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pharmacology > respiratory drugs > Flashcards

respiratory drugs Flashcards

1
Q

a substance found in various parts of the body (liver, lungs, intestines, skin)
-Produced in response to injury

A

histamine

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2
Q

effect of histamines

A
  • Dilation of arterioles = localized redness

- Increased permeability of capillaries and veins = localized swelling

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3
Q

Mast cells release ____ in allergic reactions such as anaphylactic shock

A

histamine

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4
Q

first generation antihistamines

A

benadryl

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5
Q

second generation antihistamines

A

allegra, zyrtec

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6
Q

Drugs to counteract the effects of histamine. Also referred to as H1 Blockers.

A

antihistamines

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7
Q

examples of antihistamines

A
  • diphenhydramine (Benadryl)
  • desloratadine (Claritin)
  • fexofenadine (Allegra)
  • cetirizine (Zyrtec)
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8
Q
  • Relief of symptoms of seasonal allergies
  • Allergic rhinitis
  • Allergic conjunctivitis
  • Relief of allergic reactions to medications or blood products
  • Relief of coughs associated with allergies
  • Relief of uncomplicated urticaria
  • Treatment of Parkinsonism
  • Relief of nausea and vomiting
A

uses of antihistamines

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9
Q

adverse reactions of antihistamines

A
  • Drowsiness and sedation common
  • May have anti-cholinergic effect =
  • –Dryness of mouth, change in vision, difficulty urinating, and constipation
  • –Thickening of bronchial secretions
  • Possible photosensitivity
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10
Q
  • Caution in use with patients with bronchial asthma, CV disease, hypertension, urinary retention, impaired kidney function
  • Increase in anti-cholinergic effects when given with an MAO inhibitor (MAOI)
  • Additive sedative effect with other CNS depressants or alcohol
  • Do not consume antihistamines with apple, grapefruit, or orange juice. This can make the anticholinergic effects worse.
A

precautions of antihistamines

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11
Q
  • Do not drive
  • Avoid use of alcohol
  • Inform about mouth dryness (frequent water). If fluids are contraindicated, then use hard candy.
  • 30 min to 1 hour prior to travel if used for motion sickness
  • Possible photosensitivity so use sunscreen and sun barrier devices.
A

pt teaching for antihistamines

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12
Q

A drug that decreases swelling of the nasal passages = opens clogged nasal passages and enhances drainage of the sinuses

A

decongestants

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13
Q

Three main groups of decongestants

A

adrenergic (sympathomimetic), nasal steroids, and anticholinergics

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14
Q

examples of decongestants

A
  • oxymetazoline (Afrin)- nasal spray
  • pseudoephedrene (Sudafed)
  • Fluticasone furoate (Flonase)- nasal steroid

OPF

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15
Q

actions of decongestants: Sympathomimetic (mimics the SNS) =

A

produce localized vasoconstriction of the small blood vessels of the nasal membranes (reduces swelling)

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16
Q

actions of decongestants: Nasal steroids

A

work on the inflammatory response by eliciting a strong anti-inflammatory action which in turn reduces swelling in the nasal passage.

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17
Q
  • Treat congestion associated with rhinitis, hay fever, allergic rhinitis, sinusitis and common cold.
  • Caution = OVERUSE = can result in rebound congestion = congestion becomes worse than it originally was.
A

uses of decongestants

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18
Q

adverse reactions of decongestants

A
  • Tachycardia
  • Cardiac arrhythmias
  • Nervousness, restlessness, insomnia
  • Can increase blood pressure
  • Mucosal irritation and dryness
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19
Q

Drug used to relieve coughing
–Productive cough = secretions from lower respiratory tract are expelled
–Non productive cough = dry, hacking cough with no secretions
(May be combined with other drugs to combine actions and effects)

A

antitussives

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20
Q
  • Depress cough center located in medulla

- Anesthetize stretch receptors in respiratory passages = decrease coughing

A

Actions of Antitussives

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21
Q

uses of antitussives

A
  • To relieve non productive cough
  • To relieve a cough when it can be harmful
  • When the patient has a productive cough, physical exam may indicate whether to suppress cough or allow expectoration
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22
Q

Codeine may result in respiratory depression, nausea, vomiting, sedation, lightheadedness, and constipation

benzonatate (Tessalon) may result in dizziness, headache, sedation, constipation, nausea, and nasal congestion.

