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VEEB > Resp System(Pharm) > Flashcards

Resp System(Pharm) Flashcards

1
Q

Dextromethorphan

A

Generic Name: Dextromethorphan
Trade Name: Romilar
-Antitussive(central acting)(non narcotic)
most commonly used for nonproductive, dry cough
-working in CNS(central acting non-narcotic)
-non narcotic
-cause hypotension, decrease resp.drowsiness(not as severe), increase risk of tolerance/abuse, euphora,misused by adolescents
-not for children under 4
-caustion 4-12
-adolescents can abuse

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2
Q

Guaifenesin

A 
Generic Name: Guaifenesin
Trade Name: Robitussin
-rarely has adv reaction
-is expectorant
-10ml/2tsp q4hr
    side effect:
-hypersensitvity
-gastrotoxivity
-drowsiness
          nursing implication:
-give meals(after meal), do not follow by water
-position in high fowlers
-teach deep breathing cough
-humidification
-increase fluids
-temp control
-suction as needed
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3
Q

Acetylcysteine

A 
Generic Name: Acetylcysteine
Trade Name: Mucomyst
-Mucolytic
-liquify thick tenacious secretion, breaks down mucous
-break down mucous
-antidote to tylenol
-indication-emphysema,copd,
-smells like rotten egg
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4
Q

Albuterol

A 
Generic Name: Albuterol
Trade Name: Proventil
Sympathomimetics(drug) 
bronchodilator(anti-asthmatic drug)
-short acting beta agonist(drug)
PO/Inhalation-q6h
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5
Q

Theophylline

A

Generic Name: Theophylline
Trade Name: Elixophyllin/Theo-Dur/Unipyhyl
Methyl-Xanthine
Xanthinal/Xanthine Derivatives-Theophylline(Theo-Dur/Uniphyl)
-300-800mg
-start of with theophylization
-10-20mcg per ml(therapeutic level)action: act directly to relax the smooth muscle of the bronchus to increase the size and lumen of the bronchioles
-they are mild diuretics(remove fluid)
-indicated for pulmonary edema=dilate bronchi,get rid of fluid

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6
Q

Diphenhydramine

A

Generic Name: Diphenhydramine
Trade Name: Benadryl
-25-50mg 3x day, po,im
indication:
-seasonal allergy
-Hypersensitivity=from medication,blood products,seasonal allergies
-N&V,motion sickness
-Parkinsons-have anticholegerin like effect=decrease in strength/muscle tone
-adjucts to anesthesia-drying,prevent nausea
-allergy to drugs and blood products

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7
Q

Phenylephrine

A 
Generic Name: Phenylephrine
Trade Name: Neosynephrine
-Nasal Decongestant
-Sympathomimetics/Ageneric
-Topical, Local
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8
Q

Beclomethasone

A

Generic Name: Beclomethasone
Trade Name: Beclovent/Vanceril
-Beconase/Vancenase
-Corticosteroid nasal decongesant

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9
Q

Dexamethasone

A

Generic Name: Dexamethasone
Trade Name: Decadron
-corticosteroid/antiinflammatory/antiasthmatic
–po, 3-5days, ac exacerbation

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10
Q

Ipratropium Bromide

A

Generic Name: Ipratropium Bromide
Trade Name: Atrovent
-Anticholinergic/Broncodilator
inhalation-short term relief of symptoms-last 4hrs

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11
Q

Triamcinolone

A

Generic Name: Triamcinolone
Trade Name: Azmacort, Nasocort
Corticosteroid nasal decongesant

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12
Q

Isoproterenol

A 
Generic Name: Isoproterenol
Trade Name: Isuprel
-bronchodilator
-sympathomimetic
-short acting beta 2 agonist
-subcut,inhal,iv
-cause pink coloration of mucus
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13
Q

Loratadine

A 
Generic Name: Loratadine
Trade Name: Claritin
-Anti histamine
-2ng gen
-10mg daily,Tab,liq,and peds dose
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14
Q

Zafirlukast

A

Generic Name: Zafirlukast
Trade Name: Accolate
-bronchodilator
-Leukotrine antagonist

