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Respiratory Meds Flashcards

1
Q

Guidelines for inhaled medication regimen

A

Take beta2 agonist before inhaled glucocorticoid to increase steroid absorption

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2
Q

Steps for taking inhaled medications (7)

A
  • Remove cap on mouthpiece
  • If needed shake medication
  • Standup/sit upright and exhale deeply
  • Place mouthpiece between teeth and close lips tightly around inhaler
  • Breathe in while pressing down on inhaler to release medication continue breathing slow/long/steady breaths for several seconds
  • Hold breath for 5-10 seconds
  • Breathe in/out normally
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3
Q

Beta2 adrenergic agonists action

A

Promote bronchodilation by activating beta2 receptors in bronchial smooth muscle

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4
Q

Beta2 adrenergic agonists meds (4)

A
  • Albuterol
  • Formoterol
  • Salmeterol
  • Terbutaline
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5
Q

Albuterol route and onset

A
  • Inhaled
  • Short acting
  • 5-10 minutes
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6
Q

Albuterol use

A
  • Acute bronchospasm
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7
Q

Formoterol/salmeterol use

A

Long term control of asthma

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8
Q

Formoterol onset and duration

A
  • Onset: 1-3 minutes
  • Duration: 10 hours
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9
Q

Salmeterol onset and duration

A
  • Onset: 10-20 minutes
  • Duration: 12 hours
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10
Q

Formoterol/salmeterol route

A
  • Inhaled
  • Long acting
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11
Q

Beta2 adrenergic agonists precautions (4)

A
  • Don’t use in patients with tachydysrhythmias
  • Use caution in patients with diabetes, hyperthyroidism, heart disease, HTN, angina
  • Beta blockers reduce effectiveness
  • MAOIs increase effectiveness
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12
Q

Beta2 adrenergic agonists side/adverse effects (3)

A
  • Tachycardia
  • Palpitations
  • Tremors
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13
Q

Beta2 adrenergic agonists precaution

A
  • Don’t use salmeterol more frequently than every 12 hours
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14
Q

Methylxanthines action

A

Relaxes bronchial smooth muscle causing bronchodilation

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15
Q

Methylxanthines meds (2)

A
  • Aminophylline
  • Theophylline
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16
Q

Therapeutic uses of methylxanthines (2)

A
  • Relieve bronchospasm
  • Long term control of asthma
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17
Q

Precautions for methylxanthines (5)

A
  • Don’t use in patients with active peptic ulcer disease
  • Use caution in patients with diabetes, hyperthyroidism, heart disease, HTN, angina
  • Don’t mix parenteral form with other medications
  • Phenobarbital/phenytoin decrease theophylline levels
  • Caffeine, furosemide, cimetidine, fluoroquinolone, acetaminophen, phenylbutazone cause false elevated levels
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18
Q

Side/adverse effects of methylxanthines (2)

A
  • Irritability
  • Restlessness
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19
Q

Toxic effects of methylxanthines (3)

A
  • Tachycardia
  • Tachypnea
  • Seizures
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20
Q

Nursing interventions for methylxanthines (5)

A
  • Monitor therapeutic levels
  • Avoid caffeine
  • Monitor for signs of toxicity
  • Smoking decreases effects
  • Alcohol abuse increases effects
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21
Q

How to treat methylxanthines toxicity (4)

A
  • Stop infusion
  • Give activated charcoal to decrease absorption in oral overdose
  • Give lidocaine for dysrhythmias
  • Give diazepam to control seizures
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22
Q

Inhaled anticholinergics action

A

Blocks muscarinic receptors causing bronchodilation

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23
Q

Inhaled anticholinergics meds (2)

A
  • Ipratropium
  • Tiotropium
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24
Q

Therapeutic uses for inhaled anticholinergics (3)

