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Med- Math Exam 1 > Respiratory Meds > Flashcards

Respiratory Meds Flashcards

1
Q

Beta-2 Adrenergic Agonists prototype

A

Albuterol

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2
Q

Beta-2 Adrenergic Agonists action

A

activate beta-2 receptors in the bronchial smooth muscle which results in bronchodilation relieving bronchospasm, inhibiting histamine release, and increasing ciliary motility

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3
Q

Beta-2 Adrenergic Agonists therapeutic uses

A
  • prevention of exercise induced asthma episode
  • inhaled short acting form used for prevention of asthma
  • treatment of bronchospasm
  • long term control of asthma
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4
Q

Beta-2 Adrenergic Agonists complications

A

TACHYCARDIA, ANGINA due to activation of alpha- 1 receptors in the heart (client should report pain or increase of HR 20-30 bpm, avoid caffeine, consider reduction of dose)
TREMORS due to activation of beta- 2 receptors in skeletal muscles (usually resolves with continued medication use, consider dose reduction)

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5
Q

Beta-2 Adrenergic Agonists contraindications/ precautions

A

pregnancy risk category C, clients with tachydysrhythmias, or clients with DM, hyperthyroid, heart disease, HTN, and angina

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6
Q

Beta-2 Adrenergic Agonists nursing administration

A

follow instructions for administration, use beta- 2 before glucocorticoid if prescribed both b/c will allow for bronchodilation and increased absorption, do not exceed prescribed dose, know dosage schedule, log asthma exacerbations and inform provider of change in frequency

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7
Q

Methylxanthines prototype

A

Theophylline

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8
Q

Methylxanthines action

A

relaxation of bronchial smooth muscle, resulting in bronchodilation (used less frequently because newer meds are safer)
administered oral or IV (emergency use)

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9
Q

Methylxanthines therapeutic uses

A

long-term control of chronic asthma or COPD

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10
Q

Methylxanthines complications

A

MILD TOXICITY REACTION CAN INCLUDE GI DISTRESS AND RESTLESSNESS and more severe reactions can occur with higher therapeutic levels and can include DYSRHYTHMIAS and SEIZURES (monitor serum levels, if symptoms occur stop treatment - activated charcoal decreases absorption, lidocaine treats dysrhythmias, and diazepam controls seizures, periodic blood monitoring required, report - nausea, diarrhea, or restlessness)

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11
Q

Methylxanthines contraindications/ precautions

A

pregnancy risk category C
use cautiously with heart disease, hypertension, liver & kidney dysfunction, diabetes mellitus, in children, and older adults

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12
Q

Methylxanthines nursing administration

A

do not double dose if dose missed, do not crush or chew sustained- release preparations

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13
Q

Inhaled Anticholinergics prototype

A

Ipratropium

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14
Q

Inhaled Anticholinergics action

A

block muscarinic receptors of bronchi resulting in bronchodilation

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15
Q

Inhaled Anticholinergics therapeutic uses

A

relieve bronchospasm associated with COPD

allergen-induced and exercise induced bronchospasm

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16
Q

Inhaled Anticholinergics complications

A

DRY MOUTH and HOARSENESS considered local anticholinergic effects (advise client to sip fluid and suck on sugar free hard candy to control dry mouth)

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17
Q

Inhaled Anticholinergics contraindications/ precautions

A

pregnancy risk category b
allergy to peanuts
used cautiously when narrow-angle glaucoma and benign prostatic hyperplasia

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18
Q

Inhaled Anticholinergics nursing administration

A

rinse mouth after inhalation to decrease unpleasant taste, adult dose is usually 2 puffs, wait directed length of time between puffs, if two meds are prescribed wait at least 5 minutes between medications

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19
Q

Glucocorticoids prototype

A

Prednisone (oral form)

Beclomethasone (inhaled form)

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20
Q

Glucocorticoids action

A

prevent inflammation, suppress airway mucus production, promote responsiveness of beta2 receptors in bronchial tree
reduction in airway mucosa edema
use is not to provide immediate effects, but rather promote decreased frequency and severity of exacerbations and acute attacks

