Respiratory Flashcards
Class of meds that terminate asthma attack
order is important
Beta2-adrenergic agonists
Methylxanthines
Inhaled anticholinergics
Beta2-adrenergic agonists
most common for tx for bronchoconstriction
Short-acting, intermediate-acting, long-acting
Methylxanthines
long-term management of asthma with the beta agonists and anticholinergics don’t work
Methylxanthines therapeutic index
narrow
What should be avoided when on methylxanthines
caffeine (CNS stimulant)
Inhaled anticholinergics
promote bronchodilation by blocking muscarinic ACH receptors
alternative to short-acting beta2 agonists (can also be combined with these)
Focus for preventing asthma episodes
reducing inflammation
Classes of meds that prevent asthmatic episodes
Corticosteroids
Mast cell stabilizers
Leukotriene Modifiers
Monoclonal Antibodies
Corticosteroids
suppress the immune system
most effective
Mast cell stabilizers
prevent histamine release
VIA MDI or nebulizer
Mast cell function
respond to environmental triggers by releasing histamine which causes inflammation of the bronchi
Leukotriene modifiers
reduce inflammation by
- blocking enzyme that controls leukotriene synthesis
- blocking leukotriene receptors
Leukotriene function
promote inflammation and recruit WBCs to site of injury
Monoclonal Antibodies
prevent release of histamine by mast cells differently than mast cell stabilizers
reduced frequency of asthma episodes
Asthma
Characterized by bronchoconstriction and inflammation in response to environmental triggers
Bronchocontriction
sudden contraction of smooth muscle causing dyspnea
with inflammatory process (thick secretions are produced) - narrows lumen
Further edema
Chronic inflammation results in…
increase in airway edema
increase in mucous secretions
smooth muscle constriction in bronchioles
Adverse effects pf beta-adrenergic
throat irritation
headache
anxiousness
dry mouth
tachycardia, chest pain
paradoxical bronchospasm
Allergic rxn
Why are the order of meds taken to terminate an asthma attack important?
short acting bronchodilator should be given first for fast effects
Why is a spacer used
If the patient has difficulty coordinating breathing with inhaler activation
increase delivery of drugs to the lungs and decrease deposition of drug on the oropharyngeal mucosa
How long to wait between puffs of a MDI
1 minute
Metered-dose inhaler (MDI)
pressurized devices that deliver a measured dose of drug with each activation
Hand-mouth coordination is required
Dry-powder inhalers (DPI)
easier to use
drugs are in the form of dry, micronized powder
no propellant employed
Antitussives side effects
Dizziness, sedation
Depression ataxia stupor seizure coma
Antitussives
Manage non-productive coughs
Raise the cough thershold in the CNS
Opioids
Non-opioids
Expectorant
reduce thickness or viscosity of bronchial secretions
to encourage coughing
Mucolytics
Breaks down thick mucous
When to use expectorants
used with caution in elderly, asthma or respiratory insuffiency
they should receive more fluids
COPD
Nutritional therapy for COPD
Eat 5 to 6 small meals Rest 30 min. before eating Use a bronchodilator before meals Foods that are easy to prep Fluid 2-3L per day between meals unless they have heart failure. Fluids should be taken between meals Avoid foods that cause gas Late stage - increased calories. High calorie, high protein
Mucolytics should be used…
COPD
