Respiratory Module 3 Flashcards
Where in the body is Histamine found
Body tissue
Where is the highest concentration of Histamine found
Mast Cells and Basophils
What is produced in response to injury and released in allergic and hypersensitivity reaction
Histamine
What forms the foundation for many cold remedies
Histamine
Antihistamine is an antagonist of the __ receptor site
H1
Antihistamine is considered a ____ because it _____ secretions
Drier
Dries
A _______ blocks the action of histamine
Antihistamine
Seasonal allergy, Hypersensitivity, N&V, motion sickness, Parkinson’s, are indications for what drug category
Antihistamines
Histamine should be taken _____ before travel
30-60 min
Patients should want to take med _____ exposure to pollen because it is more effective in ______ them than _____ the allergic reaction
Before
Preventing
Treating
______ is sometimes used to balance anesthesia
Antihistamine
If patient is having an allergic reaction use ________ antihistamine
First generation
Dry mouth, Decreased muscle tone, dilated pupils, burred vision are common side effects of
First generation antihistamines
Fexofenadine (Allegra) should not be given with
Fruit Juice
People may use Second generation Antihistamine because is _______ however has a ________
Non drowsy / Not a sedative
Longer Onset w/ a short duration
____ is the daily dose for Second generation Antihistamines
10mg
DROWSINESS, dry mouth, CONSTIPATION, Urinary retention, Anticholinergic like, Sedation, Hypotension, Gastrotoxicity, Hypersensitivity, Photosensitivity, Paradoxical Excitement, are common side effects of
Antihistamines
Some nursing intervention of taking Antihistamines would be
Monitor B/P
Take food with meals to decrease N&V / Toxicity
Allegra cannot be given with fruit juice
Avoid UV rays use sun block
Asthma, COPD, Glaucoma, Prostate, Pregnant and lactating women are Contraindications of
Antihistamines
People with COPD/Asthma should not take Antihistamines because
Antihistamines dry up secretions
People with glaucoma should not take Antihistamines because
it dilates the pupils so built pressure could lead to lost sight.
Antihistamines can cause respiratory distress leading to __________
thickened secretions
To shrink engorged mucous membranes in the nose to relieve stuffiness is the action of
Nasal Decongestants
________ constrict the blood vessels in the nose to decrease the formation of mucous and increase drainage to LESSEN SWELLING
Nasal Decongestants
Best way to drain sinuses is to have patient
Blow nose
Keep head upright
Sympathomimetics are drugs used as
Nasal Decongestants
Sympathomimetics are commonly used to
Drain sinus cavity
Adjunct indications of Nasal Decongestants are
Middle ear infection, common cold
Gastrotoxicity, and REBOUND CONGESTION are side effects of
Nasal Decongestants / Sympathomimetics
Rebound congestion can come from Drug ____
overuse
Corticosteroids can be used as
Nasal Decongestants
Always assess _____ before administering Nasal Decongestants
Nasal Mucosa
If burning or stinging occur during use of Nasal Decongestant it is important to ______ the medication
discontinue
When taking Nasal Decongestants it is important to monitor
B/P and heart rate
People with _____ should not be taking Nasal Decongestants
HTN
Heart disease
Diabetes
To suppress cough reflex center located in the medulla in the brain is the action of
An Antitussive
______ that are ______ acting as it acts DIRECTLY ON THE COUGH REFLEX CENTER IN THE MEDULLA.
Antitussives
Central
Where is the cough reflex center located
Medulla
Most common adverse effect of Antitussives is
Drowsiness
The two types of Antitussives are
Peripheral
Central
The most effective narcotic form of an Antitussive is
Codeine
Hydrocodone
Most common non narcotic form of Antitussive is
Dextromethorphan (Romilar)
________ acting Antitussives act DIRECTLY ON THE COUGH RECEPTOR IN THE TRACHEA, PHARYNX, AND THE LUNG for a demulcent or LOCAL anesthetic effect
Peripheral
Most commonly used for patients with dry hacking non - productive cough.
