Respiratory Meds. Flashcards
rotation 1 - week 5
If you’re taking a glucocorticoid in combination w/ a bronchodilator, which one do you take first?
you take the bronchodilator first to allow the airways to open, which then allows the glucocorticoid to be more effective
Albuterol and Salmeterol are both bronchodilators used to treat acute asthma attacks. Which one is a SABA + which one is a LABA?
Albuterol is a short acting Beta2 Agonist and Salmeterol is a long acting Beta2 Agonist
Why should patients who have a history of tachydysrhythmias, HTN, or other cardiovascular diseases be cautious when taking albuterol or salmeterol?
because these drugs increase the stimulation of the sympathetic nervous system, which increases HR + BP, and can cause chest pain
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?
Ipratropium is a short acting muscarinic antagonist and umeclidinium is a long acting muscarinic antagonist
If SAMAs + LAMAs are also anticholinergic what 3 kinds of patients should not take this medication?
-Hx. of glaucoma
-Hx. of BPH or bladder neck obstruction
-Hx. of urinary retention
Which medication is a Methylxanthine, that relaxes smooth muscle of the bronchi to dilate them, for long term treatment of chronic stable asthma?
Theophylline
When a patient is going to be taking Theophylline, why is it important to know if they smoke?
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.
What is the therapeutic range of Theophylline, before it causes toxicity?
If it does become toxic what will the patient present with?
10-15mg/L; seizures and/ or dysrhythmias
Glucocorticoids are steroids. How are they used to treat chronic asthma long term and short term treatment of COPD exacerbation?
steroids are anti-inflammatory, they prevent the release of:
-histamines
-leukotrienes
-prostaglandins
to decrease edema in the airways
True or False? These 3 drugs are glucocorticoids and this is how they’re administered.
-Beclomethasone: inhalant
-prednisone: oral
-fluticasone: nasal
TRUE
Why is it important to take calcium + vitamin D supplements while on a glucocorticoid?
these drugs cause muscle wasting and bone demineralization that could lead to osteoporosis
What are mast cells?
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
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?
take this about 30 minutes prior to doing yardwork or exercising
cromolyn is a mast cell stabilizer, when being used does this drug dilate the bronchioles?
NO. this drug should not be used for an acute asthma attack because it can take a few weeks to reach a therapeutic effect
cromolyN is given via _________.
nebulizer
Montelukast is a Leukotriene Modifier that decreases bronchoconstriction and inflammation by preventing the activation of ___________ in the inflammatory response.
Leukotrienes
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……….
neuropsychiatric manifestations that include suicidal thoughts and behavior
Zileuton + Zafirlukast are 2 other kinds of leukotriene modifiers, but aren’t as popular to use because they have a huge risk of causing__________.
liver damage
1st gen. antihistamines are sedating whereas 2nd gen. antihistamines are ______.
non-sedating
what drug is an example of a 1st gen. antihistamine?
Diphenhydramine
True or false?
1st gen. antihistamines, like diphenhydramine, are also mild anticholinergics.
True
What makes a 2nd gen. antihistamine, like cetirizine, non sedating?
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
True or false? cetirizine’s therapeutic effects last loner so the dose is only 1x/ day.
true
If phenylephrine is a Alpha 1 Agonist and mimics the SNS, how is it treating allergic rhinitis, sinusitis and the common cold?
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
why are Pseudoephedrine and Ephedrine rarely prescribed to help reduce nasal congestion?
because of their abuse potential
Dextromethorphan is a non-opioid antitussive but in HIGH does it can still cause________ + __________.
euphoria + hallucinations
Antitussives suppress what?
the cough reflex in the brain
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?
Naloxone
If your patient is taking codeine, why is it important to educate them not to use St. John’s Wort?
this drug can increase sedative effects
Guaifenesin is a mucous expectorant, what does that mean?
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
What are the therapeutic uses for Guaifenesin (Mucinex)?
-viral URI’s + bronchitis
How does a Mucolytic, like Acetylcysteine (mucomyst) this the mucus and allow it to be removed more easily?
this drug breaks the disulfide links of the proteins in mucus which decreases viscosity
true or false? mucomyst can also be used to treat overdose of acetaminophen.
true
Why does Acetylcysteine ESPECIALLY cause GI upset with N/V?
because it has a rotten egg smell