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21
Q

Glucocorticoids therapeutic use

A

short term IV agents for status asthmaticus, inhaled for long-term prophylaxis of asthma, short-term oral therapy following acute asthma episode, long-term oral therapy for chronic, severe asthma, promote lung maturity and decrease respiratory distress in fetuses at risk for preterm birth

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22
Q

Glucocorticoids complications

A

BECLOMETHASONE
DIFFICULTY SPEAKING, HOARSENESS, and CANDIDIASIS (rinse mouth or gargle with water after use, monitor for redness, sores, or white patches - treat candidiasis with nystatin oral suspension)
PREDNISONE with greater than 10 day use
SUPPRESSION OF ADRENAL FUNCTION due to decrease in ability of adrenal cortex to produce glucocorticoids secondary to inhaled or oral agents (administer oral med on alternate day dosing schedule, monitor blood glucose levels, taper dose and do not stop abruptly)
BONE LOSS with inhaled or oral agents (perform weight bearing exercises, consume diet with sufficient calcium and vitamin D, use lowest possible does, oral med should be given on alternate day schedule)
HYPERGLYCEMIA and GLYCOSURIA (monitor blood glucose, clients with DM may need increase in insulin dosage)
MYOPATHY as evidenced by muscle weakness (report signs of weakness, med dosage should be decreased)
PEPTIC ULCER DISEASE (avoid NSAIDs, report black tarry stools, check stool for occult blood periodically, administer with food or meals)
INFECTION (report early signs of infection including sore throat, weakness, malaise)
DISTURBANCES OF FLUID AND ELECTROLYTES fluid retention as evidenced by weight gain and edema and hypokalemia as evidenced by muscle weakness (observe for manifestations and report to provider)

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23
Q

Glucocorticoids contraindications/ precations

A

pregnancy risk category C
contraindicated in clients who have received a live virus vaccine and those who have systemic fungal infections
use cautiously with children, pts with DM, HTN, heart failure, PUD, osteoporosis, and/or kidney dysfunction

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24
Q

Glucocorticoids nursing administrations

A

use on a fixed schedule not for acute episodes
administer using MDI, DPI, or nebulizer
devices with HFA do not require spacer
inhale beta-2 agonist before glucocorticoid
oral glucocorticoids are used short term, 3-10 days after acute episode
if on long term therapy, may require additional doses in times of stress

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25
Q

Leukotriene Modifiers prototype

A

Montelukast

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26
Q

Leukotriene Modifiers action

A

suppress the effects of leukotrienes, thereby reducing inflammation, bronchoconstriction, airway edema, and mucous production

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27
Q

Leukotriene Modifiers therapeutic use

A

long-term therapy of asthma in adults and children, and to prevent exercise-induced bronchospasm

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28
Q

Leukotriene Modifiers complications

A

DEPRESSION and SUICIDAL IDEATIONS (monitor for behavior changes)

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29
Q

Leukotriene Modifiers contraindications/ precautions

A

pregnancy category B, use cautiously in patients with liver dysfunction

30
Q

Leukotriene Modifiers nursing administration

A

monitor for behavior changes, obtain baseline liver function tests, monitor for liver damage (nausea, anorexia, abdominal pain), take montelukast once daily at bedtime, or take 2hr before exercise if exercise-induced bronchospasm (but dont take additional dose)

31
Q

Antitussives - opioids prototype

A

Codeine

32
Q

Antitussives - opioids action

A

suppresses cough by acting on CNS to increase cough threshold

33
Q

Antitussives - opioids therapeutic use

A

chronic nonproductive cough to decrease frequency and intensity

34
Q

Antitussives - opioids complications

A

CNS - DIZZINESS, LIGHTHEADNESS, DROWSINESS, RESPIRATORY DEPRESSION (obtain baseline vitals, monitor ambulation, change positions slowly, lay down if light headed, monitor for respiratory depression - antidote: Naloxone, avoid activities that require alertness)
GI - NAUSEA, VOMITING, CONSTIPATION (take with food, increase fluids and dietary fiber)
OPIOID USE DISORDER (alert client of potential abuse, use for short duration)

