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Patho 1 > Respiratory drugs > Flashcards

Respiratory drugs Flashcards

1
Q

H1 blockers MOA

A

bind to H1 receptors and block histamine release; mild anticholinergic effect

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2
Q

SE for all H1 blockers

A

Anticholinergic–constipation, urinary retention, dry mouth

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3
Q

Contraindications for H1 blockers

A

can inc BP–Closed angle glaucoma, cardiac disease, kidney disease, HTN, bronchial asthma, COPD, PUD, seizures, BPH, preg
- if disease is controlled, its prob fine

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4
Q

Diphenhydramine Class and indications

A
  • 1st gen sedating antihistamines
  • Mild allergic rxns, motion sickness, insomnia, can be given with severe anaphylactic rxns
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5
Q

Diphenhydramine SE

A

Drowsy, dizzy, severe CNS depression, dry mouth, urinary retention, constipation, often knocks people out, can make ppl hyperactive (often kids)

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6
Q

Diphenhydramine NC

A
  • PO and IV
  • monitor for urinary retention and constipation, dizziness when ambulating
  • avoid driving and tasks for mental alertness (take drug at night if necessary)
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7
Q

Loratadine (claritin), fexofenadine (Allegra), cetirizine (Zyrtec) class and indications

A

2nd gen non-sedating antihistamines
- allergic rhinits
- chronic idiopathic urticaria

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8
Q

Loratadine (claritin), fexofenadine (Allegra), cetirizine (Zyrtec) SE

A

Fewer SE, less drowsy and fatigue

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9
Q

Loratadine (claritin), fexofenadine (Allegra), cetirizine (Zyrtec) NC

A
  • can take in the morning
  • all PO
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10
Q

Dextromethorphan, codeine, benzonatate (Tessalon Perles) class and indications

A

Antitussive; cough suppressant (chronic or acute)

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11
Q

Dextromethorphan, codeine, benzonatate (Tessalon Perles) MOA

A

Directly suppresses the cough reflex in the brain

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12
Q

Dextromethorphan, codeine, benzonatate (Tessalon Perles) SE

A

CNS depressant

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13
Q

Dextromethorphan, codeine, benzonatate (Tessalon Perles) NC

A
  • PO, syrups, sprays, lozenges
  • DON’T take with other CNS depressants (esp codeine)
  • dextro and codeine can by abused
  • Codeine and benzonatate RX
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14
Q

Guaifenesin (mucinex) class and indications

A

Expectorant, dec mucus in colds, bronchitis

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15
Q

Guaifenesin (mucinex) MOA

A

Dec surface tension of sec helping make mucus easier to cough up

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16
Q

Guaifenesin (Mucinex) SE and NC

A
  • few mild GI
  • encourage fluids
  • be careful with asthma pt and chronic cough
  • questionable efficiency
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17
Q

Acetylcysteine (Mucomyst) class and indications

A

Mucolytics; bronchopulmonary disease, CF

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18
Q

Acetylcysteine (Mucomyst) MOA

A

dec viscosity of mucus–easier to cough up

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19
Q

Acetylcysteine (Mucomyst) SE and NC

A
  • Few SE, BRONCHOSPASM may occur, SMELLS AWFUL
  • best thru neb or trach
  • monitor lungs closely
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20
Q

ipratropium class and indications

A

Anticholinergics, PROPHYLAXIS and maintenance, not rescue

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21
Q

ipratropium MOA

A

Work on acetylcholine receptors–turn off PNS and on SNS–bronchodilation

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22
Q

ipratropium SE and NC

A
  • Dry as a bone, hot as a hatter, blind as a bat, red as a beet, mad as a hatter
  • often given with albuterol
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23
Q

Theophylline (TheoDur/Theo-24) and aminophylline MOA

A

Inc levels of the cAMP enzyme by inhibiting phosphodiesterase–stim CNS and CVD sys–inc smooth muscle relax and bronchodilate

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24
Q

Theophylline (TheoDur/Theo-24) and aminophylline class and indications

A
  • xanthine derivatives
  • prevent tx asthma attack and COPD exacerbations
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25
Q

Theophylline (TheoDur/Theo-24) and aminophylline SE

A

Caffeine high (theophylline); N/V/D and lack appetite more normal SE; tox–tachy, HA, insomnia, dysrthmias, sz

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26
Q

Theophylline (TheoDur/Theo-24) and aminophylline NC

A
  • 2nd line bc high risk tox–reverse with activated charcoal
  • CI: peptic ulcer, sz dx, hyperthyroid, uncontrolled cardiac dysrhythmias
  • intx with caffeine (inc fx) and smoking (dec absorption)–may dec dose if stop smoking
  • narrow therapeutic index–monitor serum levels
  • lots drug intx
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27
Q

Montelukast, zafirlukast class and indications

A

Leukotriene receptor antagonist (LTRA); Prophylaxis and chronic tx of asthma

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28
Q

Montelukast, zafirlukast MOA

A

Prevent leukotrienes from attaching to receptors located on immune cells and within the lungs, prevent inflam

29
Q

Montelukast, zafirlukast SE

A

HA, N/D, dizzy, insomnia

30
Q

Montelukast, zafirlukast NC

A
  • give PO
  • can give to kids over 12M
  • zafirlukast can only be given to kids over 5Y
  • chewable tabs and granules
  • improve in a week
  • mont has few drug intx (Zafir has more)
  • NOT acute asthma
31
Q

Beclomethasone, budesonide, fluticasone, dipropionate class and indications

A

Inhaled corticosteroids; prevent persistent asthma attacks and COPD

32
Q

Beclomethasone, budesonide, fluticasone, dipropionate MOA

A

Dec inflam and enhance activity of beta agonists (also help with bronchodilate)

33
Q

Beclomethasone dipropionate, budesonide, fluticasone SE

A

Pharyngeal irritation, cough, dry mouth, oral fungal infx

34
Q

Beclomethasone diproprionate , budesonide, fluticasone NC

A
  • Give with neb or MDI
  • can takes weeks of cont therapy before full effect
  • give bronchodilator FIRST then corticosteroid
  • RINSE MOUTH AFTER
35
Q

Budesonide & formoterol, fluticasone & salmeterol class and indications

A

Combo: inhaled glucocorticoid and bronchodilator; mod to severe asthma, never for ACUTE attack

36
Q

Which drug combo works faster?

