Respiratory Meds. Flashcards

rotation 1 - week 5

1
Q

If you’re taking a glucocorticoid in combination w/ a bronchodilator, which one do you take first?

A

you take the bronchodilator first to allow the airways to open, which then allows the glucocorticoid to be more effective

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2
Q

Albuterol and Salmeterol are both bronchodilators used to treat acute asthma attacks. Which one is a SABA + which one is a LABA?

A

Albuterol is a short acting Beta2 Agonist and Salmeterol is a long acting Beta2 Agonist

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3
Q

Why should patients who have a history of tachydysrhythmias, HTN, or other cardiovascular diseases be cautious when taking albuterol or salmeterol?

A

because these drugs increase the stimulation of the sympathetic nervous system, which increases HR + BP, and can cause chest pain

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4
Q

IPRATROPIUM and umeclidinium are both Anticholinergic Muscarinic Antagonists used to treat COPD to relieve bronchoconstriction and reduce secretions. Which one is a SAMA and which one is the LAMA?

A

Ipratropium is a short acting muscarinic antagonist and umeclidinium is a long acting muscarinic antagonist

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5
Q

If SAMAs + LAMAs are also anticholinergic what 3 kinds of patients should not take this medication?

A

-Hx. of glaucoma
-Hx. of BPH or bladder neck obstruction
-Hx. of urinary retention

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6
Q

Which medication is a Methylxanthine, that relaxes smooth muscle of the bronchi to dilate them, for long term treatment of chronic stable asthma?

A

Theophylline

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7
Q

When a patient is going to be taking Theophylline, why is it important to know if they smoke?

A

Smoking affects the rate at which your body metabolizes things, this could either cause a toxic buildup of the drug or cause it to be metabolized much faster and not have a therapeutic effect at all.

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8
Q

What is the therapeutic range of Theophylline, before it causes toxicity?

If it does become toxic what will the patient present with?

A

10-15mg/L; seizures and/ or dysrhythmias

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9
Q

Glucocorticoids are steroids. How are they used to treat chronic asthma long term and short term treatment of COPD exacerbation?

A

steroids are anti-inflammatory, they prevent the release of:
-histamines
-leukotrienes
-prostaglandins
to decrease edema in the airways

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10
Q

True or False? These 3 drugs are glucocorticoids and this is how they’re administered.
-Beclomethasone: inhalant
-prednisone: oral
-fluticasone: nasal

A

TRUE

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11
Q

Why is it important to take calcium + vitamin D supplements while on a glucocorticoid?

A

these drugs cause muscle wasting and bone demineralization that could lead to osteoporosis

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12
Q

What are mast cells?

A

a WBC that is key in allergic reactions and inflammation; and when combined with an antigen histamines, leukotrienes and prostaglandins are released which causes the inflammation response

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13
Q

A mast cell stabilizer is used to treat allergy related or exercise induced asthma, by suppressing the immune system + inflammatory response. When should they take this medication to have an effective response?

A

take this about 30 minutes prior to doing yardwork or exercising

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14
Q

cromolyn is a mast cell stabilizer, when being used does this drug dilate the bronchioles?

A

NO. this drug should not be used for an acute asthma attack because it can take a few weeks to reach a therapeutic effect

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15
Q

cromolyN is given via _________.

A

nebulizer

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16
Q

Montelukast is a Leukotriene Modifier that decreases bronchoconstriction and inflammation by preventing the activation of ___________ in the inflammatory response.

A

Leukotrienes

17
Q

what is the most important adverse effect of Montelukast that monitor for as a nurse?

its a MODIFIER, this drug can MODIFY your thoughts in a negative way and cause……….

A

neuropsychiatric manifestations that include suicidal thoughts and behavior

18
Q

Zileuton + Zafirlukast are 2 other kinds of leukotriene modifiers, but aren’t as popular to use because they have a huge risk of causing__________.

A

liver damage

19
Q

1st gen. antihistamines are sedating whereas 2nd gen. antihistamines are ______.

A

non-sedating

20
Q

what drug is an example of a 1st gen. antihistamine?

A

Diphenhydramine

21
Q

True or false?
1st gen. antihistamines, like diphenhydramine, are also mild anticholinergics.

A

True

22
Q

What makes a 2nd gen. antihistamine, like cetirizine, non sedating?

A

this drug is only “antagonizing” the histamine receptor sites instead of binding, and also targeting only the peripheral histamine receptor sites, which is what’s causing it to be non-drowsy

23
Q

True or false? cetirizine’s therapeutic effects last loner so the dose is only 1x/ day.

A

true

23
Q

If phenylephrine is a Alpha 1 Agonist and mimics the SNS, how is it treating allergic rhinitis, sinusitis and the common cold?

A

this drug is vasoconstricting the blood vessels to open the nasal passages and relieve nasal congestion to allow the patient to get rid of secretions

24
Q

why are Pseudoephedrine and Ephedrine rarely prescribed to help reduce nasal congestion?

A

because of their abuse potential

25
Q

Dextromethorphan is a non-opioid antitussive but in HIGH does it can still cause________ + __________.

A

euphoria + hallucinations

26
Q

Antitussives suppress what?

A

the cough reflex in the brain

27
Q

Codeine is an Opioid antitussive used to suppress a chronic, non-productive cough. if you assess your patients RR is <12, what can be given to counteract the opioid to bring their RR + o2 sat. back up?

A

Naloxone

28
Q

If your patient is taking codeine, why is it important to educate them not to use St. John’s Wort?

A

this drug can increase sedative effects

29
Q

Guaifenesin is a mucous expectorant, what does that mean?

A

this drug is thinning the mucus/ secretion so it drains from the nose + sinuses more easily, also so it is easier for the patient to cough + clear it from their lungs

30
Q

What are the therapeutic uses for Guaifenesin (Mucinex)?

A

-viral URI’s + bronchitis

31
Q

How does a Mucolytic, like Acetylcysteine (mucomyst) this the mucus and allow it to be removed more easily?

A

this drug breaks the disulfide links of the proteins in mucus which decreases viscosity

32
Q

true or false? mucomyst can also be used to treat overdose of acetaminophen.

A

true

33
Q

Why does Acetylcysteine ESPECIALLY cause GI upset with N/V?

A

because it has a rotten egg smell