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Pharmacology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Therapeutic Use

Beta2-Adrenergic Agonist - albuterol

A

Long-term management of asthma
Prevention of exercise-induced bronchospasm
Treatment of ongoing asthma exacerbations

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2
Q

Adverse Effects

Beta2-Adrenergic Agonist - albuterol

A

Chest pain, palpitations

Nervousness, restlessness, tremors

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3
Q

Medication Administration

Beta2-Adrenergic Agonist - albuterol

A

Follow manufacturer’s instructions for using delivery devices
Use short-acting preparations for acute exacerbations
Use long-acting preparations for long-term control
Inhale beta2-adrenergic agonists before inhaling glucocorticoids
Follow dosage limits and schedules
Watch for signs and triggers of impending exacerbations of asthma
Keep a log of the frequency and intensity of exacerbations
Notify the provider of changes in patterns of exacerbations

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4
Q

Therapeutic Use

Anticholinergics - ipratropium

A

Relief of bronchoconstriction in clients who have COPD

Decrease secretions in clients with COPD

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5
Q

Expected Pharmacological Action

Anticholinergics - ipratropium

A

Inhibits interaction of acetylcholine at receptor sites on the bronchial smooth muscle, resulting in decreased cyclic guanosine monophosphate and bronchodilation

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6
Q

Adverse Effects

Anticholinergics - ipratropium

A

Dry mouth, irritation of pharynx
Increased intraocular pressure
Urinary retention

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7
Q

Medication Administration

Anticholinergics - ipratropium

A

Follow manufacturer’s instructions for using delivery devices
Follow the dosage limits and schedules
Allow the prescribed time between puffs
Delay use of other inhalants for 5 minutes
Do not use as an emergency rescue medication
Rinse the mouth after use to reduce unpleasant taste

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8
Q

Contraindications

Anticholinergics - ipratropium

A

Hypersensitivity to ipratropium, atropine, belladonna alkaloids, or bromide, history of sensitivity to soy or peanuts- avoid Combivent (ipratropium/albuterol combination) MDI form of drug

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9
Q

Adverse Effects

Methylxanthines - theophylline

A

Rare at therapeutic levels
When therapeutic levels are exceeded: restlessness, insomnia
Nausea, vomiting, diarrhea

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10
Q

Toxicity Symptoms

Methylxanthines - theophylline

A

Seizures, dysrhythmias

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11
Q

Client Education

Methylxanthines - theophylline

A

Reduce or eliminate caffeine intake
Have periodic laboratory testing of drug levels
Stop takin the drug and notify provider if experiencing seizure
Stop taking the drug and notify provider if experiencing dysrhythmias

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12
Q

Contraindications

Methylxanthines - theophylline

A 
Clients with impaired metabolism
Tobacco or marijuana use
Caffeine
Heart disease
Liver dysfunction
Acute pulmonary edema
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13
Q

Adverse Effects

Glucocorticoids - beclomethasone dipropionate

A

Inhaled: oral candidiasis
Oral: Suppression of adrenal function, bone demineralization, muscle wasting, hyperglycemia, peptic ulcer disease, infection, fluid and electrolyte imbalances
Nasal: dry mucous membranes, epistaxis, sore throat, headache

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14
Q

Client Education

Glucocorticoids - beclomethasone dipropionate

A

Rinse mouth or gargle water after use
Monitor for redness, sores, or white patches and report to provider if they occur. Treat candidiasis with nystatin oral suspension

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15
Q

Therapeutic Use

Mast Cell Stabilizers - cromolyn

A

Long-term treatment of allergy-related asthma
Prophylaxis for exercise-induced bronchospasm
Prophylaxis for seasonal allergy symptoms
Management of allergic rhinitis (intranassaly)

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16
Q

Medication Administration

Mast Cell Stabilizers - cromolyn

A

Use with a nebulizer or metered-dose inhaler
Expect several weeks of use for full effects to become apparent
Administer four times daily on a fixed schedule
Use the inhaler 15 minutes before exercising to prevent exercise-induced bronchospasms
Do not use to relieve an acute asthma exacerbation

17
Q

Nursing Interventions

Mast Cell Stabilizers - cromolyn

A

Administer epinephrine and/or antihistamines to reverse anaphyaxis

18
Q

Adverse Effects

Leukotriene Modifiers - Montelukast

A

Leukotriene modifiers zileuton and zafirlukast can cause liver damage. Does not occur with Montelukast
Neuropsychiatric effects such as suicidal ideations

