respiratory medications Flashcards by kyle camryn

albuterol (Proventil)
C:
MOA:
I: SABA vs LABA
CI: SABA vs LABA

C: bronchodilator; beta 2 receptor agonist
MOA: stim B2 receptors in lungs –> relax SM in bronchioles = dilation, dec resist, inc cAMP
I:
- SABA: PRN, intermittent, emergency, acute
- LABA: daily use, maintenance
CI:
- SABA: nonemergency
- LABA: emergency/severe situations

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albuterol (Proventil)
K:
- SABA O, P, D
- LABA O, P, D

K:
- SABA: O = 5min (strong), P = fast, D = 4-8hrs
- LABA: O = 5min (weak), P = slow, D = 12hrs

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SE of albuterol (Proventil)

SNS stimulation
- rebound b.spasms
- throat irritation
- tremor/nervous/arrythmias (adult)
- tachy, palpitations

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what route of B2 agonists lead to less side effects

inhaled

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name short acting beta agonists (SABAs)
-“LAMP”

levalbuterol, albuterol, metoproterenol, pirbuterol

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name long acting beta agonists (LABAs)

formoterol, salmeterol

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pt education with albuterol (Proventil)

limit caffeine, SABA vs LABA

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what should the nurse monitor when giving albuterol (Proventil)

monitor O2 sats, VS, lung sounds

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theophylline
C:
MOA:
I:
CI:

C: bronchodilator; xanthine derivative
MOA: direct effect –> SM in lungs –> inhib phosphodiesterase = inc cAMP = b.dilation
I: chronic asthma (prevent/maintenance), modest bronchodilator
CI: acute attack, cardiac arryth, heart/seizure/PUD/liver pts, no babies or elders

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theophylline
K: TR?
INT:

K: TR = 5-20 mcg/mL
INT: everything, check compatibility w other meds

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SE of theophylline

hyperglycemia, HA, seizures, insomnia, inc HR, inc RR, dec BP, theophylline toxicity

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SE of theophylline toxicity
- measurements for mild and severe theophylline toxicity
- tx?

irritable, arrythmias
- mild: 20-25 mcg/mL
- severe: >30 mcg/mL

tx: charcoal and wait

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what is another xanthine derivative

aminophylline

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pt education with theophylline

take without food
limit caffeine
low carb, high protein help with elimination
don’t smoke

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ipratropium (Atrovent)
C:
MOA:
I:
CI:

C: bronchodilator; anticholinergic
MOA: inhib muscarinic receptors, dec cGMP, dec SM contract = b.dilation
I: maintenance
CI: bladder obs (prostate hyper.), glaucoma, peanut/soybean allergy

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ipratropium (Atrovent)
K: longer D than _____
SE:

K: longer duration than B2 agonists
SE: can’t see, can’t spit, can’t pee, can’t shit
HA, dizzy, anxiety

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what are other anticholinergic bronchodilators

tiotropium (long acting)
aclidinium (for COPD)

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name the bronchodilator respiratory medications

albuterol (Proventil)
theophylline
ipratropium (Atrovent)

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cromolyn sodium (Intal)
C:
MOA:
I:
CI:

C: anti-inflammatory; mast cell stabilizer
MOA: inhib mast cell rupture = inhib release of histamine/leukotrienes
I: prophylaxis to b.spasms/asthma
CI: acute attacks, cardiac pts (arryth), lactose intolerance

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cromolyn sodium (Intal)
K: O, TR in___, exc thru___?

