Respiratory

Question 1

Bronchodilators: Beta-adrenergic agonists

Answer 1

Albuterol

Salmeterol

Question 2

Bronchodilator

Answer 2

MOA: Beta 2 agonist

• selective v. non-selective
• short acting: albuterol (rescue inhaler)
• long acting: salmeterol (exercised induced bronchospasms COPD)

Indications: Bronchospasm

Contraindications: Allergy, uncontrolled HTN or Dysrhythmias, Inc. risk of stroke

Adverse Effects: R/T Selective v. Non-Selective

Interactions: Beta Blockers, Diabetics

Nursing Considerations:

Question 3

Bronchodilators Anticholinergic: ipratropium

Answer 3

MOA: Block ACh from binding

Indications: Prevention of Bronchospasm

Contraindications: Allergy to Atropine, Glaucoma, BPH

Adverse Effects: Dry Mouth, Anxiety, Coughing,

Interactions: Additive effects

NCs: will take a little longer to work to prevent bronchospasm; respiratory, lung sounds, pulse ox, BP

Question 4

Bronchodilators: xanthine derivatives

Answer 4

theophylline (Caffeine)

MOA: prevents breakdown of cAMP

Indications: bronchospasms unrelieved by other meds

Contraindications: dysrhythmias, seizures, liver impairment

AE: lots of coffee, buzzed feeling

Interactions: caffeine, St. John’s Wort

NC: worry about pt not having patent airway

Question 5

nonbronchodilating: leukotriene receptor antagonists (montelukast)

Answer 5

MAO: Block Inflammatory Response

Indications: Prophylactic Seasonal Allergy

Contraindications: Specific Allergy to the drug or components of drug

Adverse Effects: Liver Dysfunction

Interactions: Phenobarbital & Rifampin

Nursing Considerations: liver enzymes, respiratory

Question 6

nonbronchodilating: corticosteroid (methylprednisolone)

Answer 6

MAO: Stabilize Cell Wall & Inc. smooth muscle response to beta stimulation

Indications: Bronchospasm

Contraindications: Hypersensitivity to glucocorticosteroids, Fungal Infections

Adverse Effects: pharyngeal irritation, Oral infections, Adrenal suppression, Cushing’s syndrome, CNS stimulation, Hyperglycemia

Interactions: antidiabetic meds., inc. levels of immunosuppressants, antifungals dec. clearance of steroids. Pg. 599

Nursing Considerations: mental status (some pts become crazy)

Question 7

antihistamines

Answer 7

diphenhydramine: benadryl
loratadine: claritin

Question 8

antihistamines

Answer 8

MOA: H1 Antagonists

Indicated for Allergies and Colds

Contraindicated: Allergy, Glaucoma and HTN

Adverse Effects: Sedative V. Nonsedative

Interactions: Additive V. Competitive

Nursing Considerations sedative vs non-sedative reactions

Question 9

Decongestants (phenylephrine)

Answer 9

MOA: Shrink Mucosal Membranes

Indication: Nasal Congestion

Contraindication: Glaucoma, HTN, CV Dx, Diabetes

Adverse Effect: Alpha-Adrenergic

Interaction: Few mainly HTN effects

Nursing Considerations: diabetes, might increase blood sugars