Respiratory Flashcards

Question

Leukotriene modifier

Answer 1

– Long-term treatment of chronic asthma – Prophylaxis for exercise-induced bronchospasm – Management of allergic rhinitis

Answer 2

– Suppress inflammation by inhibiting the release of leukotrienes

Answer 3

Headache daily in the evening Take 2 hours before exercising and do not repeat dose in 24 hours.

Answer 4

Acute asthma exacerbation status asthmaticus PKU Severe asthma

Answer 5

■ Phenobarbital and rifampin may require higher dosage

Answer 6

– MOA: nonselective adrenergic drug that stimulates alpha, beta 1, and beta 2 receptors in heart and lung tissue – IM administration, to be carried with client at all times – Side effects: insomnia, restlessness, anorexia, cardiac stimulation, hyperglycemia, tremor, vascular headache – Nursing: PREVENTION!, recognize symptoms, call EMS

Answer 7

Benadryl, dramamine

Answer 8

``` – Seasonal allergic reactions – Mild transfusion reactions – Urticaria (hives) ■ Management of severe Anaphylactic reactions – Hypotension – Acute laryngeal edema – Bronchospasms ■ Treatment of motion sickness and insomnia ```

Answer 9

1. Drowsiness and dizziness 2. Anticholinergic effects 1. Dry mouth 2. Constipation 3. Urinary hesitancy 3. GI discomfort – nausea vomiting 4. Acute toxicity 1. Adults 1. Flushed face 2. High fever 3. Tachycardia 4. Dry mouth 5. Urinary retention 6. Pupil dilation 2. Children 1. Excitation 2. Hallucinations 3. Seizures

Answer 10

Can administer activated charcoal and cathartics (laxatives to remove remaining drug from bowels) Administer acetaminophen Apply ice packs/give sponge baths Anticipate the need for phenytoin IV if patient experiences seizures

Answer 11

1. Newborns and children under 2 years 2. Breastfeeding women (anticholinergics can dry up milk) 3. Narrow-angle glaucoma 1. Sudden/painful increase in IOP that can damage the optic nerve 4. Prostatic hypertrophy 5. Acute asthma exacerbation 6. Children and older adults 7. Patients with history of: 1. Asthma 2. Urinary retention 3. Open-angle glaucoma 4. Hypertension 5. Impair Kidney function

Answer 12

avoid alcohol and other CNS depressants

Answer 13

Loratadine (claritin) – Binds to H1 receptors blocking the release of histamine – Does not cross the BBB – Longer duration of action

Answer 14

1. Drowsiness and fatigue (less than with diphenhydramine) 1. Monitor during ambulation 2. Avoid driving/activities that require mental alertness until effects are known 2. Mild anticholinergic effects 1. Dry mouth, nose, throat 2. Encourage fluids 3. Can give with or without food 4. DON’T give with other OTC antihistamines 5. Lower doses for patients with renal/liver function impairment

Answer 15

1. Newborns under 6 months 2. Breastfeeding women 3. Allergies to H1 receptors 4. Impaired Kidney/liver function

Answer 16

■ Theophylline can reduce clearance and lead to toxicity of antihistamines ■ Atropine may cause anticholinergic effects ■ Oral contraceptives

Answer 17

– Reduces nasal congestion – Allergic rhinitis – Sinusitis – Common cold

Answer 18

– Mimic SNS by activating alpha1-adrenergic receptors in the nose  vasoconstriction of blood vessels occur – Turbinates shrink  open nasal passages

Answer 19

1. Related to CNS stimulation 1. Agitation, anxiety, insomnia 2. Systemic vasoconstriction, tachycardia and heart palpitations 3. Administer only when needed and only recommended dose 1. Advise patient of abuse potential 4. Rebound nasal congestion because of short action 1. Nasal glucocorticoid may minimize symptoms

Answer 20

1. Chronic rhinitis 2. Narrow-angle glaucoma 3. Uncontrolled heart disease 4. Hypertension 5. Dysrhythmia 6. Diabetes Mellitus 7. Coronary artery disease 8. Hypertension 9. Older adults

Answer 21

■ MAOI’s potentiate effects of sympathomimetics | ■ Beta2 adrenergic agonists potentiate hypertensive effects

Answer 22

■ Antitussives | – Suppress chronic, nonproductive cough reflex in medulla

Answer 23

Opioid (Codeine) | – Suppress cough center in CNS, increases viscosity of mucus

Answer 24

dextromethorphan (Delsym, Robitussin) – benzonatate (Tessalon Perles) ■ Anesthetizes cough receptors in respiratory tract, prevent stimulation of cough center

Answer 25

CNS depression (less with dextromethorphan and benzonatate) 1. Drowsiness, sedation – monitor when ambulating 2. Dizziness/lightheadedness 2. GI – nausea, vomiting, constipation 1. Administer with food/milk 2. Encourage fluids and fiber 3. Respiratory depression 4. Potential for abuse 1. Use only when needed and lowest effective dose

Answer 26

1. CNS depression can occur with large doses OR concurrent 2. GI – nausea, vomiting, 3. Abuse potential

Answer 27

1. Acute asthma 2. Liver/renal disease 3. Acute alcoholism 4. All antitussives 5. Reduced respiratory reserve (COPD) 6. History of substance abuse 7. Prostatic hypertrophy 8. Opioid antitussives 9. Children and older adults

Answer 28

 Opioids + CNS depressants = increased CNS depression  Non-opioid antitussives increase analgesic effects of opioid  Nonopioid antitussives + MAOIs = fever, hypotension  St. John’s Wort may increase sedation  Head trauma

Answer 29

Guaifenesin (mucinex) – Reduce the surface tension of secretions which thins out thick mucus – Makes secretions easier to remove

Answer 30

1. Dizziness, drowsiness 1. Monitor when changing positions 2. Avoid driving or mentally alert activities until side effects known 2. GI – nausea and diarrhea 1. Give with food or 8 oz of water 2. Increase fluid intake 3. Allergic reaction - rash 1. Stop drug and use alternate drug 4. Notify provider if fever worsens or develops 5. Use only when needed 6. Don’t give with combination products for colds that also contain guaifenesin 1. Don’t chew/crush SR tablets

Answer 31

1. Cough due to heart failure 2. ACE inhibitor therapy 3. Chronic cough 4. Asthma

Answer 32

■ Increased risk of hemorrhage with heparin/warfarin and guaifenesin use – inhibits platelet function