A

Budesonide & formoterol

37
Q

Cromolyn (Intal) class and indications

A

mast cell stabilizer; prevent acute asthma attack

38
Q

Cromolyn MOA

A

Stabilize membranes of mast cells and prevent release of broncho-constrictive inflam subs

39
Q

How to use cromolyn

A

Take 15-20 minutes prior to known trigger

40
Q

Omalizumab (Xolair) class

A

monoclonal antibody anti-asthmatic

41
Q

Omalizumab MOA

A

Monoclonal antibody selectively binds to immunoglobulin IgE which limits release of mediators of allergic response

42
Q

Omalizumab NC

A
  • injection
  • monitor for hypersensitivities–BIG RISK ANAPHYLAXIS (CLOSE MONITOR)
43
Q

Roflumilast class and indications

A

Selective PDE-4 inhibitor; prevention of COPD exacerbation

44
Q

Roflumilast MOA

A

PDE-4 inhibitor–dec inflam in lungs

45
Q

Roflumilast SE and NC

A

N/V/D, HA, muscle spasm, dec appetite, uncontrolled tremors
- oral
- not work acute or immediate

46
Q

Target of traditional allergy meds

A

H1 receptors

47
Q

Phenylephrine, pseudoephedrine (Sudafed) class and indications

A

Sympathomimetics
- nasal congestion, allergic rhinits, sinusitis, common cold

48
Q

Phenylephrine, pseudoephedrine (Sudafed) MOA

A

Mimics the action of SNS, activates alpha1-adrenergic receptors–causes vasoconstriction of BVs, causing nasal turbinates to shrink and opens nasal passages

49
Q

Phenylephrine, pseudoephedrine (Sudafed) SE

A

Dry you out, all r/t to CNS stimulation–agitation, insomnia, anxiety, tachy, heart palpitations “wired”

50
Q

Phenylephrine, pseudoephedrine (Sudafed) NC

A
  • don’t use for over 4 days bc rebound congestion occurs when stop after prolonged use–TAPER
  • pseudoephedrine has potential for abuse but works better bc CNS stim “upper”–register and limit on it
  • OTC about requirements and limits on how much
51
Q

Beta adrenergic agonists

A

short or long acting drugs

52
Q

How long do long acting drugs work? indications?

A

12-24h; prevention drugs (extended release-like)

53
Q

Beta adrenergic agonist MOA

A

mimic action of SNS with fight or flight; relax and dilate airways by stim beta2-adrenergic receptors thru lungs–bronchial dilation and inc airflow in and out is the goal

54
Q

Non-selective adrenergic drugs: name and MOA

A

Epinephrine; Stim both beta 1 and 2 receptors AND alpha receptors which causes vasoconstrict and dec edema and swelling in mucus mems, dec secretions; also stim beta1 which causes CV fx like inc HR and BP and CNS stim–nerves and tremors

55
Q

Non-selective beta-adrenergic MOA

A

stim beta 1 and 2 receptors, no alpha

56
Q

Selective beta 2 receptors: MOA

A

Only acts on beta 2 receptors; preferred for pulmonary conditions

57
Q

Which beta agonist drugs have the most adverse effects?

A

non-selective

58
Q

beta adrenergic agnonist indications

A

prevention or relief of bronchospasm r/t asthma/bronchitis, other pulm condx (will be used for condx otuside pulm sys too)

59
Q

Beta adrenergic agonist CIs

A

Uncontrolled HTN, cardiac dysrhythmias, high risk for stroke

60
Q

Short acting beta agonist: name, indication, length of time to work

A

Albuterol and levalbuterol, work immediate, last 4-6h, rescue, PO or inhaler

61
Q

long acting beta agonist name, indication, runtime

A

Salmeterol and formoterol, preventers, last 12-24h, only inhaled

62
Q

Beta agonist SE

A

HTN or hypotxn, insomnia, restlessness, anorexia, cardiac stimulation, hyperglycemia, tremor, vascular HA

63
Q

Beta agonist NC

A
  • fx may dec with beta blockers
  • avoid use with MAOIs and sympathomimetics–HTN
  • if give with beta blocker (can reverse), watch for bronchospasm
  • v short half life
  • may inc need for insulin
64
Q

Albuterol/Proventil indications

A

***first line tx of acute asthma attack, also bronchitis, emphysema; acute wheeze, chest tight, SOA–Not for everyday use; prevent exercise-induced asthma

65
Q

Albuterol/Proventil NC

A
  • onset in minutes
  • inhale q4-6h
  • used for exercise induced asthma inhaler
  • NOT for daily use
  • use more than 1 canister/M indicates inadequate control os asthma–need to inc anti-inflam therapy
66
Q

salmeterol NC

A
  • inhale 2x/d
  • use with inhaled corticosteroid
  • inc asthma-related deaths (esp in Black pop)
67
Q

Preventer meds

A

Anticholinergics, xanthine derivatives, inhaled corticosteroids, leukotriene modifiers, mast cell stabilizers, LABA

68
Q

Quick relief/rescue meds

A

SABA, albuterol/Proventil

Patho 1 (30 decks)

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