O = 15min
TR = 2-4wks
exc thru poop

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SE of cromolyn sodium (Intal)

abrupt cessation = rebound b.spasms
HA, throat irritation, bad taste, nausea

pt education with cromolyn sodium (Intal)

drink water b4/after to sooth throat
take 15-20min before strenuous activity

what are other mast cell stabilizer anti-inflammatory medications

nedocromil, omalizumab

omalizumab (Zolair)
C:
MOA:
I:
CI:

C: anti-inflammtory; mast cell stabilizer
MOA: inhib IgE receptors = no IgE bind = no allergic response
I: pts >12yrs, mod-severe asthma
CI: acute attacks, cardiac, lactose intolerance

omalizumab (Zolair) K: route and TR in___ SE:

K: SUBQ, TR in 2-4 weeks SE: inj site rxn, life threatening anaphylaxis, viral infections

pt education with omalizumab (Zolair)

stay in Dr's office for a few min to monitor for allergic rxn

what respiratory medication to take if inhaled corticosteroids don't help

omalizumab (Zolair): anti-inflammatory mast cell stabilizer

zafirlukast (Accolate) C: MOA: CI:

C: anti-inflammatory; leukotriene receptor antagonist [2nd LINE AGENTS] MOA: inhib receptor for leukotrienes = no cysteine = no b.constriction CI: neuropsychiatric events, liver disease

zafirlukast (Accolate) K: route, take without ____ INT:

K: PO, take without food INT: warfarin, theophylline, erythromycin

SE of zafirlukast (Accolate)

HA #1, dizzy, fever, rash, anaphylaxis, inc LFT

pt education with zafirlukast (Accolate)

take without food

name other leukotriene receptor antagonist anti-inflammatory medications

montelukast, zileuton

SE of zafirlukast (Accolate)

HA #1, dizzy, fever, rash, anaphylaxis, inc LFT

montelukast (Singulair) C: MOA: I: CI:

C: anti-inflammatory; leukotriene receptor antagonist [2ND LINE AGENTS] MOA: inhib receptor for leukotrienes = no cysteine, no b.constriction I: better option for liver disease CI: neuropsychiatric events

montelukast (Singulair) K: best abs at ____, how many times daily INT:

K: best abs at night, once daily INTR: phenobarbital, rifampin

SE of montelukast (Singulair)

HA, dizzy, fever, rash, inc LFT

pt education with montelukast (Singulair)

take at night

zileuton (Zyflo) C: MOA: I: CI:

C: anti-inflammatory leukotriene receptor antagonist [2ND LINE AGENTS] MOA: inhib enzyme in lipoxygenase pathway = dec prod of leukotrienes I: pts >12yrs CI: neuropsychiatric events

zileuton (Zyflo) K: 1/2 life INT:

K: short 1/2 life INT: warfarin, theophylline, propanolol

SE of zileuton

HA, fever, rash, anaphylaxis, inc LFTs

name the second line agent anti-inflammatory medications

zafirlukast, montelukast, zileuton leukotriene receptor antagonists

flunisolide (Aerobid) C: MOA: I:

C: anti-inflammatory; corticosteroids MOA: inhib cytokine, leukotriene, prostaglandin prod = no release of inflammatory mediators inc # of B2 receptors = promote b.dilation airway eosinophil recruitment = immunosuppressive I: best anti-inflammatory effect (high effective, high potent)

CI of flunisolide (Aerobid)

acute attacks systemic fungal infections live virus vax HTN, CHF, PUD, diabetes, resp infections

INT with flunisolide (Aerobid)

azole antifungals, ASA BC, barbs, diuretics, theophylline warfarin

SE of inhaled flunisolide (Aerobid) - what are inhaled corticosteroids for

oral fungal infections PNA delayed child growth - inhaled corticosteroids are 1st line asthma tx

SE of PO/IV flunisolide (Aerobid) - what are PO/IV corticosteroids for

anxiety, seizures, insomnia hirsutism, obesity, buffalo hump electrolyte imb (hyperkalemia) striae, osteoporosis - PO/IV corticosteroids are for short term tx

pt education with flunisolide (Aerobid) - how many days to taper off? - why do we need to taper off?

- don't abruptly stop, taper off over 7 days - taper off due to adrenal suppression

why can corticosteroids cause hirsutism

structurally similar to sex steroids

which corticosteroids are MDI

flunisolide (Aerobid), fluticasone (Advair), beclomethasone

which corticosteroids are PO

prednisone, methylprednisone

which corticosteroid is available IV

methylprednisone