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NURS124 > Resp Meds > Flashcards

Resp Meds Flashcards

1
Q

name of Beta2 adrenergic agonists

A

“terol”
- albuterol
- formoterol
- salmeterol
- terbutaline

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2
Q

pharma action of beta2 adrenergic agonists

A

activating beta2 receptors in bronchial smooth muscle
resulting in bronchodilation

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3
Q

3 effects of beta2 adrenergic agonists

A
  1. relieve bronchospasm
  2. histamine inhibited
  3. ciliary motility increased
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4
Q

therapeutic uses of beta2 adrenergic agonists

A

albuterol for both short & long acting asthma
formoterol, salmeterol, terbutaline long acting asthma
prevent exercise induced bronchospasm

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5
Q

side effects of beta2 adrenergic agonists

A

tachycardia, angina -> check pulse increase of >20 (lower dose)
tremors -> may resolve or lower dose
nervousness, restlessness

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6
Q

contraindications/side effects of beta2 adrenergic agonists

A
  • contraindicated in pts w/ tachydysrhythmia
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7
Q

interactions with beta2 adrenergic agonists

A
  • beta adrenergic blockers make meds useless
  • tricyclic antidepressants, MAOIs increase risk of tachycardia & angina
  • antidiabetic drugs need to increase dose
  • no caffeine
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8
Q

names of Methylxanthines

A

theophylline

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9
Q

pharma action of Methylxanthines

A
  • relax bronchial smooth muscle -> bronchodilation
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10
Q

therapeutic use of theophylline

A

oral used for long-term control of asthma
IV for emergencies

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11
Q

side effects of theophylline

A

mild: GI distress (V/D), restlessness/insomnia
severe: dysrhythmias, seizures

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12
Q

therapeutic range of theophylline

A

5-15 mcg/mL

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13
Q

treating toxic effects of theophylline

A
  • activated charcoal to reduce absorption
  • diazepam for seizures
  • lidocaine for dysrhythmias
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14
Q

contraindications/precautions of theophylline

A
  • impaired metabolism
  • tobacco/marijuana use
  • caffeine
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15
Q

interactions with theophylline

A
  • caffeine
  • phenobarbital, phenytoin, rifampin (seizure meds) increase metabolism
  • cimetidine, ciprofloxacin (fluoroquinolones) increase risk for toxicity
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16
Q

name of inhaled anticholinergics

A

ipratropium
tiotropium
“tropium”

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17
Q

pharma action of inhaled anticholinergics

A

inhibits acetylcholine in parasympathetic system -> bronchodilation

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18
Q

therapeutic uses of inhaled anticholinergics

A
  • relieve bronchospasm of: COPD, allergen-induced, exercise-induced
  • decrease secretions in COPD
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19
Q

side effects of inhaled anticholinergics

A
  • dry mouth, hoarseness -> drink water, suck on candies
  • increased intraocular pressure
  • urinary retention
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20
Q

contraindications/precautions with inhaled anticholinergics

A
  • contraindicated for pts with peanut allergies
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21
Q

nursing teachings for pts using inhaled anticholinergics

A
  • wait 5 mins between inhaled doses
  • don’t swallow capsules, use inhalation device
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22
Q

names of glucocorticoids

A
  • inhalation: beclomethasone (QVAR), fluticasone (Flonase)
  • oral: prednisone
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23
Q

pharma action of glucocorticoids

A
  • prevent inflammation, suppress airway mucus production, promote responsiveness to beta2 receptors (use albuterol before glucocorticoid)
  • decrease airway mucosa edema
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24
Q

therapeutic use of glucocorticoids

A
  • long term chronic asthma - inhaled
  • short term post exacerbation
  • take albuterol before glucocorticoids
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25
Q

side effects of beclomethasone or fluticasone

A
  • difficulty speaking, hoarseness, candidiasis -> rinse mouth after
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26
Q

side effects of prednisone

A

use >10days:
- suppressed adrenal glands,
- bone loss,
- hyperglycemia/glycosuria,
- myopathy (muscle weakness),
- peptic ulcer dx -> take with food, avoid NSAIDS
- infection,
- changes in fluid/electrolytes,
- increased appetite & weight gain,
- insomnia

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27
Q

contraindications in glucocorticoids

A
  • contraindicated for pts receiving live culture vaccine, systemic fungal infections
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28
Q

interactions with glucocorticoids

A
  • K-depleting diuretics -> hypokalemia
  • avoid NSAIDs -> GI bleed
  • DM watch for insulin dosage
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29
Q

name of Leukotriene modifiers

A

montelukast (Singulair)
Zileuton
Zafirlukast

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30
Q

pharma action of leukotriene modifiers

A

suppress leukotrienes -> reduce inflammation, bronchoconstriction, airway edema, mucus production

31
Q

therapeutic uses of leukotriene modifiers

A
  • adjunctive therapy
  • long term therapy for asthma (oral med)
  • exercise induced bronchospasm
32
Q

side effects of montelukast

A
  • depression, suicidal ideation
  • liver injury with zileuton & zafirlukast
33
Q

interactions with leukotriene modifiers

A
  • zileuton & zafirlukast increase warfarin levels, increase theophylline levels
  • phenobarbital, rifampin, phenytoin need to increase montelukast dose
34
Q

drug name for mast cell stabilizers

35
Q

pharmac action of cromolyn

A

similar to corticosteroids
prevent release of leukotrienes & histamines -> inflammation

