respiratory medications

Question 1

where are histamines stored?

Answer 1

mast cells

Question 2

what are the s/sx of H1 receptor stimulation?

Answer 2

vasodilation
increased capillary permeability
bronchoconstriction
pain/itching
mucus production

Question 3

where are antihistamine found in the body?

Answer 3

bone marrow, GI tract, and skin

Question 4

what is the distribution of histamine?

Answer 4

found in practically all tissues in the body, but highly concentrated in GI tract, skin, and lungs

Question 5

where are mast cells stored?

Answer 5

skin and soft tissues

Question 6

how or why are mast cells released

Answer 6

allergic reaction: mediated by IgE
non allergic reaction: drugs or cell injury

Question 7

what are the 4 histamine receptors?

Answer 7

H1
H2
H3
H4

Question 8

what happens if H2 is stimulated?

Answer 8

stomach acid secretion

Question 9

what are classic antihistamines for the H1 blockers (antagonists)?

Answer 9

highly sedating (1ST GEN)
- diphenhydramine
- chloropheniramine
- hydroxyzine
- meclizine
- promethazine

less sedating (2ND GEN)
- certerizine
- loratadine
- fexofenadine

Question 10

what is meclizine used for?

Answer 10

vertigo

Question 11

what are the side effects of diphenhydramine?

Answer 11

extreme sedation (it is used in most sleeping aids)

Question 12

do antihistamines alter the length of the common cold?

Answer 12

NO

Question 13

what does H1 blocking work well for?

Answer 13

local swelling (bee sting)
acute rash
hay fever

Question 14

how do anticholinergics alter nasal secretions and sx of allergic rhinitis?

Question 15

what are adverse effects of H1 blockers?

Answer 15

sedation
constipation
urinary retention
dry mucus membranes

Question 16

what are seasonal allergies

Answer 16

they are inhaled (such as pollen)

Question 17

what are perennial allergies?

Answer 17

inhaled ones would be: dust mites, dander, dust

ingested ones would be: wheat, eggs, milk, and nuts

Question 18

if someone is allergic to sage brush and they move to another area with “no allergens”, how come this might no be effective?

Answer 18

often times allergic people are allergic to more than one type of pollen.

Question 19

are antihistamines good for unclogging a stuffy nose?

Answer 19

no, they are only effective at controlling sneezing, itching, and rhinorrhea.

Question 20

what is the most common nasal antihistamine?

Answer 20

Azelatine

Question 21

what is one example of a glucocorticoid?

Answer 21

fluticasone

Question 22

what is the response rate to glucocorticoids?

Answer 22

90%

Question 23

what is so important about cromolyn?

Answer 23

serious side effects are rare
long acting
not used in emergencies

Question 24

what is an example of a leukotriene modifier?

Answer 24

motelukast:
safe and helps with congestion

Question 25

what will help someone ween themselves off a nasal decongestant like oxymetazoline?

Answer 25

if they start one course of intranasal glucocorticoids 1 week prior to discontinuing oxymetazoline. also discontinuing one nostril at a time.

Question 26

what should a provider use caution with when prescribing an oral decongestant?

Answer 26

should be given WITH EXTREME CAUTION to someone with cardiac disease

Question 27

why do we have to keep pseudoephedrine behind the counter

Answer 27

because people make meth with it.

Question 28

what routes can a decongestant be given?

Answer 28

oral tablets or liquid

Question 29

what CNS change does decongestants cause?

Answer 29

CNS stimulation

Question 30

what do opioid antitussives do?

Answer 30

increase the cough threshold

Question 31

why is a cough good at times

Answer 31

cough can help expel pathogens and mucus/sputum

Question 32

what is the number one antitussive?

Answer 32

codeine

Question 33

what does DM stand for in Robitussin DM?

Answer 33

dextromethorphan

Question 34

what does dextromethorphan do?

Answer 34

can diminish pain BUT can also cause hallucinations in large doses

Question 35

what action do beta 2 agonist have on the lungs?

Answer 35

they stimulate bronchoconstriction

Question 36

what is a SABA?

Answer 36

albuterol

Question 37

what are 2 LABAs?

Answer 37

salmeterol formoterol

Question 38

what are rescue inhalers?

Answer 38

SABA: albuterol

Question 39

which treatments are used on a fixed schedule (daily)?

Answer 39

salmeterol formoterol

Question 40

who should use DPIs?

Answer 40

people with COPD tend to like this more because they dont have to hold their breath stroke patients find this easier to use.

Question 41

should everyone use a spacer with an MDI?

Answer 41

YES

Question 42

what are 2 inhaled glucocorticoids?

Answer 42

fluticasone prednisone

Question 43

why are glucocorticoids beneficial?

Answer 43

quickly decrease inflammation in the lungs and decrease mucus production

Question 44

are glucocorticoids fixed dose or PRN?

Answer 44

either

Question 45

how do glucocorticoids effect growth in children?

Answer 45

slows their growth

Question 46

in what order would you give an albuterol MDI and a betamethasone MDI? why?

Answer 46

you would give albuterol first because it would open up the airway, so the steroid could get into the lungs better

Question 47

how can you prevent oral thrush in a pt taking an inhaled glucocorticoid?

Answer 47

have them rinse out their mouth with water after taking the medication

Question 48

what is the MOA of anticholinergics?

Answer 48

they work on muscanaric receptors in the lungs

Question 49

what is one major anticholinergic

Answer 49

ipratropium

Question 50

are anticholinergics used for asthma?

Answer 50

they are used in asthma in children and if your adult patient with asthma it can be used as a last resort to tweak any receptor that might open up their airway

Question 51

what are leukotriene modifiers?

Answer 51

fairly new drug class used to treat asthma

Question 52

what is the most common leukotriene modifier used?

Answer 52

motelukast

Question 53

how long does it take for montelukast to reach maximum effectiveness?

Answer 53

24 hours

Question 54

discuss montelukast use in the control of exercise induced asthma

Answer 54

needs to be taken 2 hours before anticipated activity but its rarely used for this purpose .

Question 55

what is the safest of all asthma drugs?

Answer 55

cromolyn

Question 56

how does cromolyn work?

Answer 56

suppressed inflammation by stabilizing cytoplasmic membrane of mast cells, preventing the release of histamine.

Question 57

in what cases might theophylline still be used?

Answer 57

in old cases of asthma and COPD

Question 58

what do you need to monitor when a pt is on theophylline?

Answer 58

plasma levels

Question 59

are there any drugs that shorten the length of the common cold?

Answer 59

no there are only drugs to treat the symptoms

Question 60

what is the best method to treating the symptoms of a common cold?

Answer 60

use separate drugs to treat the symptoms you already have rather than take a combo drug that has effects you dont need

Question 61

what kind of drug is guaifenesin?

Answer 61

expectorant

Question 62

what does guaifenesin do?

Answer 62

thins mucus and makes it easier to cough up