A

ADVERSE REACTIONS OF ANTITUSSIVES

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23
Q
  • Caution with persistent cough, productive cough, fever. Depression of cough reflex can result in pooling of secretions in the lungs.
  • Additive CNS effects when combined with other CNS depressants or alcohol.
A

special precautions of antitussives

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24
Q

Mucolytic

A
  • loosens respiratory secretions
  • –Reduces viscosity (thickness)
  • –Example = Mucomyst
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25
Q

Expectorant

A
  • Aids in raising thick mucus from the respiratory passages
  • -Increases production of secretions
  • -Example = Guaifenesin
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26
Q

actions of expectorants

A
  1. reflex stimulation

2. direct stimulation of secretory gland in the respiratory tract

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27
Q

where loosing and thinning of secretions in the respiratory tract occur due to response to an irritation of the GI tract produced by the drug.

A

Reflex stimulation

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28
Q

uses of expectorants

A
  • Relief of productive cough
  • Thinning and loosening sputum and bronchial secretions
  • Indirectly work on suppression of cough
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29
Q

nursing process for expectorants

A

Antitussives may be given to suppress non productive cough that may cause problems with the increased strain of coughing

For productive coughs = note the color and amount of expectorant

Assess for effect of medication

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30
Q

Bronchodilators

A
  • Short-acting beta-2 adrenergic (SABA)
  • Long-acting beta-2 adrenergic (LABA)
  • Xanthine derivative
  • Cholinergic blocking (anticholinergic)
31
Q

antiasthma

A
  • Inhaled corticosteroids
  • Mast cell stabilizer
  • Leukotriene modifier & Immunomodulator
32
Q

Respiratory condition characterized by recurrent attacks of dyspnea and wheezing caused by spasmodic constriction of the bronchi

A

asthma

33
Q

what happens with asthma?

A
  • Body responds with inflammatory response
  • Histamine released from mast cells
  • Increased mucous production
  • Edema of airway = = bronchospasm and inflammation
34
Q
  • To decrease inflammatory process

- Increase sensitivity of the B2 receptors

A

corticosteroids (asthma meds)

–Example = beclomethasone (QVAR); fluticasone (Flovent)

35
Q
  • Leukotriene (Bronchoconstrictive substance)

- Inhibiting results in bronchodilation

A 
leukotriene inhibitors (asthma meds)
--Example = montelukast sodium (Singular); zafirlukast (Accolate)
36
Q

-Prevent release of substances causing bronchoconstriction and inflammation from mast cells

A

Mast cell stabilizers (asthma meds)
(Mast cells contain histamine)
–Examples = cromolyn (Gastrocrom)

37
Q

Drug used to relieve bronchospasm associated with:
Asthma
Bronchitis
Emphysema

A

bronchodilators

38
Q

Decrease in lumen of bronchi
Decrease in amount of air into the lungs
Results in respiratory distress

A

Bronchospasm

39
Q

Open the airway
Allows more air to enter the lungs
Relieves respiratory distress

A

Bronchodilators

40
Q

two types of bronchodilators

A
  1. Sympathomimetic bronchodilator

2. Xanthine derivatives

41
Q

ex of Sympathomimetic bronchodilator

A
  • epinephrine (Adrenalin)
  • albuterol (Proventil)
  • levalbuterol (Xopenex)
42
Q

ex of Xanthine derivatives

A
  • theophylline (Theolair)

- aminophylline

43
Q

(anti asthma) manage inflammation

A

corticosteroids

44
Q

(anti asthma) can be used in prevention of exercise induced asthma

A

Mast Cell Stabilizers

45
Q

_____ to treat reversible airway obstruction caused by bronchospasm with a asthma, bronchitis, emphysema

A

Bronchodilators

46
Q

adverse reactions of bronchodilators

A
  • Restlessness, anxiety
  • Increased in blood pressure
  • Palpitations, arrhythmias
  • Dry mouth and throat
  • Headache
  • Insomnia, tremors
47
Q
  • Potent drugs
  • Act quickly and work well during acute asthma attacks
  • Epinephrine, albuterol, alupent
A

Sympathomimetics (beta-agonist)

48
Q
  • Theophyllinizaton
  • They are used to dilate the airways in patients with asthma
  • Discourage caffeine type drugs
  • Monitor for tachycardia
A

Xanthine Derivatives

49
Q

give loading doses and monitor blood level

A

Theophyllinixation (xanthine derivatives)

50
Q
  • They help with bronchial dilation and prevent bronchial constriction or spasms.
  • They are used in Chronic Obstructive Pulmonary Disease (COPD)
A

Anticholinergic

51
Q

example of anticholinergic meds

A

Ipratropium (Atrovent)

52
Q

When receiving sympathomimetic bronchodilator and corticosteroid by inhalation, give the ______ first, then after several minutes give the ________.