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15
Q

Histamine

A
  • substance found in various body tissue
  • highest concentration in the mast cells and basophils
  • produced in response to injury and released in allergic and hypersensitivity reaction
  • forms in foundation for many cold remedies
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16
Q

Antihistamine/Driers

A

action: blocks the action of histamine at the H1 receptor site and prevent histamine from entering the receptor site
- H1 receptor blocker
- H1 receptor antagonist
- more effective in prevention
- best given at early sign and symptoms
- better at preventing than reversing effect
- pallitive treatment(makes feel better)

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17
Q

Antihistamine/Driers(Indication)

A
  • seasonal allergy
  • Hypersensitivity=from medication,blood products,seasonal allergies
  • N&V,motion sickness
  • Parkinsons-have anticholegerin like effect=decrease in strength/muscle tone
  • adjucts to anesthesia-drying,prevent nausea
  • allergy to drugs and blood products
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18
Q

Antihistamine/Driers(First Generation s/s)

A
  • works centrally at the brain
  • works periphally at the site
  • have anti-cholegernic effect(drying,decrease muscle tone,decreased mobility,dilated pupils,cause drowsiness(sedation)
  • fast onset(30min), short duration=taken more frequetly
  • decrease muscle strength, urinary retention,constipation,dilated pupils, blurry vision, hypotension, monitor BP
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19
Q

Antihistamine/Driers(First Generation Drugs)

A

Diphenhydramine(Benadryl)
-25-50mg 3x day, po,im
Hydroxyzine(Atarax Vistaril)
-25-50mg 3x day, po,im

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20
Q

Antihistamine/Driers(Second Generation s/s)

A
  • slower onset: 1hr or more
  • dont have to take as often
  • less effective in drying
  • less sedating/drowsiness
  • Anticholinergic like effect
  • sedation, hypotension
  • gastrotoxicity
  • hypersensitivity
  • photosensitivity
  • paradoxical excitement-some pt may have insomnia-elderly
  • tolerance-w/ prolonged use-less drowsy as continue to take medication
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21
Q

Antihistamine/Driers(Second generation drugs)

A
  • Loratadine(Claritin)-10mg daily,Tab,liq,and peds dose
  • Cetirizine(Zyrtec)
  • Fexofenadine(Allegra)- 2x day dose, 60mg cap, BID, po, not to be used by anyone under the age of 12,pt should not be drinking fruit juice, decrease absorbtion
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22
Q

Antihistamine/Driers(contraindication)

A
  • asthma,copd=b/c drying effect=mucous harde to expel
  • glaucoma=b/c dilates pupil
  • prostate=b/c decreae unrinary output/retention
  • pregnant and lactating women
  • interaction-MAOI
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23
Q

Antihistamine/Driers(Nursing implication)

A
  • take with meal, parental deep IM(exception allegra(fruit juice)
  • for motion sickness 30min to 1hr before traveling
  • stop 4 days before allergic testing: b/c can mask allergic response
  • watch for degree of drowsiness
  • provide safety: decrease bp: orthostatic hypotention-watch for hot showers
  • relieve drynes
  • alcohol and other CNS depressants increase drowsiness
  • can cause resp difficulty
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24
Q

Nasal Deocongestants(action/indication)

A

shrink engorged mucous membrane in the nose to relive stuffiness
-constrict blood vessels in the nose to decrease the formation of mucous and increase drainage to lessen swelling

indication: drain sinuses/adjunct in middle ea infectino, cold

  • increase drainage
  • decrease swelling
  • decrease formation of mucous
  • adjunct for common cold/ear infection/pre op med for balance anesthesia
  • systemic last longer
  • topical works faster
  • locally/systemic
  • topical/ by mouth
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25
Q

Nasal Deocongestants(Drugs)

A
  • Sympathomimetics/Ageneric
  • Phenylephrine Hcl(Neo synephrine)

Corticosteriods

  • Flucticasone
  • Tramcinolone
  • Beclomethasone
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26
Q

Nasal Deocongestants(side effects)