35
Q

Antitussives - opioids contraindications/ precautions

A

pregnancy class C, contraindicated in clients with respiratory depression, acute asthma, head trauma, liver and renal dysfunction and alcohol disorder, use cautiously with children, older adults and those with a history of substance abuse

36
Q

Antitussives - opioids nursing administration

A

avoid activities that require alertness, change positions slowly, lay down if feeling dizzy, avoid alcohol and other CNS depressants

37
Q

Antitussives - non-opioids prototype

A

Dextromethorphan

38
Q

Antitussives - non-opioids action

A

acts on CNS to depress cough, although it is not an opioid it is derived from opioids

39
Q

Antitussives - non-opioids therapeutic use

A

cough suppression, reduce pain when combined with an opoid

40
Q

Antitussives - non-opioids complications

A

med has few adverse effects but may cause nausea, dizziness, sedation
potential for abuse as the medication can instill euphoria in high doses

41
Q

Antitussives - non-opioids contraindications/ precautions

A

pregnancy risk category C

42
Q

Antitussives - non-opioids nursing administration

A

cause fever if given within 2 weeks of a MAOI, risk of abuse, some formulas can contain alcohol and/or sucrose

43
Q

Expectorants prototype

A

Guaifenesin

44
Q

Expectorants action

A

increased cough production by increasing and thinning mucus secretion. This decreases chest congestion by coughing out secretions

45
Q

Expectorants therapeutic use

A

combined with antitussives or decongestant to treat cold, allergic or non allergic rhinitis or cough caused by lower respiratory disorders

46
Q

Expectorants complications

A 
GI UPSET (take with food if upset occurs)
DROWSINESS/ DIZZINESS (do not do activities that require alertness)
ALLERGIC RXN - RASH (stop med and call doctor if this occurs)
47
Q

Expectorants contraindications/ precautions

A

pregnancy risk class C, breastfeeding, might be contraindicated in children

48
Q

Expectorants nursing administration

A

take with food, increase fluid, do not take prior to driving, tablets should not be crushed, read label - this is often used in combination with other medications, report a cough lasting longer than 1 week

49
Q

Mucolytics prototype

A

Acetylcysteine

50
Q

Mucolytics action

A

thin and enhance flow of secretion in the respiratory passages

51
Q

Mucolytics therapeutic use

A

acute or chronic pulmonary disorders exacerbated by large amounts of secretions, cystic fibrosis, antidote for acetaminophen poisoning

52
Q

Mucolytics complications

A

ASPIRATION and BRONCHOSPASM when administered orally (monitor for conditions, if indicated stop med immediately and notify provider)
DIZZINESS, DROWSINESS, HYPOTENSION, TACHYCARDIA (monitor vital signs, change positions slowly, avoid activities that require alertness)
HEPATOTOXICITY (monitor liver function tests)

53
Q

Mucolytics contraindications/ precautions

A

pregnancy risk category B, clients hypersensitive to acetylcysteine, use cautiously in clients with hypothyroidism, CNS depression, renal, liver disease, seizure disorders, and asthma (potential for bronchospasm)

54
Q

Mucolytics nursing administration

A

monitor vitals, change position slowly, assess for manifestations of aspiration, monitor liver function tests, tell patient the medication smells like rotten eggs (ew!), be prepared to suction

55
Q

Decongestants prototype

A

Phenylephrine

56
Q

Decongestants action

A

sympathomimetic decongestant that stimulates alpha 1-adrenergic receptors causing reduced inflammation of the nasal membranes

57
Q

Decongestants therapeutic use

A

allergic/non-allergic rhinitis, relieves nasal stuffiness, decongestant for sinusitis and common cold

