Respiratory and Antihistamines+ Flashcards
Asthma vs. COPD
asthma: recurrent/reversible shortness of breath
-mucus production, bronchospasms, inflammation of respiratory system
-triggered by allergies, illness, environment
COPD: progressive, irreversible lung disease
-damaged cilia –> hard to clear lungs
-often from smoking
Name the Bronchodilator drugs.
Beta-adrenergic agonists, anticholinergics, xanthine derivates
Short-acting bronchodilators (examples, MOA, side effects)
-albuterol, levalbuterol (rescue inhalers)
-MOA: binds to beta 2 receptors in lungs –> bronchodilation
-SFX: tachycardia, headache, tremor
The ‘nursing consideration’ for almost all respiratory drugs
-make sure med is appropriate for symptoms (long vs short acting)
-make sure technique is appropriate if using inhaler
-respiratory assessment, maybe cardiac
Long-acting bronchodilators (examples, MOA, side effects)
-salmeterol, formoterol, arformoterol
-MOA: binds to beta 2 receptors in lungs –> bronchodilation
-SFX: hypertension, headache
Anticholinergic drugs (examples, MOA, side effects)
-ipratropiums, tiotropium, combivent
-MOA: Ach agonist –> bronchodilation
-SFX: dry mouth (reduces secretions), congestion, palpitations, GI distress
Xanthine derivates (examples, MOA, side effects, considerations)
-theophylline, aminophylline
-MOA: stimulates cAMP production –> bronchodilation + respiratory drive
-SFX: nervousness, tremors, insomnia, GI distress
-Consider: AVOID other sources of caffeine!
Non-Bronchodilating medications
leukotrine receptors, corticosteroids, mast cell stabilizers
Leukotrine receptor antagonists (examples, use, MOA, considerations)
-montelukast, zafirlukast
-use: reduces mucus production, inflammation, coughing for allergic rhinitis and asthma
-MOA: leukotrine antagonist (duh)
-consider: takes a week to work, best used prophylactically (like for flu season), take HS
What population should not take L-receptor antagonists?
For asthma: under 12 y/o
Corticosteroid examples, MOA, SFX/considerations,
+systemic?
-fluticasone, budensonide, belcomethasone
-MOA: anti-inflammatory (mostly used for chronic asthma)
-SFX/consider: thrush–rinse mouth after use, take a week to work
Systemic: prednisone/prednisolone–work thru whole body, must taper, makes you Hangry
You should always take _______ before taking _____ for asthma, if taking both. Why? What med has both of those meds?
-bronchodilators, corticosteroids
-Allows anti-inflamm steroids to reach more of airway
-Combo med: fluticasone/salmeterol
Phosphodiesterase-4 inhibitor (examples, MOA/use, side effects)
-roflumilast
-MOA is in name, prevents coughing/mucus from worsening for COPD
-SFX: GI/weight loss, headache, insomnia
Monoclonal antibodies (example, MOA, SFX)
-omalizumab
-MOA: competitively binds to IgE (immune response that causes allergic reaction)
-SFX: MI, venous thromboembolism, inj. site reaction
First line meds to treat active TB + their side effects
“RIPE ONGLE”
Rifampin (Orange tears/sweat/urine)
Isoniazid (peripheral Neuropathy)
Pyrazinamide (Gout-like symptoms)
Ethambutol (Liver toxicity and Eyesight impaired)
Nursing considerations for TB treatment
-intense side effects
-need for multiple meds
-risk of MRD-TB
-STRICT ADHERENCE NECESSARY, but difficult!
Meds for latent TB, in order of treatment time
-isoniazid and rifapentine (weekly, 3 mo)
-rifampin (daily, 4 mo)
-isoniazide (daily, 6-9 mo)
Preventing TB and TB risks
Prevention:
-Mantoux skin test
-BCG vaccine
Risks:
-immunocompromised
-travel
Meds to treat MDR-TB
-bedaquiline (ATP synthetase inhibitor)
-streptomycin (antibiotic)
Patients taking ______ for ___ may need to supplement w/ a B6 vitamin
Isoniazid, TB
The common cold is caused by:
And are treated by:
a virus, often rhinovirus
antihistamines, decongestants, antitussives, expectorants, rarely antivirals etc.
Cough and cold products shouldn’t be given to children under ___ due to side effects like…
-2
-oversedation, tachy, seizure, death
herbal cold remedies/properties
-Echinacea: stimulates immune system while sick
-adverse effects: GI, dizziness, headaches
no w/: amiodarone, cyclosporine, phenytoin, methotraxate, barbituates
-Goldenseal: URIs, allergies, congestion
adverse effects: mood, GI
-promotes GI excretion, vasodilation so interacts w/ antacids, hypertensive meds, H2 blockers
Older antihistamine examples, MOA, side effects, interactions/contraindications
-diphen, promethazine, meclizine/dramamine, hydroxyzine
-MOA: Nonspecific antagonists for H1 (+H2) sites, prevent body overreaction/reduce symptoms. Are also are sedative, anticholinergic
-SFX: drowsiness, additive w/ other meds (some SSRIs, alcohol), dry mouth, constipation, dysuria
-contras: COPD, cardiac disease, kidney disease
New antihistamines (ex, MOA, considerations)
-fexofenadine (Allegra), loratadine (Claritin), certirizine (Zertec)
-MOA: same as older A-hists, but work only peripherally and reduce side effects
-do good assessment, discontinue 4d before allergy testing
Oxymetazoline (Afrin) class, MOA, considerations
adrenergic decongestant
MOA: vasoconstriction
-SFX: CNS stim: jitters, insomnia, palpatations, tremor
-take only for 3 days at a time (can lead to rebound)
Sudafed class, MOA, considerations
adrenergic decongestant
-MOA: vasoconstriction
-SFX: CNS stim: jitters, insomnia, palpatations, tremor
-considerations: hypertension, abuse potential
Ipratropium MOA, class
anticholinergic decongestant
-not used often
-reduces amount of mucus in noes
Corticosteriod decongestants: examples, MOA, considerations
-fluticasone, triamcinolone, budenoside
-MOA: decrease inflammation
-SFX: dryness, local irritation
-local given (spray, topical)
Contraindications for nasal decongestants
-gluacoma
-CV disease
-hypertension
-long-standing asthma
Opiod antitussives: example, MOA, side effects
-codeine (S5 drug), hydrocodone
-MOA: pain relief, dry secretions, dull cough reflex in medulla
-SFX: sedation, N/V, constipation, lightheaded
Opioids are the ______ effective cough supressant
most
Non-opiod antitussive examples and their MOAs, SFX
-Benzonatate: numbs stretch receptors in respiratory
-Robatussin: dries mucosa of res system (prevents post nasal drip)
SFX (both): drowsy, dizzy, nausea
Expectorants example/use, MOA, side effects
-for productive coughs
-SFX: NV, drink fluids!
Epinephrine class, MOA
-nonselective adrenergic med
-MOA: stimulates B1, B2 (cardiac and respiratory receptors) and alpha receptors –> relaxes sm muscle, increases HR
