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pharm 2 > Respi > Flashcards

Respi Flashcards

1
Q

Codeine (opioid) dextromethorphan (nonopioid) Class/Use

A

Antitussive
Suppression of cough

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2
Q

Anittussive Adverse effects

A

CNS depress, dizzy, constipation with opioids
GI disturb

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3
Q

Antitussive Interventions

A

Monitor for CNS issues - respiratory - give narcan if needed
Take with food or milk
May need stool softener - high fiber

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4
Q

Antitussive Admin

A

short term use
use only when needed

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5
Q

Antitussive Teaching

A

Change positions slowly
avoid alcohol
don’t drive

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6
Q

Antitussive Contraindications

A

MAO inibi or SSRI
HX of substance abuse
prostatic hypertrophy

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7
Q

Antitussive Interactions

A

Alcohol other opioids - Ince CNS effect
St Johns wart inc sedation

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8
Q

Albuterol (short acting) Salmeterol (Long acting) Class and Use

A

Beta 2 Adrenergic Agonist
Relief of acute bronchospasm and prevent EIB - broncholdilation

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9
Q

Which Beta 2 albuterol or salmeterol?

A

depends on on the intended effect - fast relief (rescue inhaler) like for asthma or long term management like for COPD

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10
Q

Beta 2 - albuterol/salmeterol Adverse reactions

A

Chest pain, palpitations
* Nervousness, restlessness, tremors

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11
Q

Beta 2 - albuterol/salmeterol Interventions

A

Monitor for adverse reactions - dizzy, palpitations, chest pain tremors

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12
Q

Beta 2 - albuterol/salmeterol Admin

A

Short acting: for acute exacerbation Use long-acting preparations for long-term control.
* Inhale beta2-adrenergic agonists before inhaling glucocorticoids.
* Follow dosage limits and schedules.
* Watch for signs and triggers of impending exacerbations of asthma.
* Keep a log of the frequency and intensity of exacerbations.
* Notify the provider of changes in patterns of exacerbations.

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13
Q

Beta 2 - albuterol/salmeterol Teaching

A

avoid caffeine
don’t overuse rescue inhaler
report side effects

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14
Q

Beta 2 - albuterol/salmeterol Precautions

A

DM
CVD
HTN
Angina

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15
Q

Beta 2 - albuterol/salmeterol Interactions

A

MAOI and tricyclic antidepressant = inc risk of HTN, tacky and angina
Anti-diabetic drugs - require inc dosage because of hyperglycemic effect

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16
Q

Guaifenesin Class/use

A

Expectorant - Mucinex
Coughs related to viral upper respiratory infection

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17
Q

Guaifenesin Adverse Reaction

A

Dizziness, drowsiness, headache
* Gastrointestinal distress (nausea, diarrhea)
* Allergic reaction (rash)

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18
Q

Guaifenesin Interventions

A

Monitor clients when changing positions or ambulating.
* Give drug with food and/or 8 oz of water.
* Stop drug and recommend alternative therapy.
* Encourage fluid intake of 1,500 to 2,000 mL daily

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19
Q

Guaifenesin Admin

A

use only when needed
watch for other OTC meds that contain same guaifenesin

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20
Q

Guaifenesin Teaching

A

Do not take before driving or activities requiring mental alertness.
* Sit or lie down if feeling lightheaded.
* Change positions gradually.
* Take the drug with food and/or 8 oz of water.

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21
Q

Guaifenesin Contraindicaitons

A

DM - due to sugar content
PKU

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22
Q

Diphenhydramine (Benadryl) Class and use

A

1st generation antihistamine - sedating
Management of:
* Mild allergic reactions (seasonal allergic rhinitis, cough, urticaria, mild transfusion reaction)
* Anaphylaxis (hypotension, acute laryngeal edema, bronchospasm)
* Motion sickness

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23
Q

Diphenhydramine (Benadryl) Adverse Drug Reaction

A

Drowsiness, dizziness
* Anticholinergic effects (dry mouth, constipation)

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24
Q

Diphenhydramine (Benadryl) Interventions

A

Monitor the client when ambulating - Advise against driving or operating machinery requiring mental alertness.
* Encourage sips of water or sucking on hard candy.
* Give with food.
* Encourage high intake of fluids.

  • Monitor for urinary retention.
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25
Q

Diphenhydramine (Benadryl) Admin

A

Do not crush or chew enteric-coated formulations.
* Do not take with alcohol or other CNS depressants.

