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NCLEX > Respiratory Meds > Flashcards

Respiratory Meds Flashcards

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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
Q

Precautions for inhaled anticholinergics (3)

A
  • 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
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26
Q

Side/adverse effects of inhaled anticholinergics (2)

A
  • Dry mouth/eyes
  • Urinary retention
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27
Q

Nursing interventions for inhaled anticholinergics (4)

A
  • 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
Q

Glucocorticoids action

A

Prevent inflammatory response by suppressing airway mucus production, immune responses, and adrenal function

29
Q

Oral glucocorticoid medications (3)

A
  • Prednisone
  • Prednisolone
  • Betamethosone
30
Q

Inhaled glucocorticoid medications (4)

A
  • Beclomethasone dipropionate
  • Budesonide
  • Fluticasone propionate
  • Triamcinolone acetonide
31
Q

IV glucocorticoid medications (3)

A
  • Hydrocortisone sodium succinate
  • Methylprednisolone sodium succinate
  • Betamethasone sodium phosphate
32
Q

IV short term respiratory use of glucocorticoids

A
  • Status asthmaticus
33
Q

Oral short term respiratory use of glucocorticoids

A
  • Treat symptoms following acute asthma attacks
34
Q

Inhaled long term respiratory use of glucocorticoids

A

Asthma prophylaxis

35
Q

Oral long term respiratory use of glucocorticoids

A

Treat chronic asthma

36
Q

Glucocorticoids precautions (2)

A
  • Diabetic patients might need higher doses
  • Don’t stop abruptly
37
Q

Side/adverse effects of glucocorticoids (8)

A
  • Euphoria
  • Insomnia
  • Psychotic behavior
  • Hyperglycemia
  • Peptic ulcer
  • Fluid retention
  • Withdrawal symptoms
  • Increased appetite
38
Q

Nursing interventions for glucocorticoids (4)

A
  • Assess activity and behavior
  • Give with meals
  • Don’t take NSAIDS
  • Teach client to gradually reduce dose to prevent Addisonian crisis
39
Q

Leukotriene modifiers action

A

Prevent effects of leukotriene resulting in decreased inflammation, bronchoconstriction, airway edema, and mucus production

40
Q

Leukotriene modifiers medications (3)

A
  • Montelukast
  • Zileuton
  • Zafirlukast
41
Q

Therapeutic uses of leukotriene modifiers (2)

A
  • Long term management of asthma in adults and kids
  • Prevent exercise induced bronchospasm
42
Q

Precautions for leukotriene modifiers (4)

A
  • 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
Q

Side/adverse effects of leukotriene modifiers (3)

A
  • Elevated liver enzymes
  • Warfarin/theophylline toxicity
  • Increased levels of beta blockers causing hypotension/bradycardia
44
Q

Nursing interventions for leukotriene modifiers (5)

A
  • 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
Q

Antitussive medications (2)

A
  • Hydrocodone
  • Codeine
46
Q

Antitussive action

A
  • Suppress cough through action in CNS
47
Q

Therapeutic use of antitussive medications

A
  • Chronic non-productive cough
48
Q

Expectorant medications (1)

A
  • Guaifenesin
49
Q

Expectorant medication action

A
  • Promote increased mucus secretion to increase cough production
50
Q

Therapeutic use of expectorant medications

A
  • Combined with other medications to manage respiratory disorders
51
Q

Mucolytic medications (2)

A
  • Acetylcysteine
  • Hypertonic saline
52
Q

Mucolytics action

A

Enhance flow of secretions in respiratory tract

53
Q

Therapeutic use of mucolytics (3)

A
  • Acute/chronic pulmonary disorders with copious secretions
  • Cystic fibrosis
  • Antidote for acetaminophen poisoning
54
Q

Antitussives, expectorants, mucolytics precautions (3)

A
  • Saline solutions only used in kids younger than 2 years
  • Opioid antitussives can lead to abuse
  • Caution with OTC medications for potentiate effects
55
Q

Side/adverse effects of antitussives, expectorants, mucolytics (4)

A
  • Drowsiness
  • Dizziness
  • Aspiration/bronchospasm risk with mucolytics
  • Constipation
56
Q

Antitussives, excpectorants, mucolytics (5)

A
  • 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
Q

Decongestant medications (3)

A
  • Phenylephrine
  • Pseudoephedrine
  • Naphazoline
58
Q

Decongestant medications action

A

Stimulate alpha1 adrenergic receptors causing reduced inflammation of nasal membranes

59
Q

Therapeutic uses of decongestant medications (3)

A
  • Allergic rhinitis
  • Sinusitis
  • Common cold
60
Q

Antihistamine medications (5)

A
  • Diphenhydramine
  • Loratidine
  • Cetirizine
  • Fexofenadine
  • Desloratidine
61
Q

Antihistamine action

A

Decrease allergic response by competing for histamine receptor sites

62
Q

Therapeutic use of antihistamines

A
  • Relieve/prevent hypersensitivity reactions
63
Q

Decongestants/antihistamines precautions (4)

A
  • 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
Q

Side/adverse effects of decongestants/antihistamines (2)

A
  • Anticholinergic effects
  • Drowsiness
65
Q

Nursing interventions for decongestants/antihistamines (4)

A
  • Assess for hypokalemia
  • Monitor bp
  • Teach how to manage anticholinergic effects
  • Take at night

NCLEX (40 decks)

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