Respiratory Flashcards
How do mucolytics/expectorants work?
Reduce viscosity of secretions making cough more efficient
Name two mucolytics
Guafenesin, NAC (Mucomyst)
Name three cough suppressant’s
Codeine, dextromethorphan, benzonatate (Tessalon pearls)
What is the nickname for people who abuse dextromethorphan?
Syrup heads
Define asthma
Hyper reactive bronchi causing chronic inflammation
Describe what it means to say asthma is a polygenic disorder
Histamine, leukotrienes, and prostaglandins all play an inflammatory role
What is a life-threatening asthma attack requiring IV steroids and potential intubation called?
Status asthmaticus
Describe the three step approach to asthma treatment
Prevent allergen exposure, reduce inflammation/hyperactivity, dilate narrowed bronchi
Which kind of drug is the mainstay of asthma treatment?
Inhaled Glucocorticoids (can also be given PO or IV)
What is an adverse effect of glucocorticoid inhalation? How can it be prevented?
Thrush- gargle with water after using inhaler
What is the benefit of using an inhaled glucocorticoid rather than another form?
No systemic effects and little risk of immune suppression
What is a stress dose and when is it used?
Increase steroid dose in times of bodily stress due to rapid metabolism
Which kind of drug can cause growth stunting in children?
Systemic steroids
What are Cromolyn and Nedocromil?
Mast cell stabilizers that reduce histamine release in inflammatory reaction
Are cromolyn and Nedocromil preventative or acute asthmatic treatments?
Preventative therapy (does not terminate acute attacks)
Which type of coughs should be suppressed?
Useless (unproductive), and useful (productive) cough when exhausting to patient
Name a short acting and 4 long acting B2 agonists
Short acting: albuterol (rescue agent)
Long acting: salmeterol, formoterol, bambuterol, salbutamol
Which long-acting B2 agonist has the quickest onset and greatest potency?
Formoterol (Foradil/ Perforomist)
Why is albuterol PO rarely used?
Less B2 selectivity (causes tachycardia)
Which patients should be especially careful to avoid nonselective beta blockers, especially if on beta-2 agonists?
Patients with asthma
Describe a tocolytic and give an example
Delays labor/delivery
Ex. Turbutaline a beta-2 agonist with effects on smooth muscle
Name two anti-cholinergics used as adjunct in asthmatics
Ipratropium (Atrovent), Spiriva
How do anti-cholinergics work to treat asthma?
Parasympatholytic effects cause bronchodilation
When are Leukotriene receptor antagonists like Singulair and Accolate used?
Usually second line agents to MDIs (not as effective but benign adverse effects)
