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Pharmacology > Respiratory Meds > Flashcards

Respiratory Meds Flashcards

1
Q

Antihistamines

A
  • blocks histamines from H1 receptor sites and prevents histamine (inflammatory) response
  • decreases nasopharyngeal secretions, itching
  • 1st and 2nd gen antihistamines
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2
Q

1st Gen Antihistamines

A
  • -mine
  • S/E: drowsiness, dry mouth, blurred vision, fluid retention

diphenhydramine (benadryl) anticholinergic, chlorpheniramine is cardiac safe

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3
Q

2nd Gen Antihistamines

A
  • -dine
  • preferred over 1st gen
  • for daily use
  • less drowsiness & other anticholinergic symptoms

loratadine (claritin), fexofenadine (allegra)

loratadine given sublingual, not strong enough for violent anaphylactic response

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4
Q

Diphenhydramine

Benadryl

A
  • used for acute/allergic rhinitis, pruritis, urticaria, common cold, sneezing, cough, motion sickness prevention
  • S/E: drowsiness, dry mouth, dizziness, fatigue, blurred vision, disturbed coordination, urinary retention
  • 98% protein bound drug (may interact w/ warfarin, gemfibrozil)
  • onset 30-60 min, don’t take when driving
  • contraindicated in Hx glaucoma, urinary retention, severe liver disease
  • interacts w/ CNS depressants

suggest candy/gum for dry mouth

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5
Q

Nasal Decongestants

A
  • stimulates alpha adrenergic receptors
  • produces nasal vascular constriction, shrinks nasal mucous membranes, reduces nasal secretions
  • S/E: nervousness, restlessness, rebound nasal congestion w/ prolonged use, HTN, renal failure, dysrhythmias
  • may interact w/ caffeine, MAOIs, beta blockers

pseudophedrine, ephedrine, oxymetazoline (afrin)

max use 72 hrs

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6
Q

Intranasal glucocorticoids

A
  • antiinflamatory steroids that decrease rhinorrhea, sneezing, congestion
  • S/E: drowsiness, dizziness, nervousness, GI distress if swallowed, over drying w/ increased use

beclamethasone, fluticasone (flonase)

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7
Q

Antitussives

A
  • act on cough control center in medulla to suppress cough reflex
  • usually used w/ expectorants or other agents
  • Rx
  • same S/E as opiates
  • often opioids, may be nonopioid

codeine and codeine & guaifenesin are narc, benzonatate non-narc

benzonatate aka tessalon pearls

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8
Q

Expectorants

A
  • loosens bronchial secretions by reducing surface tension via dilution/thinning
  • allows for elimination via coughing, does not cause coughing
  • S/E: drowsiness, dizziness, irritability, nausea

guaifenesin (mucinex), dextrimethorphan (robitussin)

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9
Q

Restrictive vs Obstructive lung diseases

A
  • restrictive causes decreased air capacity (issue with inhalation)
  • obstructive causes air trapping (issue with exhalation)
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10
Q

Diseases w/in COPD

A
  • chronic bronchitis, asthma, emphysema
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11
Q

Bronchial Asthma

A
  • allergens attach to mast cells and basophils causing antigen-antibody reaction on mast cells
  • mast cells stimulate release of chemical mediators and initiate the inflammatory process

MCAS

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12
Q

Chronic bronchitis

A
  • “blue bloaters”
  • dusky/cyanotic color, hypoxia, hypercapnia, respiratory acidosis, increasd Hgb, exertional dyspnea, clubbing, use of accessory muscles
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13
Q

Epinephrine

A
  • bronchodilator
  • catecholamine
  • used for acute bronchospasms, asthma, anaphylaxis, angioedema, nasal congestion, status asthmaticus
  • S/E: dizziness, nervousness, tremors, HTN, palpitations, tachycardia, dysrhythmias, angina
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14
Q

Albuterol

A
  • selective beta adrenergic
  • bronchodilator
  • rapid onset (for rescue use)
  • longer duration
  • fewer side effects
  • S/E: headache, rhinitis, excitability, tremors, bronchospasm, palpitations, tachycardia
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15
Q

Metaproterenol

A
  • selective beta adrenergic
  • inhalation
  • long term asthma treatment
  • S/E: headache, tremors, nausea, palpitations, tachycardia
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16
Q

Tiotropium

A
  • anticholinergic
  • maintenance treatment of bronchospasms associated w/ COPD
  • S/E: dry mouth, GI distress, depression, insomnia, headache, pharyngitis, sinusitis, infection, arthralgia, peripheral edema
17
Q

Iprotropium

A
  • anticholinergic
  • combined in a dose w/ albuterol to augment its effects

DuoNeb

18
Q

Methylxanthine derivatives

A
  • relaxes smooth muscle of bronchi/bronchioles & promotes bronchodilation
  • used for asthma
  • therapeutic range –> 5-15 mcg/mL (toxic >20)
  • S/E: hyperreflexia, GI distress, seizures, insomnia, hyperglycemia, hypotension

Theophylline

rhymes with caffeine, similar s/e

19
Q

What is the first choice/best mucolytic?

A

Water

20
Q

Leukotriene receptor antagonists

A
  • -kast and/or z
  • reduce inflammatory process and decrease bronchoconstriction
  • for long-term prophylaxis, not acute distress
  • used for asthma, prophylaxis of exercise-induced bronchospasms
  • S/E: dizziness, headache, confusion, GI distress, depression, weakness, infection, liver impairment

zafirlukast, zileuton, montelukast

21
Q

Complementary therapy interactions

A
  • ephedra may increase effect of theophylline & cause toxicity
  • St. John’s wort may decrease montelukast concentration
22
Q

Glucocorticoids

steroids

A
  • -sone
  • made in adrenal cortex, driven by pituitary gland
  • antiinflammatory effect
  • S/E: dry mouth, throat irritation, hyperglycemia, HTN, electrolyte imbalance, fluid retention, osteoporosis, psychosis, superinfections
  • cannot abruptly stop taking, can be fatal
23
Q

Cromolyn sodium

A
  • inhibits histamine release from mast cells
  • prevents asthmatic attacks
  • good for kids
  • S/E: cough, bad taste, rebound bronchospasm
24
Q

Acetylcystine

A
  • mucolytic
  • liquifies and loosens thick mucus secretions
  • nebulizer 5 min after bronchodilator
  • should not be mixed w/ other drugs, can be mixed w/ flavor
  • S/E: stomatitis, rhinorrhea, N/V

also antidote for acetaminophen

25
Q

Dornase alfa

A
  • mucolytic
  • breaks down DNA in thick sputum of cystic fibrosis pts
  • S/E: sore throat, laryngitis, horseness, chest pain
26
Q

Trimethoprim-sulfamethoxazole

Bactrim

A
  • antibiotic/antimicrobial
  • used to treat mild to moderate exacerbations of chronic bronchitis from infectious causes

Pharmacology (15 decks)

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