Resp Drugs Flashcards
Asthma is a chronic inflammatory disorder of the (fill in the blank) ?
airways
Asthma is an intermittent and reversible airflow obstruction that affects the (fill in the blank)
bronchioles
Medication management addresses both inflammation and bronchoconstriction True or False
True
The same medications used for the treatment of asthma can be used to treat chronic obstructive pulmonary disease (COPD) True or False
True
Medications which treat asthma and COPD include a group of bronchodilator agents called ?
(Beta2 adrenergic agonists) - Albuterol (levalbuterol)
What is the expected action of a Beta 2 adrenergic agonists?
This group activates beta 2 receptors in the bronchial smooth muscle, which results in bronchodilation
What routes of delivery are available for (Beta 2 adrenergic agonists?
Oral & Inhaled
When would a provider order an oral Albuterol (levalbuterol) ?
The oral dosing is for long-term control of asthma (the Rx is long acting)
What are complications or adverse reactions for Albuterol?
Tachycardia and angina (due to the activation of alpha receptors in the heart), also tremors - also cause by activation of beta receptors in skeletal muscle.
What are some Contraindications?
Contraindicated in patients who have tachydysrhshythmia, pregnancy risk category & use cautiously in patients or clients with narrow-angle glaucoma & benign prostatic hyperplasia ( due to the anticholinergic effects)
What are two medication interactions?
Monoamine Oxidase Inhibitor (MAOIs) (used to treat depression
and other neurological illness like Parkinson’s and tricyclic antidepressants (because they can increase the risk of tachycardia and angina
Name some important patient or client teaching instructions for using an inhaler
Instruct to rinse the mouth after inhalation, if there are 2( two) inhaled medications ( inhalers) wait at least 5 ( five ) minutes between medications
What is the usual dose for adults for an albuterol inhaler?
2 puffs
Phenylephrine is in what class?
Alpha agonist
Phenylephrine is used for what conditions?
Nasal decongestant & also for pupil dilation ( vasoconstriction) Treatment for wide-angle glaucoma
Name side effects of Phenylephrine
Anorexia, anxiety, blurred vision, cardiac arrhythmias, decreased urine output, dizziness & drowsiness
What is the medical term for rebound nasal congestion?
Rhinitis Medicamentosa (RM)
Describe rebound nasal congestion
Rebound congestion is simply when nasal congestion gets worse because a person overuses a nasal decongestant spray like Afrin ( oxymetazoline). It is actually a nasal spray addiction
This class of medication should not be used for more than 3 ( three days True or False
True
What is important to teach patients or clients about using nasal sprays?
Follow the dosing schedule, maintain hydration
A person 68 years old with chronic obstructive pulmonary disease ( COPD) is discharged with prescriptions albuterol, a short-acting beta-agonists ( SABA), and salmeterol, a bronchodilator, also a long-acting beta-agonist ( LABA). Which statement by the client or patient would indicate that the patient will require additional teaching?
1. I will inset my inhaler into the spacer and shake the whole unit three or four times before taking my dose of the drug.
2. I will use my salmeterol whenever I become suddenly short of
breath.
3. I will wait at least one minute between the first and second puff of my inhaler.
4. I will check my pulse before and after using my bronchodilator inhaler.
- Salmeterol is a LABA and used to prevent episodes of shortness of breath. When someone experiences a sudden episode of shortness of breath the drug of choice is a SABA ( Albuterol). * a person > 65 may be more sensitive to the cardiac effects of these drugs and should check the heart rate before and after these drugs.
Answers 1, 3 & 4 demonstrate the correct way to use an inhaler.
What class is Dextromethorphan?
Nonopioid Antitussive ( it is related to opioids but it has NO analgesic effect
What is the intended use for Dextromethorphan
Cough suppressant ( nonproductive)
What are the adverse effects of Dextromethorphan?
CNS- high dose dizziness, sedation, nausea- respiratory depression( with overdose), bradycardia,
Important nursing instructions for patients and clients- name some
No ETOH when taking the medication, avoid smoking
Dextromethorphan is found in Robitussin, Vicks Formulas- what is the action?
Suppresses the cough reflex with a direct effect on the cough center in the medulla
What class is Codeine Sulfate?
Antitussive opioid agonist, analgesic
What is Codeine Sulfate indicated for?
Relief of mild to moderate pain and Cough suppression
Codeine Sulfate is a BBW drug, why ?
( Death related to ultrarapid metabolism of codeine to morphine ( MSO4) in children after T&A
What are the routes of administration for codeine?
Oral, (Adults, 15-60 mg orally) IM, IV, or subq.
What are adverse effects?
Cardiac Arrest, Clamminess, Constipation, confusion, dizziness, floating feeling, lethargy, shock, CONVULSIONS IN CHILDREN AND Infants & Drug dependence,
What are interactions with Codeine Sulfate ?
Anticholinergics, barbiturate anesthetics, CNS depressants
Things to know & remember about Codeine *****
Do not give IV codeine to children! Do not give to manage pain in post op children with T&A., Use of laxative is advised (because of the effect of constipation).
* Important to NOTE NAME CONFUSION BETWEEN CODEINE AND CARDENE (NICARDIPINE) AND LODINE
What are contraindications of Codeine?
Respiratory depression, COPD, asthma, Acute Alcoholism, convulsive disorders, comatose patients, persons with raised intracranial pressure.
What is Diphenhydramine (Benadryl)used for ? Indications
Allergy, anaphylaxis, sedation, motion sickness, antitussive
What is the pharmaceutical action of Benadryl?
Antagonizes effects of histamine, CNS depressant
What class is Diphenhydramine (Benadryl)?
First generation Antihistamine
What are adverse effects for Diphenhydramine (Benadryl)
First generation Rx’s can cause sedation, anticholinergic effects think dry, dry mouth, urinary retention, constipation, & blurred vision.
What routes of administration are available for Diphenhydramine (Benadryl)
Orally & IV, IM & topical
What should a nurse teach a patient or client about Benadryl?
Avoid ETOH or CNS depressants due to sedation
Cromolyn sodium (Brand name Nasalcrom) is in what drug class?
Mast Cell Stabilizer-anti allergy
What is the action for Cromolyn?
The Rx is used to treat mastocytosis (too many mast cells). Hence, these normal body cells release substances (histamines) (histamines are needs to defend the body and healing, but when too many mast cells are present, they then release too much of these substances. Then a person can develop diarrhea, stomach and abdominal itching , rash, & flushing. Also given for allergic rhinitis, and allergic eye disorders, also used for prophylaxis of mild to moderate bronchial asthma.
What are the routes of administration?
Nasal metered spray, oral solution, ophthalmic solution, inhalation solution
What are adverse effects for Cromolyn?
Nasal congestion, sneezing, nasal itching, nosebleeds, headaches
