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Pharmacology Exam #3 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

albuterol: class

A

Beta2 -Adrenergic Agonist

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2
Q

albuterol: EPA

A

Stimulates beta2-adrenergic receptors in the smooth muscle of the bronchi and bronchioles, resulting in bronchodilation.

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3
Q

albuterol: use

A

Rescue medication used to treat or prevent bronchospasm in people with asthma or other obstructive airways diseases.

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4
Q

albuterol: administration

A

inhaled via MDI or nebulizer

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5
Q

albuterol: ADRs

A

MDI-fewer systemic effects
higher doses can cause more systemic effects Chest pain, palpitations, nervousness, restlessness, tremors and agitation.

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6
Q

albuterol: contraindications

A

Cardiac tachydysrhythmias
Severe CAD
MAOIs & tricyclic antidepressants increase risk of HTN, tachycardia, & angina

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7
Q

albuterol: RN intervention

A

Prevention is key
Get the flu shot!
Asthma attack - short acting bronchodilators
Inhale short acting inhaler first and then long-acting steroid inhaler (glucocorticoid)
Common cause of asthma attack is not taking medications correctly
Keep rescue inhaler with you at all times
Drink 2 to 3 quarts of fluids to help thin secretions
Use MDI and spacer correctly
Avoid caffeine
Report chest pain and heart palpitations

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8
Q

Beta2 - Adrenergic Agonist: medications

A

albuterol (Proventil, Ventolin) - short acting
form
formoterol (Foradil Areolizer) & salmeterol (Serevent) - long acting

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9
Q

Proper way to use a Meter Dose Inhaler (MDI)

A

Shake well immediately before each use
Exhale to the end of a normal breath
While pressing down on the inhaler, take a slow, deep breath for 3 to 5 seconds, hold the breath for approximately 10 seconds, and exhale slowly
Wait 5 minutes before taking a second inhalation of the drug
Rinse mouth with water after each use
Rinse the mouth piece and store the inhaler away from heat
Use a spacer if having difficulty using inhaler

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10
Q

ipratropium (Atrovent): class

A

inhaled anticholinergic

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11
Q

ipratropium (Atrovent): EPA

A

Blocks the muscarinic Ach receptors in the smooth muscles of the bronchi in the lungs, inhibiting bronchoconstriction and mucus secretion (very similar to atropine)

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12
Q

ipratropium (Atrovent): Use

A

Long-term management of asthma or other conditions (COPD)that cause bronchoconstriction and increase in secretions.

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13
Q

ipratropium: ADR

A

Dry mouth, increased intraocular pressure & urinary retention

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14
Q

ipratropium: contraindications

A

Glaucoma, BPH, and bladder neck obstruction

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15
Q

ipratropium: RN interventions

A

Dry mouth-encourage water and hard candy to treat
Monitor urinary elimination patterns
Schedule regular eye examinations-monitor for glaucoma
Educate client on how to administer inhaler (slide 9&10)

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16
Q

ipratropium: administration

A

inhaled vis MDI or nebulizer

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17
Q

theophylline (Theolair): Class

A

Methylxanthines

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18
Q

theophylline (Theolair): EPA

A

Relaxes the bronchial smooth muscle, promoting bronchodilation.

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19
Q

theophylline (Theolair): Use

A

Second line treatment for chronic lung disorders that cause bronchoconstriction (COPD) *EBP no longer recommends to use to treat COPD

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20
Q

theophylline (Theolair): ADRs

A

Tachycardia, agitation and seizures. Toxicity-Ventricular dysrhythmias or convulsions

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21
Q

theophylline (Theolair): contraindications

A

heart disease, liver dysfunction and use with caution with seizure disorders

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22
Q

theophylline (Theolair): RN Interventions

A

need to monitor serum blood levels because there is a narrow therapeutic range

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23
Q

beclomethasone (QVAR): class

A

inhaled glucocorticoid, long-term control for asthma

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24
Q

beclomethasone (QVAR): EPA

A

Suppress the release of inflammatory mediators and decrease the recruitment of airway eosinophils. Increases the number and sensitivity of beta2-adrenergic bronchodilators.