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26
Q

Diphenhydramine (Benadryl) Teaching

A

Take the drug before or at bedtime.
Report difficulty urinating

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27
Q

Diphenhydramine (Benadryl) Contraindications

A

Newborns and children under 2 yr
* Breastfeeding women
* Narrow-angle glaucoma
* Prostatic hypertrophy
* Acute asthma exacerbation

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28
Q

Diphenhydramine (Benadryl) Interactions

A

Alcohol and other CNS depressants increase depressant effects of antihistamines.

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29
Q

Cetirizine (Zyrtec) Class/Use

A

2nd Generation non sedating antihistamine
Management of:
* Allergic rhinitis

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30
Q

Cetirizine (Zyrtec) Adverse Reaction

A

drowsy in high doses
anticholinergic effects - not as bas as Benadryl

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31
Q

Cetirizine (Zyrtec) Interventions

A

Monitor the client when ambulating.
* Provide water and encourage frequent sips.
* Encourage intake of 1,500 to 2,000 mL daily
* Provide hard candy to suck on.

32
Q

Cetirizine (Zyrtec) Teaching

A

Take 1 x per day

33
Q

Cetirizine (Zyrtec) Interactions

A

Theophylline
Other sedatives/alcohol = CNS depress

34
Q

beclomethasone dipropionate (QVAR)/ fluticasone (Flovent) prednisone and Fluticasone (Flonase) class/use

A

Inhaled Glucocorticoid - QVAR and Flovent
Oral Glucocorticoid - Prednisone
Nasal Glucocorticoid - Flonase
Long-term management of chronic asthma
* Short-term management of post-exacerbation symptoms (oral)

35
Q

Glucocorticoid Adverse Reaction

A

Inhaled = oral candidiasis
Oral - suppression of adrenal function
Nasal - dry mucus membranes, sore throat
All - bone demineralization/muscle wasting
Fluid and electrolyte imbalance
hyperglycemia
infection
Headache

36
Q

Glucocorticoid Interventions

A

Spacer for inhaled
Alternate day dosing for oral
give with food or meals
observe for infection
water and hard candy

37
Q

Glucocorticoid Admin

A

Inhaled: use on reg schedule - not for acute attack
Inhaled: use after beta 2 inhaler
Oral: taper dose , long term = alternate day dosing
Nasal: nasal metered dose device, use nasal decongestant first if blocked

38
Q

Glucocorticoid Teaching

A

Rinse mouth/gargle after inhaler
Never stop abruptly
Perform weight bearing exercise

39
Q

Glucocorticoid Contraindicaitons

A

Recent live vaccines
fungal infections
oral candidiasis

40
Q

Glucocorticoid Interactions

A

furosemide (Lasix) increase risk of hypokalemia.
* NSAIDs increase risk of gastrointestinal bleeding.
* Effects of insulin and oral hypoglycemics are decreased.

41
Q

Ipratropium (Atrovent) Class/Use

A

Inhaled Anticholinergics
Relief of bronchoconstriction in clients who have COPD
* Decreases secretions in clients with COPD

42
Q

Ipratropium Adverse Reactions

A

Dry mouth, irritation of the pharynx
* Increased intraocular pressure
* Urinary retention

43
Q

Ipratropium Interventions

A

Provide water and hard candy to client
* Schedule routine testing for glaucoma.
* Monitor urinary elimination patterns, especially in older adults.

44
Q

Ipratropium Admin

A

Allow the prescribed time between puffs.
* Delay use of other inhalants for 5 minutes.
* Do not use as an emergency rescue medication.
* Rinse the mouth after use to reduce unpleasant taste.

45
Q

Ipratropium Precautions

A

Glaucoma
* Prostatic hypertrophy
* Bladder neck obstruction

46
Q

Montelukast (Singular) Class/Use

A

Leukotriene Modifier
Adjunctive therapy in the treatment of allergic rhinitis, asthma, and exercise induced bronchospasm

47
Q

Montelukast (Singular) Adverse Reaction

A

Neuropsychiatric effects such as suicidal ideations

48
Q

Montelukast (Singular) Interventions

A

Observe for behavioral changes

49
Q

Montelukast (Singular) Admin

A

Take once daily in evening
take 2 hrs before exercise for EIP - do not repeat dose for 24 hrs

50
Q

Montelukast (Singular) Contraindications

A

Acute asthma exacerbations
* Status asthmaticus

51
Q

Cromolyn Class/Use

A

Mast cell stabilizer
Long-term treatment of allergy-related asthma
* Prophylaxis for exercise-induced bronchospasm
* Prophylaxis for seasonal allergy symptoms
* Management of allergic rhinitis (intranasally)

52
Q

Cromolyn Admin

A

Use with a nebulizer or metered-dose inhaler.
* Expect several weeks of use for full effects to become apparent.
* Administer four times daily on a fixed schedule.
* Use the inhaler 15 min before exercising to prevent exercise- induced bronchospasm (EIB)
* Do not use to relieve an acute asthma exacerbation.