36
Q

use of cromolyn

A
  • long-term allergy-related asthma
  • prophylaxis for exercise-induced bronchospasm & seasonal allergies
  • use as needed but expect several wks of use before full effects
37
Q

Name for antitussives:opioids

A

codeine
hydrocodone

38
Q

pharmac action of codeine & hydrocodone

A

suppresses cough through CNA to increase cough threshold

39
Q

therapeutic use of codeine & hydrocodone

A

chronic nonproductive cough

40
Q

side effects for codeine and hydrocodone

A

dizziness
drowsiness
resp. depression
GI distress - N, V, constipation

41
Q

contraindications for codeine and hydrocodone

A

MAO inhibitors, SSRIs
prostatic hypertrophy
resp disease

42
Q

interaction with codeine & hydrocodone

A

St. John’s wort increases sedation

43
Q

names of antitussives: non-opioids

A

dextromethorphan
benzonatate
diphenhydramine

44
Q

pharmac action of antitussives: non-opioids

A

suppresses coughing in CNS

45
Q

therapeutic use of dextromethorphan, benzonatate, and diphenhydramine

A

cough suppression
reduce pain when combined w/ opioid

46
Q

side effects of non-opioid antitussives

A

potential for abuse in high doses

47
Q

name 1 expectorants

A

guaifenesin (Mucinex)

48
Q

pharmac action of guaifenesin

A

reduce surface tension of secretions to thin mucus

49
Q

therapeutic use of guaifenesin

A

coughs related to viral upper resp tract infections

50
Q

side effects of guaifenesin

A

GI upset
drowsiness, dizziness
allergic reaction - rash

51
Q

contraindication for guaifenesin

A
  • phenylketonuria (increase in the amino acid phenylalanine)
  • diabetes
  • use with disulfiram (treat alcohol dependence, accumulates acetaldehyde when alcohol is consumed)
52
Q

name 1 mucolytics

A

acetylcysteine

53
Q

therapeutic uses of acetylcysteine

A

thin mucous secretions
antidote for acetaminophen poisoning

54
Q

pharmac action of acetylcysteine

A

break disulfide linkages of protein in mucus to thin it

55
Q

side effects of acetylcysteine

A
  • bronchospasm
  • GI distress due to awful smell
56
Q

contraindications for acetylcysteine

57
Q

side effects of phenylephrine

A

rebound congestion
CNS effects - agitation, nervousness, uneasiness
vasoconstriction

58
Q

contraindications/precautions for phenylephrine

A

contraindicated for closed-angle glaucoma
caution in CAD, HTN, cerebrovascular disease, dysrhythmias

59
Q

names of some antihistamines

A

1st gen - diphenhydramine
2nd gen - cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra)
intranasal - azelastine

60
Q

pharmac action of antihistamines

A

H1 receptor blocked in small blood vessels, capillaries, and nerves during allergic reactions

61
Q

first gen vs. second gen antihistamines

A

first gen has anticholinergic effects (dry mouth, constipation) & drowsiness

62
Q

what are anticholinergic effects include

A

dry mouth
constipation, urinary retention
dilated pupils, blurred vision,
decreased sweating
increased HR

63
Q

therapeutic uses for antihistamines

A
  • mild allergies
  • anaphylaxis
  • motion sickness
  • insomnia
  • 2nd gen: chronic idiopathic urticaria (chronic hives)
64
Q

side effects of antihistamines

A
  • sedation
  • anticholinergic effects (more with 1st gen)
  • GI discomfort
65
Q

contraindications for 1st generation antihistamines

A
  • kiddos
  • breastfeeding women
  • narrow-angle glaucoma
  • prostatic hypertrophy
  • acute asthma
66
Q

contraindications for 2nd generation antihistamines

A
  • kiddos
  • breastfeeding women
  • allergies
67
Q

interactions with 1st generation antihistamines

A

alcohol & CNS depressants

68
Q

interactions with 2nd generation antihistamines

A
  • theophylline -> toxicity
  • alcohol & CNS depressants
69
Q

name 2 sympathomimetic med

A

phenylephrine (Neo-synephrine)
pseudoephedrine (Sudafed)

70
Q

pharmac action of sympathomimetic meds

A

mimic sympathetic nervous system for alpha adrenergic receptors -> vasoconstriction in nasal passages

71
Q

therapeutic use of sympathomimetics

A

short term 3-5 days for allergies, common cold, sinusitis
potential for abuse & rebound congestion

72
Q

side effects of sympathomimetics

A
  • CNS stimulation (agitation, anxiety, insomnia)
  • increased BP, HR
  • heart palpitations
  • rebound congestion
73
Q

contraindications for sympathomimetics

A
  • chronic rhinitis
  • narrow angle glaucoma
  • uncontrolled HTN, heart disease, dysrhythmia
74
Q

drug interactions for sympathomimetics

A
  • MAOI antidepressants increase effects
  • beta2 adrenergic agonists & stimulants increase HTN effect

NURS124 (6 decks)

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