A
  • Prevent bronchospasm
  • Manage allergen/exercise induced asthma
  • COPD
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25
Precautions for inhaled anticholinergics (3)
- Don't use in patients with peanut allergies (contains soy lecithin) - Use caution in patients with narrow angle glaucoma, BPH - Don't use for treatment of acute bronchospasms
26
Side/adverse effects of inhaled anticholinergics (2)
- Dry mouth/eyes - Urinary retention
27
Nursing interventions for inhaled anticholinergics (4)
- Maximum effects can take 2 weeks - Shake inhaler well before giving - When using 2 different inhaled medications wait 5 minutes between - Use within 1 hour of reconstituting nebulized medication
28
Glucocorticoids action
Prevent inflammatory response by suppressing airway mucus production, immune responses, and adrenal function
29
Oral glucocorticoid medications (3)
- Prednisone - Prednisolone - Betamethosone
30
Inhaled glucocorticoid medications (4)
- Beclomethasone dipropionate - Budesonide - Fluticasone propionate - Triamcinolone acetonide
31
IV glucocorticoid medications (3)
- Hydrocortisone sodium succinate - Methylprednisolone sodium succinate - Betamethasone sodium phosphate
32
IV short term respiratory use of glucocorticoids
- Status asthmaticus
33
Oral short term respiratory use of glucocorticoids
- Treat symptoms following acute asthma attacks
34
Inhaled long term respiratory use of glucocorticoids
Asthma prophylaxis
35
Oral long term respiratory use of glucocorticoids
Treat chronic asthma
36
Glucocorticoids precautions (2)
- Diabetic patients might need higher doses - Don't stop abruptly
37
Side/adverse effects of glucocorticoids (8)
- Euphoria - Insomnia - Psychotic behavior - Hyperglycemia - Peptic ulcer - Fluid retention - Withdrawal symptoms - Increased appetite
38
Nursing interventions for glucocorticoids (4)
- Assess activity and behavior - Give with meals - Don't take NSAIDS - Teach client to gradually reduce dose to prevent Addisonian crisis
39
Leukotriene modifiers action
Prevent effects of leukotriene resulting in decreased inflammation, bronchoconstriction, airway edema, and mucus production
40
Leukotriene modifiers medications (3)
- Montelukast - Zileuton - Zafirlukast
41
Therapeutic uses of leukotriene modifiers (2)
- Long term management of asthma in adults and kids - Prevent exercise induced bronchospasm
42
Precautions for leukotriene modifiers (4)
- Don't use for acute asthma attacks - Zileuton/zafirlukast have high risk of liver disease, increased warfarin effects, theophylline toxicity - Phenobarbital decrease circulating levels of montelukast - Chewable tablets have phenylalanine
43
Side/adverse effects of leukotriene modifiers (3)
- Elevated liver enzymes - Warfarin/theophylline toxicity - Increased levels of beta blockers causing hypotension/bradycardia
44
Nursing interventions for leukotriene modifiers (5)
- Never abruptly substitute for corticosteroid therapy - Take daily in the evening - Don't decrease/stop taking other medications for asthma - Mix oral granules with cold soft foods or pour directly into mouth - Use open packets within 15 minutes of taking medication
45
Antitussive medications (2)
- Hydrocodone - Codeine
46
Antitussive action
- Suppress cough through action in CNS
47
Therapeutic use of antitussive medications
- Chronic non-productive cough
48
Expectorant medications (1)
- Guaifenesin
49
Expectorant medication action
- Promote increased mucus secretion to increase cough production
50
Therapeutic use of expectorant medications
- Combined with other medications to manage respiratory disorders
51
Mucolytic medications (2)
- Acetylcysteine - Hypertonic saline
52
Mucolytics action
Enhance flow of secretions in respiratory tract
53
Therapeutic use of mucolytics (3)
- Acute/chronic pulmonary disorders with copious secretions - Cystic fibrosis - Antidote for acetaminophen poisoning
54
Antitussives, expectorants, mucolytics precautions (3)
- Saline solutions only used in kids younger than 2 years - Opioid antitussives can lead to abuse - Caution with OTC medications for potentiate effects
55
Side/adverse effects of antitussives, expectorants, mucolytics (4)
- Drowsiness - Dizziness - Aspiration/bronchospasm risk with mucolytics - Constipation
56
Antitussives, excpectorants, mucolytics (5)
- Monitor cough frequency, effort, ability to expectorate - Monitor character and tenacity of secretions - Auscultate for adventitious breath sounds - Educate on the importance of needing multiple therapies - Promote fluid intake
57
Decongestant medications (3)
- Phenylephrine - Pseudoephedrine - Naphazoline
58
Decongestant medications action
Stimulate alpha1 adrenergic receptors causing reduced inflammation of nasal membranes
59
Therapeutic uses of decongestant medications (3)
- Allergic rhinitis - Sinusitis - Common cold
60
Antihistamine medications (5)
- Diphenhydramine - Loratidine - Cetirizine - Fexofenadine - Desloratidine
61
Antihistamine action
Decrease allergic response by competing for histamine receptor sites
62
Therapeutic use of antihistamines
- Relieve/prevent hypersensitivity reactions
63
Decongestants/antihistamines precautions (4)
- Use caution in patients with HTN, glaucoma, peptic ulcer disease, urinary retention - Children could have hallucinations, incoordination, seizures - No alcohol - Products having pseudoephedrine shouldn't be used longer than 7 days
64
Side/adverse effects of decongestants/antihistamines (2)
- Anticholinergic effects - Drowsiness
65
Nursing interventions for decongestants/antihistamines (4)
- Assess for hypokalemia - Monitor bp - Teach how to manage anticholinergic effects - Take at night

NCLEX (40 decks)

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