Respiratory Flashcards
antihistamine examples
1st gen- diphenhydramine
(benadryl)
2nd generation - Nonsedating-all OTC now cetirizine (zyrtec), fexofenadine (allegra),
(Claritin)
1 st generation antihistamine SE
- -drowsiness, dizziness
- anticholinergic- (dry mouth, urinary retention, blurred vision)
Antihistamine interaction
↑ CNS depression with alcohol, avoid MAOIs
Antihistamine CA
LOC
Antihistamine PT
- don’t drive-drowsy
- avoid alcohol
- use sunblock (photosensitivity)
nasal decongestants
adrenergic agonists:
-oxymetazoline (Afrin) -naphazoline (Allerest ) -pseudoephedrine (Sudafed)
nasal decongestants SE
- alpha adrenergic effect
- HTN, tachycardia, hyperglycemia
nasal decongestants CA
BP
nasal decongestants PT
should not use nasal decongestants longer than 5 days to prevent rebound nasal congestion
intranasal glucocorticoids treat ….
allergic rhinitis
Antitussives examples
- Narcotic-codeine
- nonnarcotic-dextrometh-orphan
Antitussives action
- suppress cough reflex
- suppress non-productive cough
Antitussives CA
cough & for Narc. RR
Expectorant examples
- guaifenesin (Robitussin, Humibid)
- iodonated glycerol
Expectorant action
liquefy and thin secretions
Expectorant CA & PT
none but encourage liquids to thin secretions
lower respiratory med classes (3)
- bronchodilators- beta 1
- anticholinergics
- methylxanthines
Bronchodilators SNS effect (2)
- -Bronchodilators- beta agonists-2.sympathomimetics
- adrenergic
Bronchodilators examples (5)
- epinephrine-alpha +beta
- isoproterenol (Isuprel) - beta1+2
- Albuterol (Proventil)-selective beta2
- Salmeterol (Serevent)-select. beta2
- Advair: Salmeterol + fluticasone(steroid)=PDI
Bronchodilators action
dilates bronchioles
Bronchodilators SE
- Palpitations
- nervousness
- tachycardia
- dysrhythmias
- HTN
Bronchodilators CA
BP
Bronchodilators PT
- Albuterol is for rescue
- Salmeterol- prophylaxis
anticholinergic bronchodilators examples (3)
- Ipratropium bromide (Atrovent)
- Tiotropium (Spiriva Handihaler)
- Combo: Ipratropium/
Albuterol(Combivent)
anticholinergic bronchodilators use
- block the effects of acetylcholine
- prevents/reduces broncho-constriction of smooth muscle of bronchus
anticholinergic bronchodilators contraind
narrow angle glaucoma
anticholinergic bronchodilators CA
none
anticholinergic bronchodilators PT
- Teaching- Use beta-agonist 5 min before anticholinergic
- use glucocorticoid 5 min after anticholinergic
methylxanthine derivative examples
aminophylline, theophylline
methylxanthine derivative action
Relaxes smooth muscle of bronchi, bronchioles cAMP promoting bronchodilation
methylxanthine T-range
10-20 mcg/ml
-toxic> 20
methylxanthine CA
theophylline blood levels
glucocorticoids examples
-Fluticasone (Flonase)
-Beclomethasone (Vanceril)
-Flunisolide (Aerobid)
-Triamcinolone (Nasacort,
Azmacort)
-Budesonide (Rhinocort)
Oral: Prednisone
IV: Methylpred-nisolone (Solu-Medrol)
glucocorticoids SE
- hyperglycemia (monitor for DM)
- risk for infection
- HTN
- HF
- hypokalemia, -hypernatremia
- peptic ulcers
glucocorticoids PT
- Do not stop the drug abruptly- must be tapered
- take every dose
- avoid exposure to infections
- must take oral meds with meals
mast cell stabilizers ex
cromolyn
mast cell stabilizers action
- anti-inflammatory effect and suppresses the release of histamine
- prophylactic
mucolytic examples(2)
- Acetylcysteine (Mucomyst)
2. Dornase alfa (Pulmozyne)
mucolytic action
-liquefies and loosens thick mucus secretions
Acetylcysteine antidote for ….
also an antidote for acetaminophen overdose-if within 12-24 hours