Antitussive
Chewing or Sucking on Benzonatate capsules can lead to ________
Cardiovascular collapse
Do not use Antitussives in patients who have
COPD, Asthma
If cough persists beyond 5-7 days it is important for the patient to
Call the doctor
_______ reduces the viscosity and help raise thick tenacious secretion MAKING EXPULSION OF SPUTUM EASIER, ACTS DIRECTLY ON BRONCHIAL GLANDS
Expectorants
Expectorants commonly cause
irritation
Common drug dose for Guaifenesin (Robitussin)
20mg typical dose every 4hours / 2ml
Nursing implications for patients who take expectorants include
POSITION HIGH FOWLER, TEACH DEEP BREATHING COUGH, increase fluids w/o following meals with water
______ is used to Liquify thick tenacious secretions
Mucolytics
Most common Mucolytic is
Acetylcystein (Mucomyst) - (also used for Acetaminophen toxicity)
Mucolytics are not considered expectorants because they ____ the mucous not _____
Break not Thin
Mucolytics cause a _____ common to a _____
Odor
Rotten Egg
Stomatitis, bronchospasms are side effects of
Mucolytics
Nursing implications for Mucolytics include
Give instilled or through a Nebulizer
If liquid mix in COLA OR FRUIT JUICE
Inflammatory respiratory condition characterized by recurrent attack of dyspnea, wheezing, and bronchospasm
Asthma
What is the objective of giving Anti-Asthmatic Drugs
Give the smallest dose and to decrease the number and frequency
____ or ____ therapy can be used to treat Asthma
Single or Multi
Bronchodilators and Anti-inflammatories are examples of
Anti-asthmatic drugs
Sympathomimetics, Methylxanthine, Anticholinergic, and Luekotriene Inhibitors are examples of
Bronchodilators
Corticosteroids and Mast Cell Stabilizers are examples of
Anti-inflammatories
________ are used to relieve bronchospasm associated with respiratory disorders such as ASTHMA, EMPHYSEMA, AND CHRONIC BRONCHITIS
Bronchodilators
_____ dilate the bronchus by stimulating the sympathetic nervous system. Most stimulate the BETA 2 RECEPTOR SITE
Sympathomimetics
Beta 2 receptor site is located in the
Lungs
Short acting Sympathomimetics have
Fast onset, shorter duration
______ drugs are referred to as Quick relief, rescue meds, and treating exercise induced asthma
Short acting Sympathomimetics
Albuterol (Proventil) are a ______ and is used to
Short acting Sympathomimetic used for quick relief for wheezing, bronchospasms
Isoproterenol (Isuprel) is a ______ and can cause
Short acting Sympathomimetic
Mucousa to become pink
Epinephrine is a ______ and is given with a _______ most common use is for _______
Short acting Sympathomimetic
Tuberculin Syringe
Anaphylaxis
Terbutaline (Brethine) is a ______ and can be used to ______ as it ________
Short acting Sympathomimetic
Prevent early labor as it decreases contractions of uterus
Long Acting Beta Agonist (Sympathomimetic) should not be used for
Acute symptoms or acute asthma attack
Beta Agonists are _________
Sympathomimetic
_______ act directly to relax to smooth muscle of the bronchus to increase the size and lumen or the bronchioles
Methyl-Xanthines
Methyl-Xanthines are mild _____
diuretics
_________ are used frequently for pulmonary edema
Methyl-Xanthines
Methyl-Xanthines can also be referred to as
Xanthines / Xanthine Derivatives
Thephylline (Uniphyl) is a ______ and can be used so that patient
Methyl-Xanthines
patient can go home
Theophylline (Uniphyl) should be given with a ______ until _______ then _______
loading dose until therapeutic effect then maintenance dose
Theophylline (Uniphyl) are usually given in what dose
10-20 mcg
Methyl-Xanthines can _______ blood pressure and cause
increase
N&V
Methyl-Xanthines should not be given with
Cola, Coffee, Chocolate, Charcoal
Betablockers erythromycin and cimetidine can