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25
Q

beclomethasone (QVAR): Use

A

Prophylactic management of asthma with inhaled steroids. Acute asthma flare-ups, systemic corticosteroids used

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26
Q

beclomethasone (QVAR): administration

A

inhaled orally or nasally

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27
Q

beclomethasone (QVAR): ADRs

A

Pharyngitis, cough, dry mouth, and candidiasis (thrush)

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28
Q

beclomethasone (QVAR): contraindications

A

recent live virus immunization and oral candidiasis

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29
Q

beclomethasone (QVAR): RN Interventions

A

Rinse the mouth and throat with water after using inhaler
Use a spacer
Educate client on how to administer inhaler

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30
Q

prednisone: class

A

glucocorticoids

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31
Q

prednisone: other medications

A

methylprednisone-IV

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32
Q

prednisone: EPA

A

Multiple mechanisms of action and each one varies depending on the cell tissue. All affect the inflammatory process to reduce inflammation.

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33
Q

prednisone: Use

A

Decreases inflammatory symptoms and alters the immune response produced by nonendocrine disorders. Used to treat:
Asthma
COPD
Arthritis
Rhinitis
Cancer
Inflammatory bowel disease
Spinal cord injury
Prevention of acute adrenocortical insufficiency

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34
Q

prednisone: ADRs

A
  • CNS stimulant (jittery inside)
  • Insomnia
  • Adrenocortical insufficiency: Fainting, Weakness, Hypotension
  • Adrenocortical excess
  • Cardiovascular symptoms: Heart failure, Shock, Cardiac dysrhythmias
  • Increase appetite (weight gain)
  • Hyperglycemia - monitor diabetes patients
  • Immunosuppressive-delayed wound healing more susceptible to infection.
  • Bone disease
  • Very fragile skin…paper thin
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35
Q

prednisone: Contraindication

A

Immunosuppression, live vaccines, systemic fungal infections, and antibiotic-resistant infections

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36
Q

prednisone: RN Intervention

A

Treats symptoms, does not cure underlying disease
Take as directed, DO NOT stop taking abruptly
Tapered off
Take with food
Educate on numerous ADRs

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37
Q

montelukast (Singulair): Class

A

anti-inflammatory/ Leukotriene Modifiers

38
Q

montelukast (Singulair): EPA

A

Prevents leukotrienes from binding to its receptors - reducing bronchoconstriction, inflammation, and mucus production

39
Q

montelukast (Singulair): Use

A

Used in patients with asthma that do not respond to other treatments. Used as a long acting antiasthmatic med. Only tablet approved for exercise-induced asthma. Can also treat allergies.

40
Q

montelukast (Singulair): ADR

A

behavioral changes, Black Box Warning (Neuropsychiatric events)

41
Q

montelukast (Singulair): BLACK BOX WARNING

A

Neuropsychiatric events have been reported in patients that take this drug (aggressive behavior, hallucinations, insomnia and suicidal ideation).

42
Q

montelukast (Singulair): contraindications

A

liver disease

43
Q

montelukast (Singulair): RN interventions

A

Not used to manage acute asthma attacks
Take 2 hours before exercise to prevent exercise induced bronchoconstriction
Take in evening daily to treat allergies

44
Q

diphenhydramine (Benadryl): Class

A

first generation/ sedating antihistamines

45
Q

diphenhydramine (Benadryl): use

A

treat allergic reactions, anaphylaxis, motion sickness, insomnia

46
Q

diphenhydramine (Benadryl): EPA

A

Structurally like histamine and occupy the same receptor sites preventing histamine acting on target tissues and thus preventing histamine response. Binds to central H1 receptors.

47
Q

diphenhydramine (Benadryl): ADR

A

CNS depression=drowsiness & sedation, paradoxical effect causing CNS stimulation and anticholinergic effects, Can cause: Dry mouth, Urinary retention, Constipation, Blurred vision

48
Q

diphenhydramine (Benadryl): Contraindications

A

Newborns and children < 2 years old
Breastfeeding women
Do not take with ETOH or other CNS depressants

49
Q

diphenhydramine (Benadryl): RN interventions

A

Do not take with ETOH or other CNS depressants
Use with caution in older adults
Assess LOC
Advise against driving and operating machinery requiring mental alertness

50
Q

cetirizine (Zyrtec): class

A

second generation/ non-sedating antihistamines

51
Q

cetirizine (Zyrtec): other medications

A

loratadine (Claritin)
fexofenadine (Allegra)

52
Q

cetirizine (Zyrtec): Use

A

seasonal allergies, minor allergies, and urticaria

53
Q

cetirizine (Zyrtec): EPA

A

Binds to histamine receptors to prevent histamine response, but binds to peripheral, not central H1 receptors. Therefore, does not cause drowsiness like the first-generation agents

