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NURS 305 - Exam 2 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Describe the pathophysiology of a cold (2)

A
  • Inflammatory response –> increased mucus
  • Mucous drips down the pharynx –> esophagus –> lower respiratory tract
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2
Q

Release of inflammatory substances in the case of a cold causes …

A

Dilation - nasal congestion

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3
Q

Describe the mechanism of action of antihistamines

A

Block histamine receptors

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4
Q

Do NOT push off histamine that is …

A

Already bound to a receptor (compete for unoccupied receptors)

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5
Q

Histamines are beneficial when …

A

Given early

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6
Q

What are the functions of histamine 1? (2)

A
  • Smooth muscle contraction
  • Capillary dilation
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7
Q

What are the functions of histamine 2? (2)

A
  • Heart rate acceleration
  • Gastric acid secretion
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8
Q

Excessive release of histamine can lead to ______

A

Anaphylaxis

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9
Q

What are the indications of antihistamines? (3)

A
  • Allergies / urticaria
  • Motion sickness
  • Parkinson’s disease
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10
Q

What are the contraindications of antihistamines? (5)

A
  • BPH
  • Bronchial asthma
  • COPD
  • Narrow angle glaucoma
  • Seizure disorders
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11
Q

What is the primary side effect of antihistamines?

A

Drowsiness

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12
Q

What are the anticholinergic effects of antihistamines? (4)

A
  • Dry mouth
  • Visual changes
  • Urinary retention
  • Constipation
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13
Q

Antihistamines require caution use in what population?

A

Elderly men (BPH)

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14
Q

What type of antihistamine is diphenhydramine (Benadryl)?

A

1st generation

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15
Q

Describe the characteristics of 1st generation antihistamines (2)

A
  • High sedating effect
  • High anticholinergic effect
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16
Q

What type of antihistamine is loratadine (Claritin)?

A

2nd generation

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17
Q

Describe the characteristics of 2nd generation antihistamines (2)

A
  • Low sedating effect
  • Low anticholinergic effect
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18
Q

2nd generation antihistamines have ______

A

High antihistamine activity

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19
Q

What are some examples of H1 blockers? (4)

A
  • Allegra
  • Benadryl
  • Claritin
  • Zyrtec
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20
Q

What are some examples of H2 blockers? (4)

A
  • Axid
  • Pepcid
  • Tagament
  • Zantac
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21
Q

What are the 3 subclasses of nasal decongestants?

A
  • Adrenergics
  • Anticholinergics
  • Corticosteroids
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22
Q

Describe the mechanism of action of adrenergics (2)

A
  • Constriction –> nasal drainage
  • Stimulation of sympathetic nervous system
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23
Q

What is the primary indication of adrenergics?

A

Sinusitis

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24
Q

What are the side effects of adrenergics? (4)

A
  • Increased BP
  • Insomnia
  • Palpitations
  • Tremors
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25
Q

What are some examples of adrenergics? (2)

A
  • Sudafed
  • Afrin
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26
Q

What side effect is associated with Afrin?

A

Rebound congestion

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27
Q

Afrin should be used for no more than ______

A

3 days

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28
Q

Describe the mechanism of action of anticholinergics

A

Dilation –> prevents nasal drainage

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29
Q

Anticholinergics block ______

A

Acetylcholine

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30
Q

What is the primary indication of anticholinergics?

A

Rhinorrhea

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31
Q

What is an example of an anticholinergic?

A

Atrovent

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32
Q

Describe the mechanism of action of corticosteroids

A

Control of inflammation

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33
Q

What is the primary indication of corticosteroids?

A

Rhinorrhea

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34
Q

What are some examples of corticosteroids? (3)

A
  • Flonase
  • Nasacort
  • Rhinocort
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35
Q

What is a contraindication of corticosteroids?

A

Nasal infection

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36
Q

Describe the effects of oral nasal decongestants (3)

A
  • Systemic
  • Delayed onset
  • No rebound congestion
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37
Q

Describe the effect of inhaled nasal decongestants

A

Risk of rebound congestion with adrenergics

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38
Q

Describe the effect of topical nasal decongestants

A

Risk of rebound congestion with adrenergics

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39
Q

What are the 2 types of antitussives?

A
  • Opioid
  • Non-opioid
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40
Q

Describe the mechanism of action of antitussives

A

Suppression of cough reflex

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41
Q

Opioid antitussives also function as ______

A

Analgesics

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42
Q

What are the only 2 opioids used as antitussives?

A
  • Codeine
  • Hydrocodone
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43
Q

What are the side effects of opioid antitussives? (3)

A
  • Sedation
  • Dizziness
  • Constipation
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44
Q

What is a possible adverse effect from large amount of opioid antitussives?

A

Respiratory depression

45
Q

Describe the teaching associated with opioid antitussives (3)

A
  • Do not combine with other CNS depressants
  • Avoid ethanol
  • No driving
46
Q

What are some examples of non-opioid antitussives? (2)

A
  • Delsym
  • Tessalon
47
Q

______ may occur if the recommended dosage of Delsym is exceeded - commonly abused

48
Q

Describe the teaching associated with Tessalon

A

Do not chew capsules - causes numbness in mouth and throat (aspiration risk)

49
Q

What is an example of an expectorant?

50
Q

Describe the mechanism of action of expectorants (2)

A
  • Respiratory tract hydration
  • Decreases mucus viscosity
51
Q

What is the primary indication of expectorants?

A

Productive cough

52
Q

What are the side effects of expectorants? (3)

A
  • Nausea
  • Vomiting
  • Gastric irritation
53
Q

Describe the teaching associated with expectorants

A

Increase fluid intake

54
Q

What is an example of a mucolytic?