19
Q

Nursing Interventions

Leukotriene Modifiers - Montelukast

A

Monitor liver function with periodic testing

Observe for behavioral changes

20
Q

Client Education

Leukotriene Modifiers - Montelukast

A

Report abdominal tenderness, nausea, or anorexia

Report behavioral changes such as agitation, insomnia, anxiety, or irritability

21
Q

Therapeutic Use

First Generation Antihistamines - diphenhydramine

A

Management of: mild allergic reactions (seasonal allergic rhinitis, cough, urticaria, mild transfusion reaction), anaphylaxis (hypotension, acute laryngeal edema, bronchospasm), motion sickness, insomnia (short-term use, no longer than 2 consecutive weeks)

22
Q

Expected Pharmacological Action

First Generation Antihistamines - diphenhydramine

A

Acts on blood vessels, GI, respiratory system by competing with histamine for H1-receptor site
Decreases allergic response by blocking histamine

23
Q

Adverse Effects

First Generation Antihistamines - diphenhydramine

A 
Drowsiness, dizziness
Anticholinergic effects (dry mouth, constipation)
24
Q

Therapeutic Use

Second Generation Antihistamines - certirizine

A

Management of: allergic rhinitis, chronic idiopathic urticaria

25
Q

Medication Administration

Second Generation Antihistamines - certirizine

A

May take with or without food
Do not take with other over-the-counter antihistamines
Expect dose to be lower in clients who have compromised renal or liver function

26
Q

Client Education

Second Generation Antihistamines - certirizine

A

Take once-daily dose at time desired
Avoid driving and activities that require mental alertness until the drug’s effects are known
Take frequent sips of water
Suck on hard candy

27
Q

Adverse Effects

Sympathomimetics - phenylephrine

A

CNS stimulation with oral agents (agitation, anxiety, insomnia)
Increased blood pressure
Tachycardia/palpitations
Overdose or systemic absorption: hypertension, tachycardia, and heart palpitations
Rebound congestion with prolonged use of topical agents

28
Q

Client Education

Sympathomimetics - phenylephrine

A

Notify provider of excessive symptoms of CNS stimulation
Consult provider regarding alternative therapy or withdrawal of drug
Report prolonged tachycardia or heart palpitations
Have blood pressure checked while on medication if previously diagnosed with hypertension
Do not use for more than 3 to 5 days
Taper and discontinue the drug using one nostril at a time

29
Q

Expected Pharmacological Action

Antitussives - codeine and dextromethorphan

A

Depress pain impulse transmission at the spinal cord level by interacting with opioid receptors
Decreases cough reflex, GI motility

30
Q

Adverse Effects

Antitussives - codeine and dextromethorphan

A

CNS depression (drowsiness, sedation common with opioid antitussives; only occurs in non-opioid antitussives if you give large doses or other CNS depressant drugs concurrently)
Dizziness, lightheadedness (more common with opioid antitussives)
Gastrointestinal distress (nausea, vomiting)
Respiratory depression (opioids only)
Potential for abuse

31
Q

Contraindications

Antitussives - codeine and dextromethorphan

A

Known sensitivity to the drug
MAO inhibitors or SSRIs
Prostatic hypertrophy
Reduce respiratory reserve (emphysema, chronic asthma)
History of substance abuse
Use cautiously in children and older adults

32
Q

Expected Pharmacological Action

Expectorants - guaifenesin

A

The expected pharmacological action of expectorants is a reduction in the surface tension of secretions. This thins out thick mucous, making it easier to cough out of the lungs and drain out of the nose and sinuses

33
Q

Client Education

Expectorants - guaifenesin

A

Do not take before driving or activities requiring mental alertness
Sit or lie down if feeling lightheaded
Change positions gradually
Take the drug with food and/or 8oz of water
Stop taking the drug and seek medical care if experiencing an allergic reaction

34
Q

Evaluation of Medication Effectiveness

Expectorants - guaifenesin

A

Cough is more productive and mucous is easier to expectorate

Chest congestion is decreased

35
Q

Therapeutic Use

Mucolytic - acetylcysteine

A

Decrease viscosity of mucous secretions

Reverse acetaminophen overdose

36
Q

Client Education

Mucolytic - acetylcysteine

A 
Report any difficulty breathing or worsening cough
Expectorate secretions
Take antiemetic as needed
Proper use and cleaning of nebulizer
Consume 2,000 to 3,000 mL of water daily
37
Q

Contraindications

Mucolytic - acetylcysteine

A

Risk of actual gastric bleeding

Pharmacology (9 decks)

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