consideration

A

should not be used more than 5 days as it damages mucosa lining of the nose. High risk of athropic rhinitis

53
Q

medications that directly travels to lungs

A

aerosol drugs via
inhalers or puffers and nebulisers

54
Q

inhalers are more delivered to lungs with the use of

A

spacers

Pharmacology (27 decks)

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