Increase thephylline toxicity and decrease effects allupurinol
_______ drugs block Acetycholine
Anticholinergic
Anticholinergics are used to ______ _______ associated with asthma and COPD and it is similar to _________ effects
prevent bronchospasm
Fight or Flight effects
A common side effect for Anticholinergics is
Decreased muscle tone
Inpratropium Bromide (Atrovent) is a ______ and is commonly used for _____ patients
Anticholinergic
COPD
Luekotriene causes __________ preventing ______
bronchoconstriction
Bronchial Asthma attacks
______ antagonizes luekotriene which is a bronchoconstrictor to DILATE THE BRONCHUS AND DECREASE MUCUS SECRETION
Leukotriene antagonists
Luekotriene Antagonists are used as _______ for _____ term management
Prophylactic
Longterm
Montelukast (Singular) are _______ and is used for ages ________ and are available in
Luekotriene antagonists
12mo+
Tablets, Chewable tablets, Granulated
Common side effects of Luekotriene Antagonists are
Hepatocixity and INCREASED INCIDENCE OF RESPIRATORY TRACT INFECTION
Nursing implications for Luekotriene Antagonists are
MUST CONDUCT LIVER ENZYME TEST
CHECK SKIN FOR JAUNDICE
CHECK STOOL for consistency
Nursing implications for Bronchodilators
Take Vital signs
Auscultate lungs
Give oral with food
Monitor IV rate closely
When using Metered Dose Inhaler (MDI) what are some important things to tell the patient
Wait one minute to recharge
If more than one drug inhaled wait 5 minutes
Rinse mouth after
Make sure Bronchodilator COMES BEFORE Corticosteroid
Not following doctors orders can lead to
Rebound ***
Isuprel and ____ should never be ______
Epinephrine
Given together
When cleaning diskus it is important to never
RINSE
Corticosteroids are most commonly used to
DECREASE INFLAMMATORY PROCESS and prophylactic treatment of bronchial asthma
Beclmethasone (Beclovent), Dexamethasone (Decadron), and Fluticasone (Flovent) are
Corticosteroids
Rinsing mouth after using corticosteroids can
Prevent side effects
Corticosteroids can have what effect on children
Stunt growth
These drugs decrease secretions of HISTAMINE BY THE MAST CELLS
Mast-Cell Stabilizer
Used for prophylactic treatment of mild bronchial asthma especially in CHILDREN when growth retardation is a concern
Mast-Cell Stabilizer
Used for exercise induced bronchospasm
Mast-Cell Stabilizer
Majority of histamine comes from
Mast Cells
Common side effects of Mast-Cell Stabilizer are
Hoarseness, Burning, Stinging, Bad taste in mouth
Mast-Cell Stabilizer are given in
MDI’s
Lafir lukast - Generic and Class?
Accolate
Age 5+
Leukotriene Antagonist
Beclomethasone - Generic and Class?
Qvar
40-160mcg
Anti-inflammatory
Beclomethasone is a Anti-inflammatory and a
corticosteroid
Diphenhydramine - Generic and Class?
Benadryl
25-50mg
Antihistamine First generation
Hydroxyzine - Generic and Class?
Atarax Vistaril
25-50mg
Antihistamine First generation
Loratadine - Generic and Class?
Claritin
10mg daily
Antihistamine Second generation
Phenylephrine HCL - Generic and Class?
Neosynephrine
Topical
Nasal Decongestant Sympathomimetic
Triamcinolone
Nasocort
Topical
Nasal Decongestant Corticosteroid
Dextromethorphan
Bomilar
Cannot be used if under age 4
Antitussives
Guaifenesin - Generic and Class?
Robitussin
200mg q 4 hours
Expectorant
Acetylcysteine - Generic and Class?
Mucomyst
Store in frig for 96 hours (Inhalant)
Mucolytic
Albuterol - Generic and Class?
Proventil
Inhalant 2-4mg
Sympathomimetic
Isoproterenol - Generic and Class?
Isuprel
SQ, IV
Sympathomimetic
Epinephrine - Generic and Class?
Adrenaline
Drug choice for rescue
Sympathomimetic
Theophylline - Generic and Class?
Theo-Dur
PO, IV 10-20mcg
Methylxanthine
Ipratropium Bromide - Generic and Class?
