Respiratory Drugs Flashcards
Xanthines cause bronchodilation by increasing levels of energy producing substance cAMP. Competitively inhibit phosphodiesterase, the enzyme responsible for breaking down cAMP. (higher cAMP contributes to smooth muscle relaxation and inhibits Ig-E induced chemical mediators
Animophylline
Prodrug of theophylline, that is metabolized to theophylline in the body
aminophylline
Sometimes given to patients with status asthmaticus that haven’t responded to fast acting b-agonists such as epinephrine
aminophylline
Adverse effects such as nausea, vomiting, anorexia, GI reflux, transient urination and hyperglycemia, and cardiac AE.
Xanthine derivatives
Consist of plant alkaloids caffeine, theobromine, and theophylline
Xanthine derivatives (natural)
Increase the levels of cAMP
xanthine derivatives
Potential overdose of xanthine derivatives
charcoal
Method for taking respiratory corticosteroid meds
shake, inhale, rinse mouth. Should use aerochamber
Important patient teaching to rinse mouth and gargle with warm water after admin. to prevent development of oral fungal infections.
Fluticasone
If taking a b-agonist bronchodilator, the bronchodilator should be taken several minutes before to provide bronchodilation before admin. of corticosteroid.
Fluticasone patient teaching
Drugs used in treatment of acute asthma attack
Short acting b2-agonists (sympathomimetics)
Inhaled ipratropium treatment for
acute asthma attack
inhaled corticosteroids and LABA (specifically budesone and formoteral - Symbicourt use)
acute asthma attack
Corticosteroid adverse effects
Irritation, dry mouth, oral fungal infections
Can affect any organ (systemic)
The nurse is teaching a group of patients about the use of bronchodilators. It is important to remind them that using bronchodilators too frequently can cause which AE? select all
a) blurred vision
b) increased heart rate
c) decreased heart rate
d) nausea
e) nervousness
f) tremors
b, d, e, f
What health teaching must the nurse provide to a patient on leukotriene agonist therapy?
a) if a dose is missed, the patient may take double the dose to maintain therapeutic blood levels
b) the patient should gargle or rinse mouth after taking
c) the drug should be taken at the first sign of bronchospasm
d) improvement should be seen within one week of use
d) improvement should be seen within 1 week of use
Which drug acts by blocking leukotrienes, thus reducing inflammation in the lungs?
a) salbutamol
b) methylprednisalone
c) theophylline
d) montelukast
d) montelukast
A patient is experiencing status asthmaticus. What priority drug should the nurse prepare to administer?
a) salbutamol
b) epinephrine
c) theophylline
d) montelukast
b) epinephrine
Which adverse effect should the nurse monitor for a patient taking parenteral xanthine derivatives, such as aminophylline?
a) decreased respirations
b) hypotension
c) tachycardia
d) hypoglycemia
c) tachycardia
A patient who is taking a B-adrenergic agonist for bronchodilation may also take which type of inhaled drug for it’s anti-inflammatory effects?
a) corticosteroid
b) anticholinergic
c) xanthine derivatives
d) antileukotriene
a) corticosteroids
A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. Which medication will the nurse choose for this situation?
a) a b-agonist
b) a leukotriene receptor agonist, such as montelukast
c) a corticosteroid, such as fluticasone
d) an anticholinergic, such as ipratropium
a) a b-agonist
After a nebulizer treatment with the b-agonist salbutamol, a patient reports feeling a little “shakey”, with slight tremors of the hands. The patients heart rate is 98 bpm, increased from the pretreatment rate of 88 bpm. The nurse knows that this reaction is a result of which effect?
a) an expected AE of the med
b) an allergic reaction from the med
c) an indication that he has received an overdose of the med
d) an idiosyncratic reaction to the med
a) an expected AE of the med
A patient has been recieving an aminophylline (xanthine derivative) infusion for 24 hrs. The nurse needs to observe for which adverse effects when assessing the patient during the infusion?
a) CNS depression
b) sinus tachycardia
c) increased appetite
d) temporary urinary retention
b) sinus tachycardia
During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (Singular), the nurse will tell the patient that the drug has which therapeutic effect?
a) improves the respiratory drive
b) loosens and removes thickened secretions
c) reduces inflammation in the airway
d) stimulates immediate bronchodilation
c) reduces inflammation in the airway
After a patient takes a dose of an inhaled corticosteroid such as fluticasone (Flovent), what is the most important action the patient needs to do next?
a) hold the breath for 60 seconds
b) rinse mouth with water
c) follow the corticosteroid with a bronchodilator inhaler if ordered
d) repeat the dose in 15 min if feeling SOB
b) rinse the mouth with water
The nurse is teaching a patient about the inhaler Advair (Salmeterol and fluticasone). Which statements by the patient indicate a correct understanding of this medication? select all
a) I will rinse my mouth with water after each dose
b) I need to use this inhaler whenever I feel SOB but make sure its not less than 4 hrs between doses
c) this medication is taken twice a day, every 12 hrs
d) I can take this inhaler if I get SOB while exercising
e) I will call my doctor if I notice white patches inside my mouth
a, c, e