55
Q

What are the possible routes of mucomyst? (2)

A
  • PO
  • Inhalation
56
Q

Describe the mechanism of action of mucolytics

A

Decreases mucus viscosity

57
Q

What are the side effects of mucolytics? (3)

A
  • Headache
  • Confusion
  • Depression
58
Q

Describe the treatment of asthma (2)

A
  • Decrease inflammation
  • Bonchodilation
59
Q

Describe COPD

A

Emphysema and chronic bronchitis

60
Q

What is the primary function of beta adrenergic agonist inhalers?

A

Bronchodilation

61
Q

Describe the mechanism of action of a beta adrenergic agonist inhalers (2)

A
  • Stimulation of beta 2 receptors in the lungs
  • Relaxation of smooth muscle - bronchodilation / increased airflow
62
Q

What are the side effects of beta-adrenergic agonists? (4)

A
  • Bronchospasm
  • Dry mouth
  • Tachycardia
  • Palpitations
63
Q

What are the 2 types of beta adrenergic agonist inhalers?

A
  • Short-acting (rescue)
  • Long-acting (prevention / control)
64
Q

When are short-acting beta-adrenergic agonists used?

A

During the acute phase of an asthma attack

65
Q

______ is more common with albuterol than xopenex

A

Tachycardia

66
Q

What is the maximum dose of short-acting beta-adrenergic agonists?

A

12 puffs / day

67
Q

What occurs if albuterol is used too frequently? (2)

A
  • Loses its beta 2 specific actions
  • Stimulates beta 1 receptors
68
Q

What is an example of a short-acting beta-adrenergic agonist?

69
Q

When are long-acting beta-adrenergic agonists used?

A

Prophylactically to prevent asthma attacks

70
Q

Long-acting beta-adrenergic agonists are often combined with ______

A

Anti-inflammatory drugs (steroids)

71
Q

What are the side effects of long-acting beta-adrenergic agonists? (3)

A
  • Hypertension
  • Hyperglycemia
  • Hypokalemia
72
Q

What are the contraindications of long-acting beta-adrenergic agonists? (2)

A
  • Acute asthma
  • COPD events
73
Q

What is an example of a long-acting beta-adrenergic agonist?

A

Salmeterol

74
Q

Anticholinergic inhalers are used more in ______ than asthma

75
Q

What is an example of an anticholinergic inhaler?

A

Ipratropium bromide

76
Q

Anticholinergic inhalers are used as a controller medication with ______ effects

A

Slow and prolonged

77
Q

Anticholinergic inhalers are used as an adjunctive therapy to prevent ______

A

Wheezing and dyspnea

78
Q

Anticholinergic inhalers require caution in patients with what conditions? (2)

A
  • Acute narrow angle glaucoma
  • Prostate enlargement
79
Q

What are the side effects of anticholinergic inhalers? (2)

A
  • Intraocular pressure
  • Urinary retention
80
Q

Describe the mechanism of action of xanthine derivatives

A

Increases cAMP –> bronchodilation

81
Q

High levels of cAMP contribute to ______

A

Smooth muscle relaxation

82
Q

Large doses of xanthine derivatives stimulate the cerebrovascular system causing …

A

Increased blood flow to kidneys –> dilation of renal blood vessels and increased GFR (diuretic effect)

83
Q

What are the possible routes of xanthine derivatives? (2)

84
Q

What is an example of a xanthine derivative?

A

Theophylline

85
Q

Xanthine derivatives are metabolized similarly to ______

86
Q

What are the primary risks associated with xanthine derivatives? (2)

A
  • Drug interactions
  • Narrow therapeutic range
87
Q

Xanthine derivatives must be closely monitored with ______

A

Blood draws

88
Q

What is the normal level of theophylline?

A

5 - 15 mcg / mL

89
Q

What are the 2 types of leukotriene modifiers?

A
  • Direct
  • Indirect
90
Q

Describe the mechanism of action of leukotriene modifiers

A

Smooth muscle relaxation –> airway dilation

91
Q

What is the route of leukotriene modifiers?

92
Q

Leukotriene modifiers are a ______

A

Controller medication

93
Q

Describe the teaching associated with leukotriene modifiers

A

Take before bed

94
Q

What are the possible routes of corticosteroids? (3)

A
  • Inhalation
  • PO
  • IV
95
Q

______ corticosteroids have systemic absorption

96
Q

Oral / IV corticosteroids should be in the ______ for the shortest time possible

A

Lowest dose

97
Q

What are the side effects of inhaled corticosteroids? (2)

A
  • Oral candidiasis
  • Oropharyngeal irritation
98
Q

What are the side effects of oral / IV corticosteroids? (2)

A
  • Hyperglycemia
  • Immunosuppression
99
Q

Describe the teaching associated with corticosteroids

A

Rinse mouth after using inhaler

100
Q

What are the primary first lines drug used to treat TB? (2)

A
  • Isoniazid (INH)
  • Rifampin
101
Q

Describe the mechanism of action of isoniazid (INH) / rifampin

A

Inhibits mycobacteria synthesis

102
Q

What is the primary indication of isoniazid (INH) / rifampin?

A

Treatment of active / latent TB

103
Q

Isoniazid (INH) can also be used for ______

A

Prophylaxis

104
Q

What is the primary contraindication of isoniazid (INH) / rifampin?

A

Liver disease

105
Q

What are the side effects of isoniazid (INH)? (2)

A
  • Peripheral neuropathy
  • Optic neuritis
106
Q

What is the adverse effect of isoniazid (INH) / rifampin?

A

Hepatotoxicity

107
Q

What is the primary drug interaction risk associated with rifampin?

A

Highly protein bound drugs

108
Q

What unique characteristic of rifampin is important in patient teaching?

A

Colors all body fluid reddish orange

NURS 305 - Exam 2 (4 decks)

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