A
  • local-use topically
  • cns stimulation
  • cardiac stimulation
  • gastrotoxicity
  • rebound congestion-no more than 3-5days-overuse of medication, more frequently than they should
  • contrainfication: MAOI(hypertensive crisis), pregancy,lactating women
  • caution HTN, Heart disease,diabetes(hyperglycemia)
  • systemic-cns stimulation,cardiac,gastrotoxity
  • local: burning, rebound congestion
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27
Q

Nasal Deocongestants(Nursing implications)

A
  • caution in htn, heart disease and diabetes
  • burning or stinging discontinue
  • do not giver for more than 4 days can cause rebound congestiion
  • monitor bp and heart rate/apical pulse
  • assess nasal mucosa
  • d/c if burning/stinging occur
28
Q

Antitussive

A
  • action: suppress cough reflex center located in the medulla in the brain
  • there are two types central and peripheral(affecting receptor sites) acting
  • central acting directly on the cough reflex center in the medulla. There are two types of central acting(narcotics and non-narcotics)
  • suppresses cough reflex center in medullar
  • drowsiness
  • decrease resp. decrease bp
29
Q

Antitussive

A

1) Narcotics:
- Morphine
- Codeine-most effective antitussive
- Hydrocodone-most effective antiitussive

2) Non-Narcotics:
- Dextromethorphan(Romilar)

30
Q

Dextromethorphan(Romilar)

A

-Antitussive
most commonly used for nonproductive, dry cough
-working in CNS(central acting non-narcotic)
-non narcotic
-cause hypotension, decrease resp.drowsiness(not as severe), increase risk of tolerance/abuse, euphora,misused by adolescents
-not for children under 4
-caution 4-12
-adolescents can abuse

31
Q

Peripheral Acting

A
  • works at receptor site
  • peripheral acting act directly on the cough receptor in the trachea,pharynx,and lung for a demulcent(soothing) or local anesthetic effect(dulling irritation)
31
Q

Peripheral Acting

A
  • works at receptor site
  • peripheral acting act directly on the cough receptor in the trachea,pharynx,and lung for a demulcent(soothing) or local anesthetic effect(dulling irritation)
32
Q

Antitussive(indication)

A

-relieve dry hacking cough non productive cough
side effects:
-all antitussive can cause some drowsiness
-central active have more degree drowsiness
-opiate like
-cns depression
central side effect:
-resp depression
-euphora
-dependency
-n/v
-constipation
peripheral side effect:
-cardiovasuclar collapse

32
Q

Peripheral Acting(Drug)

A

Benzonatete(Tessalon):

  • has cain substance,
  • anesthetic like effect,
  • must swallow whole,
  • can cause arrhythmia,
  • spasm in bronchi
  • cardiovascular collapse,
  • allergy to cain products,
  • teach pt to swallow whole(gel like substance)

Diphenhydramine(Benylin)

  • related to benadryl
  • drowsiness,dizziness
33
Q

Antitussive(indication)

A

-relieve dry hacking cough

33
Q

Antitussive(indication)

A 
-relieve dry hacking cough non productive cough
                          side effects: 
-opiate like
-cns depression
                      central side effect:
-resp depression
-euphora
-dependency
-n/v
-constipation
                     peripheral side effect:
-cardiovasuclar collapse
34
Q

Mucolytic(action)

A
  • action:liquify thick tenacious secretion, breaks down mucous
    indication: emhysema-copd-part of treatment for pulmonary diseases
35
Q

Expectorants

A
  • reduce the viscosity and help raise thick tenacious secretions making expulsion of the sputum easier. act directly on the bronchial glands
  • loosen and thin the sputum
36
Q

Expectorants(drug)

A

-Guaifenesin(Robitussin)
-rarely has adv reaction
-is expectorant
-10ml-2tsp q4hr
side effect:
-hypersensitvity
-gastrotoxivity
-drowsiness
nursing implication:
-give meals(after meal), do not follow by water
-position in high fowlers
-teach deep breathing cough
-humidification
-increase fluids
-temp control
-suction as needed

