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Pharmacology > Respiratory Midterm II > Flashcards

Respiratory Midterm II Flashcards

1
Q

Common goals for common cold (rhinovirus)

A
  • Relief of symptoms
  • Reduction of the risk for complications
  • Prevention of spread to others
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2
Q

HRV mechanisms Transmission?

A
  • Airborne transmission by small particles (droplets)
  • Airborne transmission by large particles
  • Direct contact
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3
Q

Decongestant SE’s (pseudoephedrine, Oxymetolazine HCL, Phenylephrine HCL)

A

Palpitations, headaches, increased blood pressure,

dizziness, GI upset, tremor, insomnia

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4
Q

Expectorant SE’s (Guaifenesin)

A

Drowsiness, headache, dizziness, GI upset

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5
Q

Antitussives

A

Dextromethorphan, Tessalon Perles

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6
Q

Risk Factors for Acute Rhinosinusitis?

A 
• Winter season; air pollution 
• Septal deviation; nasal polyps 
• Allergic rhinitis 
• Tobacco smoke 
• Cystic fibrosis 
• Gastroesophageal reflux 
• Asthma
-Prior upper respiratory tract infection 
• Dental infections 
• Immunodeficiency 
• Intranasal medications or illicit drugs 
• Mechanical ventilation 
• Nasogastric tubes
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7
Q

NonPharm treatment for URI

A
  • Adequate rest and hydration
  • Elevating the head of the bed while sleeping
  • Use of a humidifier
  • Avoidance of environmental factors such as allergens, cigarette smoke, and pollution
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8
Q

What are some diagnostic observations of asthma?

A

• The presence of symptoms consistent with asthma – Wheeze, shortness of breath, cough, and chest
tightness
• The presence of variable airflow limitation
– Measured by spirometry – Airflow obstruction reversibilit

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9
Q

All persons with asthma, regardless of the severity of asthma, require what kind of medication?

A

Short-acting beta2-adrenergic agonist bronchodilator for quick relief of acute symptoms.

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10
Q

Drugs used to treat asthma?

A
  • Beta2-adrenergic agonists
  • Corticosteroids
  • Leukotriene modifiers
  • Mast cell stabilizers
  • Methylxanthines
  • Monoclonal antibodies
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11
Q

1st line of asthma therapy?

A

• A short-acting rescue bronchodilator to be used as needed is required for all persons with asthma.

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12
Q

Persons with mild persistent asthma (Step 2) use?

A

Low-dose ICS

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13
Q

Persons with moderate persistent asthma (Steps 3 and 4) use?

A

Medium-dose ICS

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14
Q

Persons with severe persistent asthma (Steps 5 and 6) use?.

A

High-dose ICS

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15
Q

Persons with Step 2 mild persistent asthma could use this as an alternative?

A

Cromolyn, a leukotriene modifier, or theophylline

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16
Q

Persons with Step 3 moderate persistent asthma would use this method as an alternative?

A

A combination of low-dose inhaled corticosteroid plus a leukotriene modifier or theophylline

17
Q

Persons with Step 4 moderate persistent asthma would use this alternative?

A

A combination of medium-dose inhaled corticosteroid plus a leukotriene modifier or theophylline

18
Q

What is considered a mild asthma exacerbation?

A

Dyspnea with activity and an initial peak expiratory flow 70% or better than predicted or personal best; may be managed at home.

19
Q

What is considered a moderate asthma exacerbation?

A

Dyspnea that interferes with or limits usual activity and an initial peak expiratory flow 40% to 69% of predicted or personal best.

20
Q

What is considered a severe asthma exacerbation?

A

Dyspnea at rest that interferes with conversation and a peak expiratory flow less than 25% of predicted or personal best.

21
Q

COPD Diagnostics?

A
  • Chronic cough with our without chronic sputum production.
  • Persistent progressive dyspnea that worsens with exercise.
  • May or may not complain of chest tightness.
  • May or may not have audible wheezing, cyanosis, barrel-shaped chest, low diaphragms, and signs of cor pulmonale.
  • Spirometry is required for diagnosis of COPD.
22
Q

Drugs Used for COPD?

A

Short acting Beta Agonists, Short Acting Anticholinergics, Long-acting Beta Agonists and Long acting Anticholinergics

23
Q

Other treatments used for COPD include?

A
  • Immunizations
  • Oxygen
  • Antibiotics
24
Q

Management steps for acute COPD exacerbation?

A
  • Increasing the dose and/or frequency of the short-acting bronchodilator (SABA or SAMA)
  • Adding a 5-day course of oral corticosteroids if the FEV1 is less than 50% of predicted
  • Adding a 5- to 10-day course of antibiotics if all three cardinal symptoms COPD exacerbation symptoms are present, the person has purulent sputum plus one other cardinal symptoms, or the person required endotracheal intubation and mechanical ventilation
  • Supplemental oxygen to maintain the PaO2 55 mm Hg
25
Q

Patient education for COPD

A
  • Drug information
  • Patient-oriented information sources
  • Nutrition/lifestyle changes
  • Complementary and alternative medications
  • Respiratory devices
26
Q

Indications for antibiotics in bronchitis?

A
  • Concomitant (COPD)
  • High fevers
  • Purulent sputum
  • Respiratory symptoms for more than 4 to 6 days
  • Patients over 65 years of age
  • Those with chronic diseases
27
Q

Causes for Chronic Bronchitis?

A
  • Most common cause is tobacco smoke.
  • Colonization of the lower airways with bacteria such as H. influenzae, M. catarrhalis, and S. pneumoniae may occur.
  • There is presence of gastroesophageal reflux and hypersecretion of mucus in patients with asthma.
  • Viral infections account for nearly one third of acute exacerbations.
  • Exposures to environmental pollution or unknown factors contribute to the remainder of acute exacerbations.
28
Q

What are the cardinal symptoms of an exacerbation of COPD?

A
  • Increase in dyspnea (shortness of breath)
  • Increase in sputum volume
  • Increase in or presence of sputum purulence
29
Q

What are the indications for hospitalization due to pneumonia?

A
  • Severe vital sign abnormality: pulse >140/min; systolic blood pressure <90 mm Hg; respiratory rate >30/min
  • Altered mental status (newly diagnosed): disorientation to person, place, or time; stupor or coma
  • Arterial hypoxemia: PO2 <60 mm Hg on room air
  • Suppurative pneumonia-related infection: empyema, septic arthritis, meningitis, endocarditis
  • Inability to tolerate oral medications
  • Severe electrolyte, hematologic, metabolic laboratory value not known to be chronic
  • Lack of adequate outpatient support services for follow-up treatment
30
Q

What are indications needed for diagnosis of community acquired pneumonia?

A

– Symptoms of acute infection and acute infiltrates
detected by chest x-ray, OR
– Auscultatory findings consistent with pneumonia on
physical examination

31
Q

The primary goals for eradicating CAP?

A
  • Eradicating the offending microorganism through the selection of appropriate antibiotic therapy
  • Complete clinical cure
  • Preventing complications from pneumonia (e.g., respiratory failure, sepsis, empyema)
  • Minimizing adverse effects of medications

Pharmacology (16 decks)

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