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Respiratory medications Flashcards

1
Q

Diphenhydramine Class

A
  • oral antihistamine
  • 1st gen
  • central acting
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2
Q

Diphenhydramine MOA

A
  • block action of histamine in body
  • targets H1 and H2 receptors
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3
Q

Diphenhydramine use

A
  • seasonal allergic rhinitis
  • cold symptoms
  • allergic reactions
  • motion sickness
  • sleep aid
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4
Q

Diphenhydramine adverse effects

A

anticholinergic, drowsiness

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5
Q

Diphenhydramine specific implications

A
  • warn about alcohol and CNS depressants
  • caution in elderly due to urinary retention
  • increase fluids
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6
Q

Fexofenadine, loratadine class

A

oral antihistamine, peripheral acting, 2nd gen

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7
Q

Fexofenadine, loratadine MOA

A

block action of histamine, H1 receptors only

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8
Q

Fexofenadine, loratadine use

A

seasonal allergic rhinitis, cold symptoms

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9
Q

Fexofenadine, loratadine adverse effects

A
  • limited
  • non sedating
  • toxicity with ketoconazole and erythromycin
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10
Q

Fexofenadine, loratadine specific implications

A

increase fluid intake

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11
Q

Implications for all oral antihistamines

A
  • first line drug for allergic rhinitis
  • take before symptoms start
  • cannot push allergen off receptor once it is attached
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12
Q

Benefits of oral antihistamines

A
  • bronchial relaxation
  • decrease hypersecretions
  • alleviate itching
  • prevent vasodilation, edema
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13
Q

Beclomethasone, fluticasone, budesonide Class

A

glucocorticoid, intranasal drug

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14
Q

Beclomethasone, fluticasone, budesonide MOA

A
  • anti inflammatory response
  • stabilizes cell membrane
  • prevent release of histamine
  • interferes with normal actions of WBC
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15
Q

Beclomethasone, fluticasone, budesonide use

A

allergic rhinitis
- most effective for prevention/treatment of seasonal + perennial rhinitis
- considered first line therapy
cold symptoms
sinusitis
diagnostic and surgical procedures

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16
Q

Beclomethasone, fluticasone, budesonide adverse effects

A
  • nasal irritation
  • decrease nasal passage healing
  • sore throat, headache
  • rare effects: adrenal suppression of linear growth in kids
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17
Q

Beclomethasone, fluticasone, budesonide implications

A

may take 3-4 wks for max results

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18
Q

Cromolyn class

A

Mast cell stabilizer, intranasal drug

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19
Q

Cromolyn MOA

A

block mass cell degranulation, stabilizing the cell and preventing histamine release

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20
Q

Cromolyn use

A

allergic disorders

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21
Q

Cromolyn adverse effects

A
  • nasal irritation
  • decrease nasal passage healing
  • sore throat, headache
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22
Q

Cromolyn implications

A

may take 3-4 wks for max results

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23
Q

Azelastine class

A

intranasal antihistamine

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24
Q

Azelastine MOA

A

block action of histamine in nasal cavity

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25
Q

Azelastine use

A

seasonal allergic rhinitis, cold symptoms

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26
Q

Azelastine adverse effects

A

epistaxis, headache, unpleasant taste

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27
Q

Azelastine implications

A

may take 3-4 wks for max results

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28
Q

Sympathomimetic decongestants: nasal sprays

A

phenylephrine, oxymetazoline

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29
Q

Sympathomimetic decongestants: oral

A

pseudoephedrine

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30
Q

Sympathomimetics MOA

A

activates alpha 1 adrenergic receptors on blood vessels
- vasoconstriction
- reduces blood flow to nasal mucosa
- reduces nasal congestion
- allows nasal secretions to drain

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31
Q

Sympathomimetics use

A

seasonal allergic rhinitis, cold symptoms, sinusitis, diagnostic and surgical procedures, epistaxis

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32
Q

Sympathomimetics adverse effects

A

Nasal sprays
- nasal irritation/dryness
- headache, irritable
- rebound congestion
- increase BP, palpitations
Oral
- less potent, delayed effects, longer acting, more systemic effects
- increase BP, palpitations

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33
Q

Sympathomimetics contraindications

A

CV disease, HTN

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34
Q

Sympathomimetics implications

A
  • rebound congestion: don’t use longer than 2-3 days, one nostril at a time
  • abuse risk
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35
Q

Non-opioid anti-tussives

A

dextromethorphan, benzonatate

36
Q

Opioid anti-tussives

A

codeine, hydrocodone

37
Q

Antitussive MOA

A

suppresses cough reflex

38
Q

Anti-tussive use

A

cough suppressant, relieves pain, promotes sedation

39
Q

Anti-tussive adverse effects: opioid

A

n/v, sedation, decrease respiratory drive, addictive potential

40
Q

Anti-tussive adverse effects: non-opioid

A

nausea, drowsy, dizzy, mild sedation, abuse risk

41
Q

Anti-tussive implications

A
  • avoid driving and operating heavy machinery, alcohol, other sedatives
  • call HCP if cough lasts > week, severe headache, chest pain, fever
42
Q

