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UNRS 113 > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

1
Q

What is the pathophysiology of viral rhinitis?

A

The virus invades mucosa of the upper respiratory tract to cause URI (upper respiratory tract infection)

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2
Q

What are the parts of the upper respiratory system?

A

Nose
Pharynx
Larynx

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3
Q

What are the symptoms of viral rhinitis?

A 
Sneezing
Runny nose
Sore throat
Congestion
Coughing
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4
Q

How can viral rhinitis be managed?

A

Combined use of antihistamines, nasal decongestants, antitussives, and expectorants

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5
Q

Do not give OTC cough and cold products to children younger than 2

A

DANGER, DUDES!

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6
Q

What are some antihistamine drugs?

A

Diphenhydramine - Benadryl

Fexofenadine - Allegra

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7
Q

What is the mechanism of action of antihistamines?

A

Blocks histamine from binding to H1 receptor sites, preventing the adverse consequences of histamine binding including runny nose and sneezing

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8
Q

What is the drug effect of antihistamines?

A

Decreased symptoms of rhinitis (runny nose and sneezing)

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9
Q

What are the indications of antihistamines?

A

Nasal allergies
Typical symptoms of the common cold

Allergic reactions
Motion sickness
Vertigo

Sometimes used as sleep aids

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10
Q

What are the contraindications of antihistamines?

A 
Allergy
Glaucoma
Cardiac disease
Kidney disease
Hypertension
Asthma, COPD
Peptic ulcer disease
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11
Q

What are the adverse effects of antihistamines?

A 
Drowsiness
Anticholinergic effects:
-Dry mouth
-Difficulty urinating
-Constipation
-Changes in vision
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12
Q

What are nursing implications of antihistamines?

A

Possibility of sedation
Avoid driving or operating heavy machinery while sedated
Avoid alcohol and CNS depressants
Caution in asthma, glaucoma, and benign prostatic hyperplasia

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13
Q

What are the two types of antihistamines?

A

First-generation (centrally acting)

Second-generation (peripherally acting)

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14
Q

What are the differences between the two types of histamines?

A 
First-generation:
-Centrally acting
-More sedating
-Benadryl (diphenhydramine)
Second-generation:
-Peripherally acting
-Less sedating
-Longer duration of action
-Allegra (fexofenadine)
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15
Q

What is nasal congestion?

A

The blockage of nasal passages due to membranes lining the nose becoming swollen from inflamed blood vessels

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16
Q

What are the primary causes of nasal congestion?

A

Allergic rhinitis

Viral rhinitis

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17
Q

What are some nasal decongestants?

A

Pseudoephedrine - Sudafed (oral)
Oxymetazoline - Afrin (topical)
Triamicinolone - Nasocort

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18
Q

What are the main classes of decongestants?

A 
Adrenergic:
-Largest group
-Systemic
-Topical
Glucocorticoids:
-Topical
-Intranasal steroids
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19
Q

What is the mechanism of action of adrenergic decongestants?

A

Adrenergic/sympathomimetic decongestants stimulate alpha1-adrenergic receptors on nasal blood vessels which causes vasoconstriction and shrinkage of swollen vessels

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20
Q

What is the drug effect of adrenergic decongestants?

A

Relief of nasal stuffiness

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21
Q

What are some adrenergic decongestants?

A

Oral - Pseudoephedrine (Sudafed)

Topical - Oxymetazoline (Afrin)

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22
Q

What are the differences between oral and topical adrenergic decongestants?

A 
Oral:
-Prolonged decongestant effects
-Delayed onset
-PRO: No rebound congestion
Topical:
-Prompt onset with potent effect
-CON: Sustained use over several days causes rebound congestion, making condition worse
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23
Q

What is the mechanism of action of steroid decongestants?

A

Steroids exert their antiinflammatory effect and reduces inflammation of swollen nasal passages

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24
Q

What is the drug effect of steroid decongestants?