A

bronchodilator, corticosteroid.

53
Q

anticholinergic side effects

A
  1. Hot as a hare
  2. Dry as a bone
  3. Blind as a bat
  4. Red as a beet
  5. Mad as a hatter
54
Q

asthma s&s

A
  • cough
  • increased mucus
  • SOB
  • wheezing/prolonged expiration
  • increased CO2 retention
  • chest tightness
  • retractions
55
Q

triggers of asthma:

A
  • hypersensitivity
  • URI
  • Exercise
  • Air pollutants
  • Respiratory infections
  • GERD
56
Q

Nursing process for bronchodilators

A
  • Observation and documentation of vital signs
  • Assess lung fields (note wheezing, cough, dyspnea)
  • Describe sputum if present
  • Any symptoms of hypoxia ( restless, confusion, cyanosis)
  • monitor respiratory status every four hours
57
Q

special considerations of bronchodilators

A
  • -Caution in use of sympathomimetics with patients with hypertension, cardiac dysfunction, hyperthyroidism
  • -Additive effect when used with other sympathomimetics
58
Q
  • Do not increase dose of med unless instructed by primary provider
  • If GI Upset, take med with food or milk
  • 6-8 glasses of water (helps loosen secretions)
  • Instruct on med side effects
  • Avoid colas, coffee when on Xanthines
  • Use of medication inhalers
A

pt teaching for bronchodilators

59
Q

s&s TB

A
  • Progressive fatigue
  • Malaise
  • Anorexia
  • Weight loss
  • Chronic cough (productive)
  • Night sweats
  • Hemoptysis
  • Pleuritic chest pain
  • Low grade temp
60
Q

tuberculosis

A

Infectious disease caused by Mycobacterium tuberculosis

61
Q
  • Characterized by granulomas in the lung fields
  • Easily spread from person to person
  • Spread by droplets from coughing or sneezing
  • Primarily affects lungs but can spread via lymphatic system to other areas of the body
A

TB

62
Q

The drugs used to treat infections caused by Mycobacterium are called ________.

A

antitubercular drugs.

63
Q

two main categories of anti tubercular drugs:

A
  • first line (primary)

- second line (secondary)

64
Q

First line

A

used as a primary drug to fight off the infection (foundation).

65
Q

Second line

A

used as secondary drugs when a patient is resistant to the first line drugs or have a more complicated case of TB (more toxic than first line).

66
Q

__ responds well to ____ treatment with a combination of ___ or more ____ drugs.

A

TB, long term, two, anti tubercular drugs.

67
Q

anti tubercular drug uses

A
  • Used to treat active cases of TB

- Used as prophylaxis to prevent spread of TB

68
Q

Common treatment for pulmonary TB is combination of any of the following:

A

-Isoniazid (INH)
-Rifampin
-Pyrazinamide (PZA)
-Ethambutol or Streptomycin
-With combination the treatment is 95% effective at treating the infection and reducing resistance.
(single-dose daily for 12 months)

69
Q

anti tubercular drugs are _____ = they slow or retard growth of M. tuberculosis bacillus. Only Isoniazid (INH) is bactericidal.

A

bacteriostatic

70
Q

(anti tubercular drugs) The drugs do not “cure”, they-

A

render the patient noninfectious to others.

71
Q

Only anti TB drug that can be used alone, but it can be used in combination with other drugs as well.

A

Isoniazid

72
Q
  • Most common = peripheral neuropathy
  • Possible severe hepatitis
  • Increased risk of hepatotoxicity when used in combination with rifampin
  • Can cause depletion of the B-vitamins
  • Can turn bodily secretions an orange-red color, increased when used in combination with Rifampin (explain to patient that this is a normal finding).
A

adverse reactions of Isoniazid

73
Q

nursing process for isoniazid

A
  • With Diagnosis of TB, provider goal is to make patient noninfectious to others
  • Observe patient for signs of adverse reactions (hepatotoxicity, nephrotoxicity, and ototoxicity)
  • Meds given PO on empty stomach
  • Meds taken for a long period of time (12 months)
  • Most common problem is patient non-compliance due to side effects and the growing number of TB cases that are resistant to common drug therapies.
74
Q
  • Take meds on empty stomach
  • Periodic lab and clinic visits
  • Alcohol needs to be avoided to prevent liver failure.
  • Imperative that patient/family take as directed, and know that they will need to take the meds for long period of time
  • May need to use Direct
  • Observation for patients that are non-compliant with the treatment regimen.
A

pt teaching for isoniazid

pharmacology (26 decks)

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