Guaifenesin class

A

Expectorants

43
Q

Guaifenesin moa

A

stimulate mucus production by irritating stomach lining

44
Q

Guaifenesin use

A

relief of nonproductive cough - bronchitis, laryngitis, sinusitis

45
Q

Guaifenesin adverse effects

A

n/v, gastric irritation

46
Q

Guaifenesin implications

A
  • does not work if pt. is not drinking water
47
Q

Beta 2-adrenergic agonists drug types

A

ISABAs, LABAs, oral agent

48
Q

Beta-2-adrenergic agonists moa

A

act on beta 2 receptors in smooth mm of lung - dilation of bronchials

49
Q

Inhaled short acting meds

A

Albuterol, levabuterol

50
Q

Inhaled long acting meds

A

salmeterol

51
Q

Oral agents - B2 agonists

A

terbutaline, albuterol

52
Q

Beta 2-adrenergic agonists use

A
  • most effective for relief of acute bronchospasm and prevention of exercise-induced asthma
  • asthma and COPD
53
Q

SABA specific use

A

1-2 puffs, 3-4x a day for PRN use, rescue inhaler

54
Q

LABA specific use

A

BID, fixed schedule, not PRN, monotherapy with COPD, always w/inhaled glucocorticoids

55
Q

Inhaled B2 adrenergic agonist adverse effects

A

tachycardia, angina, tremor

56
Q

Oral B2 adrenergic agonist adverse effects

A

angina, tachydysrhythmias, tremor

57
Q

B2 adrenergic agonists in asthma implications

A
  • spacer
  • 1 min between puffs
  • inhaled long acting on fixed schedule
58
Q

Glucocorticoids inhaled: beclomethasone MOA

A

suppress inflammation and mucus production

59
Q

Glucocorticoids inhaled: beclomethasone use

A

asthma prophylactically, most effective anti-asthma drug available

60
Q

Glucocorticoids inhaled: beclomethasone adverse effects

A
  • oropharyngeal candidiasis
  • dysphonia: hoarseness, difficulty speaking
  • osteoporosis
  • cataracts, glaucoma
61
Q

Glucocorticoids inhaled: beclomethasone implications

A
  • prophylactic
  • gargle and spit after administration
  • spacer
  • monitor growth in kids
  • routine eye exams
  • minimize bone loss by taking smallest dose, calcium supplement, weight-bearing exercise
63
Q

Glucocorticoids oral: prednisone, prednisolone use

A

asthma, COPD, disease related to inflammation

64
Q

Glucocorticoids oral: prednisone, prednisolone adverse effects

A
  • adrenal suppression
  • weight gain and fluid retention
  • osteoporosis
  • hyperglycemia
  • peptic ulcer disease
65
Q

Glucocorticoids oral: prednisone, prednisolone contraindications

A

live virus vaccine, systemic fungal infection

66
Q

Glucocorticoids oral: prednisone, prednisolone implications

A
  • taper if taking >10 days
  • can cause acute respiratory exacerbation or adrenal crisis
  • short term use only
67
Q

Glucocorticoid/LABA combinations med

A

fluticasone/salmeterol, budesonide/formoterol

68
Q

Glucocorticoid/LABA combinations use

A

asthma, COPD

69
Q

Glucocorticoid/LABA combination adverse

A

same as LABA and inhaled glucocorticoids

70
Q

Glucocorticoid/LABA combinations implications

A
  • same as LABA/inhaled glucocorticoids
  • inhale B2 agonist first, wait 5 minutes, then deliver glucocorticoids
71
Q

Cromolyn: mast cell stabilizer Route

A

MID, nebulizer

72
Q

Cromolyn use (specific)

A

prophylaxis for asthma

73
Q

Cromolyn adverse effects (asthma)

A

cough, bronchospasm

74
Q

Cromolyn implications

A
  • works best taken 15 min prior to exercise/cold
75
Q

Theophylline (methylxanthines) MOA

A
  • smooth mm relaxation (bronchodilation)
  • suppress response of airways to stimuli
76
Q

Theophylline (methylxanthine) use

A

long term control of chronic asthma
- best for nocturnal asthma and COPD

77
Q

Theophylline (methylxanthines) adverse effects

A
  • narrow therapeutic index
  • toxicity: n/v/d
  • severe dysrhythmias @ levels >30
78
Q

Theophylline (methylxanthines) implications

A
  • plasma levels 10-20 mcg/mL
  • never double up after missed dose
  • antidote: activated charcoal
  • caffeine increases plasma levels - AVOID
  • do not crush
79
Q

Ipratropium bromide (anticholinergic) moa

A

block muscarinic receptors - bronchodilation

80
Q

Ipratropium bromide use

A

allergic rhinitis, cold symptoms, COPD

81
Q

Ipratropium bromide adverse effects

A

dry mouth hoarseness, unpleasant taste

82
Q

Ipratropium bromide (anticholienrgic) implications

A

rinse mouth after

83
Q

Montelukast sodium (leukotriene receptor antagonist) moa

A

blocks action of leukotriene - decrease inflammation, smooth m relaxation

84
Q

Montelukast sodium (leukotriene receptor antagonist) use

A

asthma, exercise induced asthma, allergic rhinitis

85
Q

Montelukast sodium (leukotriene receptor antagonist) adverse effects

A

mood changes, headache, fatigue, tremors, n/v/d, stomach pain, rash

86
Q

Montelukast sodium (leukotriene receptor antagonist) implications

A

stop drug immediately if mood changes or nightmares occur

Pharmacology (9 decks)

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