37
Q

Mucolytic

A
  • action:liquify thick tenacious secretion, breaks down mucous
    indication: emhysema-copd-pulmonary diseases
38
Q

Mucolytic(drug)

A
  • acetylcystein(mucomyst)-antidote/tylenol

- tyloxapol(alevaire)

39
Q

Mucolytic(side effect)

A
  • N/V
  • smells like rotten egg
  • stomatitis,bronchospasm
  • interaction: tetracycline,erythromycin H202
40
Q

Mucolytic(Nurising Implication)

A
  • given instilled or by nebulizer
  • assess mucus membrane in mouth
  • cough patient or suction before and after
  • store in fridge discard after 96hrs
41
Q

Asthma

A
  • inflammatory respiratory condition characterized by recurrent attack of dysnea, wheezing and bronchospasm
  • various combination of drugs are used to treat asthma
  • the objective is to give the smallest dose and to decrease the number and frequency
42
Q

Bronchodilator(Antiasthmatic drug)(indication)

A 
-relieve bronchospasms associated with respiratory disorders such as asthma,emphysema,and chronic bronchiits
Four types:
-Sympathomimietics
-Methyl Xanthine compounds
-Anticholinergics
-Leukotrience Receptors Antagonist
43
Q

Sympathomimetics

A
  • Broncodilator/Antiasthmatic drug
  • dilate the bronchus by stimulating the sympathetic nervous system
  • most stimulate beta 2 receptor site
  • drugs divided into short acting and long acting
44
Q

Sympathomimetics(drug)
bronchodilator(anti-asthmatic drug)
-short acting beta agonist(drug)

A

-rescue inhaler/meds
-Albuterol(Proventil)-PO/Inhalation-q6h
-Epinephrine(Adrenalin)-via inhalation-
1-1000(0.5mg-1mg)-tuberculin syringe-side effect: tremors

45
Q

Sympathomimetics(drug)
bronchodilator(anti-asthmatic drug)
-long acting beta agonist

A
  • symptom control
  • Salmeterol
  • Formoterol fumarate
  • sustained released albuterol
46
Q

Side effect(Sympathomimetic)

A
  • CNS stimulation
  • cardiac stimulation
  • gastrotoxicity
  • endrocrine
  • prolonged used lead to tolerance
47
Q

Methyl-Xanthine
Xanthinal/Xanthine Derivatives
(Action/Indication)

A

action: act directly to relax the smooth muscle of the bronchus to increase the size and lumen of the bronchioles
- they are mild diuretics(remove fluid)
- indicated for pulmonary edema=dilate bronchi,get rid of fluid

48
Q

Methyl-Xanthine
Xanthinal/Xanthine Derivatives
(Drugs)

A
  • Theophylline(Theo-Dur/Uniphyl)
  • 300-800mg
  • start of with theophylization
  • 10-20mcg per ml(therapeutic level)
49
Q

Methyl-Xanthine
Xanthinal/Xanthine Derivatives
(interaction)

A

-beta blocker,erythromycin and cimetidine: cause increase theophylline toxicity, decrease effect allupurinol, anticonvulsant, oral contraceptive

50
Q

Methyl-Xanthine
Xanthinal/Xanthine Derivatives
(Nursing implication)

A
  • Xanthine products increase toxicity like chocolate and soda
  • given with food if nausea
  • monitor site/peri care
  • educate to protect from UV light(photosensitivity)
  • monitor for theophyline toxicity: N/V, anorexia, arrthymia, seizure
51
Q

Anticholinergic(action)

bronchodilator

A
  • most useful longterm treatment with COPD

- or for asthma not able to tolerate beta 2 agonist

52
Q

Methyl-Xanthine
Xanthinal/Xanthine Derivatives
(side effects)

A
  • similar to beta 2 agonist(review A part of map)
  • increase hypotension and N/V
  • iv: bp drop(hyp0tension), pump mlxhr
53
Q

Anticholinergic(drug)

bronchodilator

A
  • Inpratropium Bromide(Atrovent)-inhalation-short term relief of symptoms-last 4hrs
  • Tiotropium Bromide(Spiriva)-long term, last about 24hrs-maintain airway, not as drying
54
Q