53
Q

Theophylline Class/Use

A

Methylxanthines
Long-term management of chronic asthma

54
Q

Theophylline Adverse Drug Reaction

A

Rare at therapeutic levels
N/V/D and dysrhymias when levels get high
Toxic levels = seizures

55
Q

Theophylline Interventions

A

Monitor plasma drug levels.
* Give activated charcoal to decrease absorption - toxic
* Prepare to initiate anticonvulsant therapy and institute seizure precautions.
* Monitor heart rate and rhythm.
* Give antidysrhythmics to restore heart rate and rhythm.

56
Q

Theophylline Teaching

A

Reduce or eliminate caffeine intake.
* Have periodic laboratory testing of drug levels.

57
Q

Theophylline Contraindications

A

Clients with impaired metabolism
* Tobacco or marijuana use
* Caffeine

58
Q

Theophylline Interactions

A

caffeine increase the risk of toxicity.
* Phenobarbital, phenytoin (Dilantin), and nicotine increase metabolism of theophylline.

59
Q

Acetylcysteine Class/Use

A

Mucolytic
Decrease viscosity of mucous secretions
* Reverse acetaminophen (Tylenol) overdose

60
Q

Acetylcysteine Adverse Reactions

A

bronchospasm
* Gastrointestinal distress due to rotten-egg smell of drug and ingestion of secretions (nausea, vomiting)

61
Q

Acetylcysteine Interventions

A

Monitor respiratory status.
Administer bronchodilator as needed.
* Have suction available.
* Administer antiemetic as needed.

62
Q

Acetylcysteine Admin

A

Give via nebulizer that does not contain metal or rubber parts or direct instillation into tracheostomy tube.
* Clear the airway before aerosol administration-
* Assess the client’s ability to cough before administration.
* Expect a sulfur-like (rotten egg) odor.

63
Q

Acetylcysteine Teaching

A

lots of water

64
Q

Acetylcysteine Contra and precautions

A

gastric bleeding
asthma or hx of bronchospasm

64
Q

Acetylcysteine Contra and precautions

A

gastric bleeding
asthma or hx of bronchospasm

65
Q

Phenylephrine Class/Use

A

Sympathomimetics
Allergic rhinitis, sinusitis, and the common cold

66
Q

Phenylephrine Adverse Reactions

A

CNS stimulation with oral agents (agitation, anxiety, insomnia)
* Increased blood pressure
* Tachycardia/palpitations
* Rebound congestion with prolonged use of topical agents

67
Q

Phenylephrine Interventions

A

Monitor for agitation, anxiety, and insomnia.
* Administer a mild hypnotic or sleep aid.
* Monitor blood pressure and heart rate.

68
Q

Phenylephrine Admin

A

Only when needed
topical - no more than 3-5 days or rebound congestion

69
Q

Phenylephrine Teaching

A
  • Report prolonged tachycardia or heart palpitations.
  • Do not use for more than 3 to 5 days.
  • Taper and discontinue the drug using one nostril at a time.
70
Q

Phenylephrine Contraindications

A

Chronic rhinitis
* Narrow angle glaucoma
* Uncontrolled heart disease, dysrhythmia, or hypertension

71
Q

Phenylephrine Interactions

A

MAOI
Beta 2 agonist/ other stimulants = inc HTN

72
Q

Neuromuscular Blocking Agents Meds

What do they do?

A

Rocuronium
Vecuronium
Pancuronium

Nondepolarizing neuromuscular blocking agents block acetylcholine (ACh) at the neuromuscular junction, resulting in muscle relaxation and hypotension. They do not cross the blood-brain barrier, so complete paralysis is achieved without loss of consciousness or decreased pain sensation.

73
Q

Neuromuscular Blocking Agents Meds used

A

control spontaneous respiratory movements in clients receiving mechanical ventilation.

● Neuromuscular blocking agents are used during endotracheal intubation and endoscopy.

74
Q

Neuromuscular Blocking Agents Meds Complication

A

Resp arrest

75
Q

Neuromuscular Blocking Agents for pain?

A

No, not anesthetics and therefore have no effect on hearing, thinking, or ability to feel pain.

pharm 2 (5 decks)

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