A

Decreased inflammation
Decreased congestion
Relief of nasal stuffiness

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25
What are some steroid decongestants?
Nasal spray - Fluticasone (Flonase) | Nasal spray - Triamicinolone (Nasocort)
26
What are indications for nasal decongestants?
Rhinitis Common cold Sinusitis Allergies
27
What are contraindications for nasal decongestants?
``` Allergy Glaucoma Uncontrolled cardiovascular disease Hypertension Diabetes Hyperthyroidism ```
28
What are the adverse effects of adrenergic decongestants?
Nervousness Insomnia Palpitations Tremor
29
What are the adverse effects of steroid decongestants?
Mucosal irritation and dryness
30
What are nursing implications for nasal decongestants?
Systemic adrenergic decongestants may cause hypertension, palpitations, and CNS stimulation Patients on medication therapy for hypertension or hyperthyroidism should check with their physician before taking OTC adrenergic decongestants
31
What are antitussives?
Drugs used to stop or reduce cough
32
What are the categories of antitussives?
Opioid | Nonopioid
33
What is the mechanism of action of opioid antitussives?
Suppresses the cough reflex by direct action on the cough center in the medulla
34
What is the drug effect of opioid antitussives?
Suppresses cough
35
What are some opioid antitussives?
Codeine - Robitussin-AC, Dimetane-DC | Hydrocodone cough syrup - Hycodan
36
What is the mechanism of action of nonopioid antitussives?
Suppresses cough reflex by numbing the stretch receptors in the respiratory tract
37
What is the drug effect of nonopioid antitussives?
Prevents the cough reflex from being stimulated
38
What are some nonopioid antitussives?
Dextromethorphan - Robitussin-DM | Benzonatate - Tessalon, Zonatuss
39
What are the indications for antitussives?
Nonproductive cough
40
What is a productive cough?
Cough that expels sputum from the respiratory tract
41
What is a nonproductive cough?
Dry cough with no sputum production
42
What are the adverse effects of opioid antitussives?
``` Sedation Respiratory depression Lightheadedness Nausea Vomiting Constipation ```
43
What are the adverse effects of nonopioid antitussives?
Dizziness Drowsiness Headache
44
What are the contraindications of antitussives?
Allergy Opioid dependency for opioid antitussives High risk for respiratory depression
45
What are nursing implications for antitussives?
Avoid driving or operating heavy equipment | Patients taking chewable tablets or lozenges should not drink or eat for 15 - 30 minutes afterwards
46
What are the differences between opioid and nonopioid antitussives?
Opioid: -Anaglesic effect -Has drying effect on mucosa of respiratory tract Nonopioid: -No analgesic effect -Does not cause CNS depression -Numbs stretch receptor cells in respiratory tract
47
What is expectoration?
Coughing up and spitting out excessive mucus that has accumulated in the respiratory tract
48
What is the mechanism of action of expectorants?
Reflex stimulation, which is the loosening and thinning of respiratory tract secretions Direct stimulation of secretory glands in respiratory tract
49
What is the drug effect of expectorants?
Cold and cough symptom relief
50
What is the indication of expectorants?
Productive cough
51
What is the contraindication of expectorants?
Allergy
52
What is an example of expectorants?
Guaifensin - Mucinex
53
What are the adverse effects of expectorants?
Guaifensin (Mucinex) may cause: Nausea Vomiting Gastric irritation
54
What are nursing implications for expectorants?
Patients taking expectorants should receive more fluids (if permitted) to help loosen and liquefy secretions Report a fever, cough, or other symptom lasting longer than a week
55
What is asthma?
A chronic respiratory disorder in which there is recurrent and reversible airflow obstruction (bronchoconstriction, inflammation and edema of bronchial mucosa, production of viscid mucus)
56
What causes asthma?
Allergen Cold air Exercise Emotional stress
57
What are the symptoms of asthma?
Wheezing Shortness of breath Chest tightness Coughing
58
Which drugs are used to manage asthma?
Bronchodilators Corticosteroids Leukotriene receptor antagonists
59
What are the classifications of bronchodilators?
Beta-adrenergic agonists Anticholinergics Xanthine derivatives
60
What are the types of medication used to manage asthma?