58
Q

Decongestants complications

A

REBOUND CONGESTION secondary to prolonged use of topical agents (only used for short term therapy - 3 to 5 days, taper use and discontinue medication using one nostril at a time)
CNS stimulation AGITATION, NERVOUSNESS, UNEASINESS (rare with topical agent, report symptoms, stop medication if symptoms occur)
VASOCONSTRICTION (advise clients who have HTN, cerebrovascular disease, dysrhythmias, and coronary artery disease to avoid these meds)

59
Q

Decongestants contraindications/ precautions

A

cardiac patients (CAD, HTN, cerebrovascular disease and dysrhythmias), closed-angle glaucoma

60
Q

Decongestants nursing administration

A

when administering drops be in lateral, head- low position to increase desired effects and to prevent swallowing meds
if using topical agent do not use for more than 3-5 days to avoid rebound congestion (no concern for rebound with oral)
taper use and discontinue one nostril at a time
do not exceed recommended dose

61
Q

Antihistamines prototype

A

1st generation H1 Antagonists–Diphenhydramine

2nd Generation H1 Antagonists– Cetirzine & Fexofenadine

62
Q

Antihistamines action

A

action on the H1 receptors, which results in the blocking of histamine release in the sm blood vessels, capillaries, and nerves during allergic reactions. These medications relieve itching, sneezing, and rhinorrhea, but do not relieve nasal congestion. 1st generation produce cholinergic effects and drowsiness

63
Q

Antihistamines therapeutic use

A

mild allergic reactions (seasonal allergic rhinitis, urticaria, mild transfusion reaction), anaphylaxis (hypotension, acute laryngeal edema, bronchospasm), motion sickness, insomnia, used in combination with sympathomimetics to provide nasal decongestant effect

64
Q

Antihistamines complications

A

SEDATION common with 1st generation H1 antagonists (take at night, avoid activities that require alertness)
anticholinergic effects DRY MOUTH, CONSTIPATION most common with 1st generation agents (sugar free gum or hard candy to avoid dryness with 2-3L water per day)
GI discomfort NAUSEA, VOMITING, CONSTIPATION (take with meals)
ACUTE TOXICITY, EXCITATION, HALLUCINATIONS, INCOORDINATION, SEIZURES in children, FLUSHED FACE, HIGH FEVER, TACHYCARDIA, DRY MOUTH, URINARY RETENTION, PUPIL DILATION (notify provider if effects occur, activated charcoal and cathartic decrease absorption, acetometophin for high fever, apply ice packs or sponge baths)

65
Q

Antihistamines contraindications/ precautions

A

3rd trimester of pregnancy, breastfeeding mothers (it can dry up their milk supply!), and for newborns (sedation effect), pregnancy risk category C, use cautiously in children and adults (respiratory depression), contraindicated in clients who have cardiac dysrhythmias, hepatic diseases, and those on MAOI therapy, caution in clients with asthma, seizure disorder, cardiac disease, renal disease, urinary retention, open-angle glaucoma, hypertension, and prostate hypertrophy

66
Q

Antihistamines nursing administration

A

avoid alcohol and meds causing CNS depression

67
Q

Nasal Glucocorticoids prototype

A

Mometasone

68
Q

Nasal Glucocorticoids action

A

decrease inflammation associated with allergic rhinitis, first line treatment for nasal congestion

69
Q

Nasal Glucocorticoids therapeutic use

A

reduce the effects of allergic rhinitis including sneezing, nasal itching, runny nose

70
Q

Nasal Glucocorticoids complications

A

SORE THROAT, NOSEBLEED, HA, BURNING IN NOSE (contact provider if adverse effects occur)

71
Q

Nasal Glucocorticoids contraindications/ precautions

A

Pregnancy risk category C

72
Q

Nasal Glucocorticoids nursing administration

A

use metered-dose spray device, dose daily, may take 7 days or more for maximum relief, if perennial allergic rhinitis may take as long as 21 days for relief, clear blocked nasal passages with a topical decongestant prior to administering

Med- Math Exam 1 (3 decks)

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