Anticholinergic(side effect)

A
  • atropine like, cough, nervousness, headache, and dizziness
  • dilation of pupils=glaucoma(blurry vision)
  • tachycardia, N/V, headache, dizzy, cough,
  • best taken when they wake in the morning
55
Q

Leukotriene Antagonist(Action)

A
  • action: antagonize leukotriene which is a bronchoconstrictor to dilate the bronchus and decrease mucus secretion
    indication: prophylactic long-term
  • good for asthma patient,prophalatic,long term management
56
Q

Leukotriene Antagonist(Drug)(Only PO routes)

A

Zafirlukast(Accolate)-5yrs and older
Montelukast-1yr and above, tab,chewable,granules
Zileuton-12 yrs and older

57
Q

Leukotriene Antagonist(side effect)

A
  • drowsiness, headache, dizziness, dyspepsia, abdominal pain, myalgia, hepatoxicity, and increased incidence of resp tract infection
  • monitor liver enzymes and s/s of infection
  • interaction-potentiate: NSAIDS, ASA, Theophyline and erythromycin decrease levels infection
  • contraindicated in pregnancy and lactation and an acute asthmatic attack
  • used to prevent not to treat acute attack
58
Q

Bronchodilators(Nursing Implication)

A
  • dose by number of puffs
  • vital signs
  • auscultate lungs
  • give oral with food
  • space dose at equal interval
  • if symptoms increase do not increase dose
  • IV rate monitor closely
  • wait one min to recharge
  • in more that one drug inhaled wait 5min
  • rinse mouth and spit out
  • check dose counter or indicator
  • check empty full if no indicator
  • if more than one drug inhaled wait 5 min
  • avoid smoking, OTDC, caffeine and beta blockers
  • increase fluids
  • sympathomimetic-epinephringe drug of choice for an acute attack asthma
  • isuprel and epinephrine should never be given together
  • methylxanthine: bp: hypotension
  • watch for theophylline toxicity
  • monitor blood levels
  • watch for seizures
  • inhalation puffs equally spaced
  • mdi wait 1 min to recharge
  • hold breathe for long as possible 10 seconds
  • use bronco dilator first than steroids to decrease inflammation
  • avoid smoking no OTC,caffeine
  • increase fluids
59
Q

Anti-Inflammatory

Corticosteroids

A
  • used prophylactic treatment of bronchial asthma
  • decrease inflammatory process
  • least amount of drug small dose
60
Q

Anti-Inflammatory

Corticosteroids(Drugs)

A

Beclomethasone:

  • Beclovent-inhalation
  • Beconase-decongestion
  • maintanece

Dexamethasone(Decadron):
-po, 3-5days, ac exacerbation

Triamcinolone(Azmacort/Nasort):
Azmacort=for asthma
Nasocort=nasal decongestion
-maintenance

61
Q

Corticosteroids(side effect)

A
  • require tappering, give body time to release own steroids
  • can cause addison crisis
  • throat irritation-rinse mouth/throat
  • hoarsenss
  • cough
  • oral fungal infection
  • vertigo
  • headache
  • steroids effect calcium levels decrease(hypocalcemia)-take calcium supplements
  • increase Blood sugar
  • stunt growth in child
  • increase BP(hypertension)
62
Q

Mast Cell Stabilizer(action)

A

-decrease secretion of histamine by the mast cells

63
Q

Mast Cell Stabilizer(indication)

A
  • prophylatic treatment of mild bronchial asthma especially in children when growth retardation is concern
  • exercise induced bronchospasm
  • need 2 to 4 weeks for optimal
64
Q

Mast Cell Stabilizer(Drugs)(side effect)

A 
-cromolyn and nedocromil
side effect:
-N/V/D
-headache
-fatigue
-hypotension
-joint swelling
-dysuria
-rash
-sneezing
-cough,hoarseness,burning,stinging, bad taste in mouth
-rinse after use and spit out

Nursing implication:

  • teach mdi
  • teach spacer
  • humdifier
  • teach peak flow

VEEB (25 decks)

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