Respiratory Meds and VTE Flashcards
_____ SNS and/or _____ PSNS is beneficial to maintain normal bronchial lumen air size
increase SNS
decrease PSNS
where are beta 2 receptors?
in lungs and skeletal muscle
beta 2 receptors are ______ for the SNS and ____ for the PSNS (adrenergic or cholinergic)
SNS - adrenergic
PSNS - cholinergic
the SNS ____ (dilates/constricts) at the beta 2 receptos
dilates
what are the 3 main causes of abnormal bronchial tone?
inflammation
excessive PSNS
reduced SNS
2 main categories of bronchodilators
sympathomimetic agents
decongestants
what are the parasympatholytic agents
muscarinic antagonists
methylxanthines
corticosteroids
the Vagus nerve carries out its efferent output via wat neurotransmitter?
ACH
what is the most common parasympatholytic agent?
atropine
bronchodilators are indicated for what respiratory diseases?
acute asthma and anaphylaxis
what is the first line of drugs used?
sympathomimetic agents
T/F: sympathomimetics are used for upper respiratory disorders.
F; lower
sympathomimetics stimulate ___ receptors
beta 2
which drug class is a short acting beta2 agonist (SABA)?
sympathomimetics
a rescue inhaler is considered a ____ class
SABA
side effects of bronchodilators
increase HR
increased BP
palpitations
angina
tremors
what is a non-selective (affects all adrenergic receptors) bronchodilator?
epinephrine
if a person has a _____% increase in FEV1 after taking a bronchodilator, asthma is diagnosed
12-15%
what meds are SABAa?
Albuterol
Salbutamol
what meds are LABAs?
formoterol
salmeterol
SABAs work for ____ hours
4-6
LABAs work for _____ hours
10-12
what meds can be given to COPD pt with bronchospasms?
selective beta 2 adrenergic agonists (SABA & LABA)
what is the largest concern with using decongestants?
blood pressure
decongestants stimulate ___ receptors to …
alpha-adrenergic
shrink mucosal membranes
side effects of decongestants
dizziness
hypertension
nausea
nervousness
insomnia
headaches
CV irregularities
where are alpha receptors?
gut
decongestants cause vaso____ in the abdominal vessels
constriction
indications for muscarinic antagonists
- bronchodilation
- reduces secretions in mouth and airways
- reverse paralysis of respiratory system due to poisoning
- used for bradycardia
are muscarinic antagonists used for asthma?
no
suffix for muscarinic antagonists
-pium
side effects of muscarinic antagonists
dry mouth and/or skin
headaches
tachycardia
blurred vision
rash
decreased GI activity
dizziness
confusion
methylxanthines promote increased ____
cAMP
suffix for methylxanthines
-lline
methylxanthines are ______ inhibitors
phosphodiesterase
indications of methylxanthines
- promote prostaglandin inhibition (decrease inflammation)
- enhance catecholamine production
- stimulate CNS and skeletal mm
how does methylxanthines increase exercise tolerance?
increased contractility of skeletal mm and reduce fatigue of diaphragm
cAMP is a precursor for
epinephrine and norepinephrine
phosphodiesterase inhibitors are a ______ class of cardiac meds
positive inotrope
side effects of methylxanthines
chest pain
dizziness
fainting
fast, slow, or irregular heartbeat
increased urine
lightheadedness
persistent vomiting
pounding or rapid pulse
seizures
tremors
which meds are immunosuppressants?
corticosteroids
indications for corticosteroids
- limit inflammation
- decrease mucus secretions
side effects of corticosteroids
all immune cells decreased
retain water (Cushing’s)
myopathy
osteoporosis
decrease tissue healing
hyperglycemia
hypokalemia !!
thrombus formation !!
growth retardation
Gold 1 COPD classification
FEV1 = 80%+
Gold 2 COPD classification
FEV1 = 50-79%
Gold 3 COPD classification
FEV1 = 30-49%
Gold 4 COPD classification
FEV1 <30%
which test measures dyspnea?
Modified Medical Research Council Dyspnea Scale (mMRC)
which test measures COPD symptoms?
COPD Assessment Test (CAT)
side effect of respiratory stimulants
respiratory drive to breath decreased due to less stimulation by CO2
respiratory depressants indications
hyperventilation cause by:
sepsis
large infection
brain injury
what class is morphine?
respiratory depressant
dopram indications
respiratory stimulant:
stimulates chemoreceptors in carotid arteries and cortical-spinal neurons
Is it worse to have a VTE distal or proximal? why?
proximal (popliteal up)
larger vessels = larger VTE
higher risk of morbidity
what is used to assess risk of VTE?
Padua Prediction Score
use ______ criteria to decide if treat pt with VTE
Wells
what Wells criteria score indicates a high risk of VTE?
greater than 3
(8 is highest)
what test assess UE VTE risk?
Constans
what Constans score indicates a high risk of UE DVT?
2-3
what interventions should PT do to decrease risk of DVT?
- encourage mobility and PA
- use mechanical compression
- consult MD about meds
- educate on VTE preventions
T/F: the Homan’s sign is an effective and validated way of testing for DVT
FALSE
normal D-dimer level
<500 ng/mL
what lab values dictate if it is safe to get pt up after coagulation?
prothrombin time (PT)
partial thromboplastin time (PTT)
what is used to monitor the effectiveness of Warfarin (anticoagulant) for blood thinning?
International Normalized Ratio (INR)
there is an increased risk of clots with a _____ International Normalized Ratio (INR)
lower
there is an increased risk of bleeding with a _____ International Normalized Ratio (INR)
higher
what is a normal International Normalized Ratio (INR)?
2-3
a pt who has had a embolectomy will be under ___ precautions
sternal
