Respiratory Flashcards
1
Q
Three classes of meds used to terminate an asthma attack:
A
- Beta 2 adrenergic Agonist
- Methylxanthines
- Inhaled anticholinergics
2
Q
Beta2-adrenergic agonists (ex. Salmeterol)
A
- most frequently prescribed for treatment of bronchoconstriction
- short-acting
- intermediate acting
- long acting
- stimulate the effects of the SNS = bronchodilation
3
Q
Methylxanthines (ex. theophylline)
A
- long term management
- narrow therapeutic index.
- avoid
- relax smooth muscle
3
Q
Methylxanthines (ex. theophylline)
A
- long term management
- narrow therapeutic index.
- a phosphodiesterase inhibitor (vasodilates blood vessels, and bronchodilates)
- avoid caffeine -> too much stimulation
4
Q
inhaled anticholinergics (reduce effects of acetylcholine) Ex. atrovent, iprotropium
A
- promote bronchodilation by blocking muscarinic Ach receptors)
5
Q
Meds to Prevent Asthma attacks in those with chronic asthma (4)
A
- Corticosteroids - most effective and most commonly used
- Mast cell stabilizers
- Leukotriene modifiers
- Monoclonal Antibodies
6
Q
Corticosteroids
A
- reduce inflammation and immune response, thus decreasing frequency of asthma episodes
- risk of masking infections and suppressing inflammatory response
- adverse effects (corticosteroids toxicity)
- increase blood glucose levels: use with caution in diabetics
7
Q
Mast cell stabilizers
A
- mast cells respond to environmental triggers or allergens by releasing histamine in the body which causes inflammation of bronchi
- mast cell stabilizers prevent histamine release and are used to prevent asthma episodes
- MDI or nebulizer
8
Q
Leukotriene Modifiers
A
- Reduce inflammation through two mechanisms
- blocking enzyme that controls leukotriene synthesis
- blocking leukotriene receptors
- Leukotrienes cause tightening of airway muscles and the production of excess mucus and fluid.
9
Q
Leukotriene
A
promote inflammation and recruit WBCs to site of injury
10
Q
Monoclonal Antibodies
A
- prevent release of histamine by mast cells through a different mechanism from mast cell stabilizer
- last resort
11
Q
3 components of an asthma attack
A
- Bronchoconstriction
- increased production of secretions, an inflammatory response, a very thick and viscous fluid
- pulmonary capillaries become engorged with blood, because of the inflammatory response they go into edematous state. They vasodilate and release fluid into the lungs which further fills the lung space with fluid.
12
Q
Long-acting:
short-acting:
A
- salmeterol (Beta2agonist)
- Albuterol Beta2agonist)
13
Q
order of meds taken to terminate an asthma attack important
A
- short acting bronchodilator first (anticholinergic or beta-adrenergic agonist) and then a long-term corticosteroid
14
Q
MDI - metered dose inhaler
A
- pressurized devices that deliver a measured dose of drug with each activation
- hand-mouth coordination is required
- when 2 or more puffs are needed, inform the patient that at least 1 minute should be allowed between puffs