Quick relief (rescue medication): -Short-acting inhaled beta2-agonists (albuterol inhaled) Long-term control: -Long-acting beta2-agonists (salmeterol inhaled) -Inhaled glucocorticoids -Leukotriene receptor antagonists (LTRA)
61
What is chronic bronchitis?
A continuous inflammation and low-grade infection of the bronchi, leading to airflow obstruction Involves excessive secretion of mucus and certain pathologic changes in bronchial structure
62
What is emphysema?
Condition in which air spaces enlarge as a result of the destruction of alveolar walls, which reduces surface area available for oxygen and CO2 exchange, impairing effective respiration
63
What is the mechanism of action of beta2-adrenergic bronchodilators?
Stimulates beta2-adrenergic receptors on bronchial smooth muscles
64
What is the drug effect of beta2-adrenergic bronchodilators?
Muscle relaxation | Bronchodilation
65
What are examples of beta2-adrenergic bronchodilators?
Short-acting - Albuterol inh (Proventil, Ventolin) | Long-acting - Salmeterol inh (Serevent), Formoterol (Foradil)
66
What is the indication of beta2-adrenergic bronchodilators?
Bronchoconstriction
67
What are the adverse effects of beta2-adrenergic bronchodilators?
``` Insomnia Restlessness Tachycardia Palpitations Vascular headache Tremor ```
68
What are contraindications for beta2-adrenergic bronchodilators?
Allergy Uncontrolled hypertension Cardiac dysrhythmias High risk for stroke
69
What is the mechanism of action of anticholinergic bronchodilators?
Anticholinergics bind to acetylcholine (ACh) receptors to prevent bronchial constriction and narrowing of airways from occuring
70
What is the drug effect of anticholinergic bronchodilators?
Airway relaxation and dilation
71
What are indications of anticholinergic bronchodilators?
Bronchocostriction
72
What are examples of anticholinergic bronchodilators?
Ipratropium bromide inh - Atrovent | Tiotropium inh - Spiriva
73
What are contraindications of anticholinergic bronchodilators?
Allergy (atropine) Caution: -Glaucoma -Prostate enlargement
74
What are the adverse effects of anticholinergic bronchodilators?
``` Dry mouth/throat Nasal congestion Heart palpitations GI distress Urinary retention Glaucoma Headache Coughing Anxiety ```
75
What is the mechanism of action of inhaled glucocorticosteroids?
Stabilizes the membranes of cells that normally release bronchoconstricting substances
76
What is the drug effect of inhaled glucocorticosteroids?
Works to continuously decrease inflammation in airways
77
What are the indications for inhaled glucocorticosteroids?
Prevent asthma symptoms Does NOT relieve symptoms of acute asthamtic attacks Primary treatment of bronchospastic disorders
78
What are examples of inhaled glucocorticosteroids?
Fluticasone - Advair | Triamcinolone acetonide - Azmacort
79
What are the contraindications of inhaled glucocorticosteroids?
Allergy | Systemic fungal infection
80
What are the adverse effects of inhaled glucocorticosteroids?
Pharyngeal irritation Coughing Dry mouth Thrush (oral fungal infection)
81
What are nursing implications for inhaled glucocorticosteroids?
Patients should gargle and rinse mouth with lukewarm water after to prevent thrush Bronchodilator should be used several minutes before corticosteroid if ordered together
82
What is the mechanism of action of leukotriene receptor antagonists (LTRAs)?
Blocks leukotrienes from attaching to receptors that would cause inflammation, bronchoconstriction, and mucus production that results in coughing, wheezing, and shortness of breath
83
What is the drug effect of leukotriene receptor antagonists?
Alleviating asthma symptoms Reduce inflammation Prevent constriction of airways Decrease mucus secretion
84
What are examples of leukotriene receptor antagonists?
Montelukast - Singulair | Zafirlukast - Accolate
85
What are indications for leukotriene receptor antagonists?
Long-term treatment and prevention of asthma
86
What are adverse effects of leukotriene receptor antagonists?
``` Headache Nausea Dizziness Insomnia Diarrhea ```
87
What are nursing implications of leukotriene receptor antagonists?
Prophylaxis and chronic treatment of asthma in adults and children older than 12 Not meant for acute asthmatic attacks Improvement seen in about 1 week Take medication every night on a continuous schedule, even if symptoms improve

UNRS 113 (7 decks)

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