Respiratory Drugs and Corticosteroids Flashcards

1
Q

What structure ends the respiratory tree and is made up of dilated sacs?

A

The alveoli

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2
Q

What are the bronchioles?

A

Muscular elastic structures who’s diameter varies with contraction or relaxation of smooth muscle.

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3
Q

What doe lumen mean?

A

Diameter

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4
Q

What is respiration?

A

The process of bringing oxygen into the body and moving carbon dioxide out?

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5
Q

What 2 processes are involved in respiration?

A

Ventilation and perfusion

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6
Q

What is ventilation?

A

Moving air into and out of the lungs.

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7
Q

What is perfusion?

A

The flow of blood through the lungs.

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8
Q

What part of the nervous system controls the diameter of airways?

A

Autonomic nervous system

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9
Q

What receptors are activated in the sympathetic branch involving the control of airways?

A

Beta 2 adrenergic receptors

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10
Q

What receptors are activated in the parasympathetic division involving the control of airways?

A

Muscarinic receptors

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11
Q

What are bronchoconstrictive disorders characterized by?

A
  • bronchial smooth muscle spasm
  • mucosal edema
  • excessive mucous production
  • infection
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12
Q

What are some examples of bronchoconstrictive disorders?

A

Asthma, COPD, and cystic fibrosis.

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13
Q

What two components are involved with asthma?

A

Inflammatory and bronchospasm

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14
Q

What is the most common symptom of asthma?

A

Chronic cough

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15
Q

What are some acute symptoms of asthma?

A

Wheezing, chest tightness, dyspnea, and productive cough.

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16
Q

What are some of the common triggers of asthma?

A

Viral infections, environmental allergens (animal hair, smoke, temp), drugs (beta blockers), exercise, and emotions.

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17
Q

What is status asthmaticus?

A

It is an acute, refractory asthmas attack unresponsive to rigorous therapy.

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18
Q

What are some symptoms of status asthmaticus?

A

Acute anxiety, markedly laboured breathing, wheezing, tachycardia, diaphoresis, absent breath sounds are an ominous finding.

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19
Q

What is chronic bronchitis?

A

Chronic inflammation, edema, hyperplasia of the submucosal glands, and excess mucus secretion which results in a chronic, productive cough.

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20
Q

What are some of the causes of chronic bronchitis?

A

Cigarette smoking, air pollutants, occupational exposure to nitrogen and sulphur oxides.

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21
Q

What are some symptoms of chronic bronchitis?

A

Copious sputum, decreased breath sounds, wheezing, tachypnea.

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22
Q

What type of drug is the most effective for relieving acute bronchospasm?

A

Beta 2 adrenergic agonists

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23
Q

What do Beta 2 adrenergic agonists do?

A

Cause vasodilation.

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24
Q

Name a Beta-2 adrenergic agonist:

A

Ventolin

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25
Q

What is the onset, peak, and duration of Ventolin?

A
Onset = 5-15 mins (inhaled), 30 mins (PO)
Peak = 0.5-2 hours
Duration = 2-6 hours if inhaled
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26
Q

What are the adverse effects of Ventolin?

A

Palpitations, headaches, throat irritation, tremor, nervousness, restlessness, and tachycardia.

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27
Q

Name another beta 2 agonist used for bronchodilation:

A

Salmeterol

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28
Q

When should bronchodilators be taken before/during exercise to prevent exercise induced asthma?

A

1 inhalation 30 mins before activity and 15-25 mins after the onset of action.

29
Q

What other type of drugs can be used to achieve bronchodilation?

A

Anti-cholinergic drugs

30
Q

Name an anticholinergic drug used to achieve bronchodilation:

A

Atrovent (Ipratropium)

31
Q

What are some side effects of anti-cholinergic drugs?

A

Cough, drying of nasal mucosa, hoarseness, and bitter taste.

32
Q

What is the onset, peak, and duration of Atrovent?

A

Onset: 5-15 mins
Peak: 1.5-2 hours
Duration: 3-6 hours

33
Q

Can overdose occur when taking too much Atrovent?

