Respiratory 2 Flashcards
COPD treatment goals
- improve a patients _____ status and QOL
- preserve optimal _____
- prevent the recurrence of _____
- treatment is guided by severity
- -reduction of risk factors: _____ cessation; _____ vaccine (vaccination)
- -_____ rehabilitation: graded aerobic physical exercise programs
- -pharmacologic agents
- -_____
- -_____
- -_____
- -_____ options
functional lung function exacerbations smoking influenza cardiopulmonary
oxygen
antibiotics
surgical
COPD pharmacological agents
- beta 2 agonists: ____ & ___
- anticholinergic agent: _____; _____
- methylxanthines: _____ (nonspecific PDE inhibitor)
- PDE Type 4 inhibitors: _____ (Ariflo) and _____ (Daxas, Daliresp)
- _____
- mucolytic agents: _____, _____
- _____
- _____ therapy
SABA, LABA ipratropium tiotropium theophylline cilomilast rofulmilast corticosteroids guaifenesin acetylcysteine antibiotics oxygen
medications
- bronchodilators:
- -_____
- -_____
- -_____
- glucocorticoids
- _____
- oxygen
- respiratory stimulants
- _____
- vaccinations
- lifestyle modification
anticholinergics B2 agonists methyxanthines mucolytics antibiotics
anticholinergics
- _____ (atrovent)
- -relaxation of _____ by inhibition of _____
- -bronchodilating effects are equal to or more than _____
- _____ (Spiriva) once daily
- combivent = _____ + _____
ipratropium bronchial smooth muscle cGMP beta agonists tiotropium salbuterol ipratropium
long acting B2 agonists
_____ (serevent)
-approved for use in COPD I997
-_____ puffs _____ vs. ipratropium _____ puffs _____
–equivalent or _____to ipatropium, greatest benefit in those with _____ response
salmeterol 2 BID 2 QID superior bronchodilator
corticosteroids
- controversial in COPD
- only appropriate for symptomatic patients with _____ and _____
- long-term treatment with ____ is not recommended
moderate
severe COPD
oral steroids
mucolytics
- _________(Mucomyst)
- pharmacotherapeutics:
- -break up thick, tenacious _____ in patients whose physical condition makes it difficult to cough up these secretions
- -antidote for severe _____ (_____) overdosage
- most frequently given by _____
- fast-acting drug, with onset of action within _____
acetylcysteine sputum acetaminophen tylenol nebulizer 1 minute
expectorants
- ________ (mucinex, Buckleys)
- decreases the _____ of secretions
- _____ can be more easily coughed up
- available in many _____ preparations
Guaifenesin
viscosity
serous secretions
OTC
antitussives \_\_\_\_\_ (DM) -used to suppress the \_\_\_\_\_ when chronic nonproductive coughing accompanies a disorder of the respiratory tract -\_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_ -\_\_\_\_\_ containing -side effects: \_\_\_\_\_
dextromethorphan cough reflex benylin robitussin coricidin morphine constipation
antihistamines
sedating: _____ (Benadryl)
- non-sedating: _____ (Claritin)
- block the _____ receptor sites, preventing histamine action when an antigen is encountered
- restores normal air flow through the _____
- many available OTC
diphenhydramine
loratadine
H1
upper respiratory system
histamine (autacoid-local hormone)
- mediates a range of cellular responses
- -_____
- -_____ reactions
- -_____ secretions
- -_____ in CNS
- has no clinical application
- clinically we block its actions
- -_____
allergies inflammatory gastric acid neurotransmission antihistamines
histamine receptors
-two receptor types: H1 and H2
H1 receptors:
- _____ reactions:
- -_____, _____, _____, etc
- smooth muscle and endothelium
- -_____ (hypotension); _____, _____; redness, hives and inflammation
- sensory nerve endings: _____, _____
H2 receptors:
-gastric mucosa: _____ gastric secretion
allergic dermatitis rhinitis conjunctivitis endothelium vasodilation bronchoconstriction edema itching pain increase
histamine antagonist
- antihistamines
- -are effective if they are able to block receptors _____ histamine release can occur:
- -_____ use provides optimum benefit
- -_____: refers to classis H1 receptor blocked
- –as compare to _____
before
prophylactic
antihistamine
H2 antagonist
histamine antagonist
- receptor antagonists- _____ antagonists at the _____ receptor
- H1 receptor antagonist (_____)
- -_____ (Benadryl)
- -_____ (atarax)
- H2 receptors antagonist (ulcers)
- -_____ and _____
competitive antagonists histamine antihistamines diphenhydramine hydroxyzine cimetidine ranitidine
H1 receptor antagonists
- first generation
- -chloropheniramine
- dimenhydrinate
- -_____
- -_____
- -_____
- -meclizine
- -distributed in CNS
- –_____
second generation
- astemizole
- cetirizine
- loratadine
- terfenadine
- do not cross _____
intra-nasal
-_____
diphenhydramine promethazine hydroxyzine sedation BBB azelastine