Atrovent
Inhalant
Anticholinergic
The highest concentration of histamine is found where
In the mast cells and basophils
Histamine is produced in response to what
Injury Allergic reactions
Antihistamines can also be called what
Dryers
What is the action of antihistamines
Block the action of histamine at the h 1 receptor site prevent histamine from entering the receptor site
Antihistamines a more effective at ____ and it is at relieving symptoms
Preventing
Antihistamine dries and blocks
Secretions
For best effect it is best to take an antihistamine —– minutes before the onset
30-60 min
What are some things that antihistamines can be used for
Seasonal allergies hypersensitivity nausea and vomiting motion sickness Parkinson’s disease sedative adjuncts to anesthesiaallergy to drugs and blood products
Because antihistamines have an anticholinergic like effect how can antihistamines help a person with Parkinson’s disease
Anticolenergics decrease muscle time and strength
Because antihistamines can prevent nausea and vomiting it can also be used as what
An antiemetic
Due to the drying effects of antihistamine One important adverse effect is
Respiratory distress
When might a person with asthma not using antihistamine
Drying effects of antihistamines can cause dehydration if respiratory secretions become dry they may become thick and hard to expel
First-generation antihistamines may cause pronounced
Drowsiness And may sometimes be used to cause ? Sedation
First-generation antihistamines have a ____ duration of action than second-generation antihistamines
Shorter
Because first-generation antihistamines have a shorter duration of action than second-generation antihistamines they must be given
More often
Diphenhydramine is Also known as
Benadryl
What is the Average adult dose for Hydroxyzine ( Atarax Vistaril)
25-50mg
By which routes can atarax be given
PO IM
Second-generation antihistamines can only be given via what route
Oral
Second-generation antihistamines do not commonly cause what
Drowsiness
Because second-generation antihistamines have a shorter duration of action opposed to first-generation antihistamines they should be given how often
Once or twice a day
Loratadine (Claritin) is in what class of drugs
Second-generation antihistamine
What 2 second-generation antihistamines average adult dose is 10 mg per day
Claritin and Zyrtec
Allegra is not hit anyone under the age of
12
Average adult dose for Allegra
60mg 2 times a day
Allegra comes in what drug form
Capsules
What drug should not be given the fruit juice
Allegra
Side effects of antihistamines
Anti-cholinergic likeSedation hypotensionGastro toxicityHypersensitivityPhotosensitivityParadoxical excitementTolerance
if first-generation antihistamines are to be given parenterally what muscle should you not use
Deltoid
Stop antihistamines ____ days before allergy testing
4
Antihistamines can be used as a part of balanced ___
Anesthesia
What drug class shrinks engorged mucous membrane in the nose to relieve it stuffiness
Nasal decongestants
What drug class is an adjunct in middle ear infection
Nasal decongestant
If nasal decongestants are used to much or too often they can cause
Rebound congestion
Don’t use nasal decongestants for longer than
3-5 days
Corticosteroids _____ the inflammatory response
Decrease
Codeine and Romilar are examples of
Central acting antitussives
Benzononate (tessalon) is an example of
Peripheral acting antitussive
What is used to relieve non productive coughs
Antitussives
What drug class is contra indicated for premature babies
Antitussive
When Romilar is given with _____ patients may exhibit side effects such as jerking motions to the leg and coma
MAOIs
A mucolytic is a drug that breaks fish thick tenacious mucus in the lower portions of the lungs. An expectorant is a drug that thins respiratory secretions to remove more easy from the respiratory system.
.
Antihistamines have _____ like side effects
Anticolenergic
Anticolenergic actions of antihistamines that affect the respiratory system include
Dryness of the mouth nose and throat Thickening of bronchial secretions
Antihistamines are contraindicated with ___
Maoi’s
Nasal decongestants are sympathomimetic
.
Uses for nasal decongestant
Common cold Hay fever Signiture Allergic rhinitis Congestion associated with rhinitis
Short acting beta agonist are used to relieve
Broncho spasms
Beclomethasone (Beclovent, beconase, Vanceril)
Antinflammatory Corticosteroid
Dexamethasone Decadrone
Antinflammatory Corticosteroid
Trimcinolone Azmacort
Antinflammatory Corticosteroid
ZafirlukastAccolate
Lukotrine antagonist
Theophylline (Theo-Dur, Uniphyl)
Methlyxanthine
Albuterol Proventil
Short acting beta agonist
Isoproterenol Isuprel
Short acting beta agonist
Epinephrine Adrenaline
Short acting beta agonist
Acetylcysterine Mucomyst
Mucolytics
Guaifenesin Robitussin
Expectorant
Dextromethorphan Romilar
Antitussive Central acting non narcotic
Diphenhydramine Benadryl
First generation Antihistamine
Loratadine Claritin
Second generation antihistamine
Pratropium bromide Atrovent
Anticolenergic
Dextromethorphan
Romilar
Guaifenesin
Robitussin
Acetylcysterine
Mucomyst
Albuterol
Proventil
Theophylline
Elixophyllin
Diphenhydramine
Benadryl
Beclomethasone
Beclovent / Vanceril
Dexamethasone
Decadrone
Patropium Bromide
Atrovent
Triamcinolone
Azmacort
Isoproteronol
Isuprel
Loratadine
Claritin
Zafirlukast
Accolate