A

No, because not much is absorbed.

34
Q

Name another anti-cholinergic drug used for bronchodilation:

A

Tiotropium (Spiriva)

35
Q

How does Tiotropium work?

A

It acts as an antagonist at muscarinic receptors resulting in smooth muscle relaxation and bronchodilation.

36
Q

Is Tiotropium long acting or short acting?

A

Long acting

37
Q

What drug is the first line agent for maintenance therapy in COPD?

A

Tiotropium

38
Q

What is another type of bronchodilator?

A

Xanthines

39
Q

Name a xanthine:

A

Theophylline

40
Q

Do Xanthines have a wide or narrow therapeutic index?

A

Narrow

41
Q

What is another class of drugs used to treat respiratory conditions?

A

Corticosteroids

42
Q

What do corticosteroids do?

A
  • supress airway inflammation
  • decrease secretion of mucus
  • decrease airway edema
  • repair of damaged epithelium
  • enhances the effectiveness of Beta-2 adrenergic bronchodilators
43
Q

Name 3 inhaled corticosteroids:

A
  1. Beclovent
  2. Pulmicort
  3. Flovent
44
Q

Name an oral corticosteroid:

A

Prednisone

45
Q

Name 2 IV corticosteroids:

A
  1. Solu-medrol

2. Solu-cortef

46
Q

What do corticosteroids treat?

A

Severe inflammation

47
Q

Where are corticosteroids naturally released from?

A

The adrenal cortex

48
Q

What do corticosteroids supress?

A

Histamine and prostaglandins

49
Q

What system can be inhibited by corticosteroids?

A

The immune system

50
Q

What are some serious adverse effects from system corticosteroid use?

A
  • suppression of adrenal gland function
  • hyperglycemia
  • peptic ulcers
  • electrolyte imbalances
  • osteoporosis
51
Q

What should be done when taking corticosteroids long-term?

A
  • keep dose as low as possible
  • use alternate-day dosing
  • discontinue gradually
52
Q

What are some of the side effects of inhaled corticosteroids?

A
  • pharyngeal irritation
  • coughing
  • dry mouth
  • oral fungal infections
53
Q

If you have a corticosteroid and and bronchodilator, which drug should be given first?

A

The bronchodilator to open the airways first

54
Q

How long should corticosteroids be weaned for when discontinuing them?

A

1-2 weeks

55
Q

Should cough meds be given for a productive cough?

A

No, because then you are going to stop coughing and the secretions will stay inside you.

56
Q

What is another type of drug to treat respiratory conditions?

A

Antitussives

57
Q

Name 2 Antitussives:

A
  1. Koffex

2. Robitussin

58
Q

What is the use of antitussives?

A

Treating non-productive cough

59
Q

How do antitussives work?

A

They raise the cough threshold in the CNS

60
Q

What are some side effects of antitussives?

A

Dizziness and sedation

61
Q

What is another type of drug used to treat respiratory conditions?

A

Expectorants

62
Q

What do expectorants do?

A

They increase productive cough to clear the airway by liquefying the lower respiratory tract secretions, reducing their viscosity and making them easier to cough up.

63
Q

Name an example of an expectorant drug?

A

Mucinex

64
Q

What is the onset, peak, and duration of Mucinex?

A

Onset: 30 mins
Peak: unknown
Duration: 4-6 hours

65
Q

What is another type of drug that treats respiratory conditions?

A

Mucolytics

66
Q

How do mucolytics work?

A

They break down mucous to help the high risk respiratory patient in coughing up thick secretions.

67
Q

Name an example of a mucolytic drug:

A

Acetylcysteine

68
Q

What is the onset, peak and duration of mucolytics?

A

Onset: 1 min (inhaled), 30-60 mins (oral)
Peak: 5-10 mins (inhaled), 1-2 hours (oral)
Duration: 2-3 hours (inhaled), unknown (oral)

69
Q

How should inhalers be taken?

A

While pressing down, inhale the drug for 3 sec, hold breath for 10 sec, exhale through the nose. Wait 1 min before taking a second inhalation.