54
Q

cetirizine (Zyrtec): ADR

A

Drowsiness & fatigue (higher doses), and anticholinergic effects

55
Q

cetirizine (Zyrtec): contraindications

A

breastfeeding, impaired kidney or liver function

56
Q

cetirizine (Zyrtec): RN Interventions

A

take once a day, take with water

57
Q

phenylephrine (Neo-Synephrine): class

A

sympathomimetics - nasal decongestants

58
Q

phenylephrine (Neo-Synephrine): other medications

A

pseudoephedrine (Sudafed)

59
Q

phenylephrine (Neo-Synephrine): Use

A

relieved pressure, swelling and congestion of the nasal mucosa

60
Q

phenylephrine (Neo-Synephrine): EPA

A

Alpha1-adrenergic agonist, causes vasoconstriction of the blood vessels… causing the nasal turbinates’ in the nares to shrink, in turn opening nasal passages and relieving nasal congestion.

61
Q

phenylephrine (Neo-Synephrine): ADRs

A

CNS excitation=tachycardia, insomnia, dizziness, palpitations, urinary retention

62
Q

phenylephrine (Neo-Synephrine): Contraindications

A

Uncontrolled heart disease
Dysrhythmia
HTN
Narrow angle glaucoma
Older adults
Caffeine may increase effect

63
Q

phenylephrine (Neo-Synephrine): RN Interventions

A

Do not use for more than 3 to 5 days
Assess for cardiac symptoms
Educate about rebound effect
Multiple drug interactions

64
Q

What is pseudoephedrine misuse?

A

it is an ingredient in methamphetamine production and has high risks of hypertension and dysthymias

65
Q

dextromethorphan (Delsym): Class

A

antitussives - nonnarcotic

66
Q

dextromethorphan (Delsym): other medications

A

benzonatate (Tessalon)

67
Q

dextromethorphan (Delsym): Use

A

to suppress nonproductive cough

68
Q

dextromethorphan (Delsym): EPA

A

depress the cough reflex in the brain

69
Q

dextromethorphan (Delsym): ADRs

A

CNS depression - drowsiness and sedation

70
Q

dextromethorphan (Delsym): contraindications

A

MAOIs, SSRIs, ETOH use

71
Q

dextromethorphan (Delsym): RN Interventions

A

look out for medication interactions and avoid alcohol

72
Q

codeine: class

A

antitussives - narcotic

73
Q

codeine: use

A

relief of cough

74
Q

codeine: EPA

A

depresses the cough reflex in the brain

75
Q

codeine: Administration

A

PO, usually combined with acetaminophen in liquid form (Tylenol #3)

76
Q

codeine: ADRs

A

N/V, respiratory sedation, constipation, dizziness

77
Q

codeine: Contraindications

A

Any respiratory impairments
Head injuries
Seizure disorders
ETOH

78
Q

codeine: RN Interventions

A

assess GI and respiratory status, avoid in patients with asthma or head injuries

79
Q

guaifenesin (Mucinex): Class

A

expectorants - loosening mucus

80
Q

guaifenesin (Mucinex): use

A

loosens mucus from respiratory tract in a productive cough

81
Q

guaifenesin (Mucinex): EPA

A

reduced viscosity of secretions

82
Q

guaifenesin (Mucinex): ADRs

A

dizziness, drowsiness, headache, skin rash

83
Q

guaifenesin (Mucinex): contraindications

A

inability to expectorate

84
Q

guaifenesin (Mucinex): RN Interventions

A

Give med with food and water
Hydration
Swallow tablets whole
Change positions carefully

85
Q

acetylcysteine (Acetadote): Class

A

Mucolytic - liquifying mucus

86
Q

acetylcysteine (Acetadote): Use

A

liquify mucus in the respiratory tract

87
Q

acetylcysteine (Acetadote): EPA

A

attacks protein bonds in the mucus reducing viscosity

88
Q

acetylcysteine (Acetadote): ADRs

A

Bronchospasm, GI distress (due to rotten egg smell and ingestion of secretions)

89
Q

acetylcysteine (Acetadote): contraindications

A

inability to expect secretions, asthma

90
Q

acetylcysteine (Acetadote): RN Interventions

A

Assess respiratory status: Difficulty breathing? Bronchospasm? Inability to expel secretions
Hydration
Report difficulty breathing or worsening cough

Pharmacology Exam #3 (10 decks)

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