RESPIRATORY-pharma Flashcards
1
Q
What are two types of Histamines?
A
- H1 receptors mediate smooth muscle contraction(allergic symptoms) and dilate capillaries
- H2 accelerate HR and gastric acid secretion
2
Q
What is allergic reactions?
A
- both H1 and H2 dilate vessels
- causes fluid to move out of vessels and into tissue causing BP to drop
- allergies are due to molds, mold spores, dust that causes hay, fever, itchy eyes, uticaria, sneezing, cough
3
Q
How do allergens produce allergic reactions?
A
- Histamine are released by mast cells, basophils due to reaction to circulating antigens in blood
- binds and activates specific receptors in eyes, nose, skin, resp tract
- histamine bind to receptors causing pruritis
- H1 Blockers block histamine if receptors are not taken yet
4
Q
What are non-sedating anti-histamine?
A
- Fexofenadine ( allegra and Seldane)
- Claritin
- EES and Ketoconazole(antifungal) can lead to seldane buildup and cause cardiac dysrythmias
- Allegra for seasonal allergic rhinitis-OTC and safe for 12 years old
5
Q
CLARITIN
A
- not used in lower resp tract diseases
-
6
Q
DIPHENDRAMINE
A
- Diphenhydramine-Benadryl
- used for allergies and motion sickness and sleep aid( safety)
- very safe -few S/E
- anticholinergic effects
- not used in neonates and nursing mothers
- combo with calamine and camphor
7
Q
MECLIZINE
A
- for tx of vertigo
for dizziness
-use for motion sickness
8
Q
PROMETHAZINE- phenergan
A
- antihistamine for antiemetics
- Rx only-Po,IV, IM, rectal
- usually ordered q4-6 hrs prn for nausea
- give in conjunction with DEMEROL
9
Q
ASTELIN
A
- only nasal
- for adults and over 12 years old
- rebound effects
10
Q
ZYRTEC
A
- used year round allergy med
- for chronic uticaria also
11
Q
CHLOR-TRIMETON
A
- OTC
12
Q
DRAMAMINE
A
- motion sickness
- age 6 and over
- causes sleepiness
13
Q
Unisom
A
- OTC for sleep aid
- take with full glass of water
14
Q
ATARAX/VISTARIL
A
- has sedative and mild antianxiety effects
15
Q
ANTIVERT
A
- for treating vertigo
16
Q
What are adverse reactions of antihistamines?
A
-dysrhythmia/palpitations
-hypotension, syncope
-dizziness, blurred vision
-sedation
-paradoxical excitement, insomnia
-nervousness, HA
seizure
-N/V/D
- rarely-Leukopenia, pancytopenia
17
Q
What are 3 types of decongestant?
A
- adrenergics
- anticholinergics
- corticosteroids
18
Q
NEO-SYNEPHRINE/ SUDAFED
A
- longest effect b/c systemic
- onset is delayed
- caution with sudafed. WHY?
19
Q
How do topical adrenergics work?
-ephedrine, afrin, neo-senephrine
A
- vasoconstrict
- shrink engorged M. mem
- if it entered blood stream: causes: HTN, palpitations, HA, dizziness
20
Q
Antitussive
A
-cough reflex
-stimulated in medulla
-
21
Q
Non-opioid antitussives
A
- less effective
- no analgesic effects
- safe for short term
22
Q
Benzonate
A
- non-opioid but anesthesize cough reflex by numbing of stretch receptors
- tesselon perle’s
23
Q
Codiene/hydrocodone
A
- directly suppresses cough reflex
- cause dizzy, drowsy, dry mouth, nausea and constipation
- addictive properties( opioid)
- in combo with cough med-robitussin AC
- depress RR and CNS
- controlled subs
- not for severe resp DO, seizures, ICP
24
Q
expectorants
A
- robitussin, guifenesin, guiatuss
- thins secretions
- can worsen hyperkalemia with K sparing diuretics
25
Nursing process for all H1 blockers
- assess s/s, allergic rxn
- URI symptoms-many safe
- LRI- not so safe
- ICP, IOP{, asthma, cardiac problems, HTN
- renal/liver
26
Implementation for H1
- take with food to avoid GI upset
-makes mouth dry- gum/hard candy
-frequent oral care
-not other meds with antihistaminer. WHY?
-increase PO flids
-If liquid- no food/drink 30 min after
-safety-drowsiness
-avoid coffee
-
27
HISTAMINE 2 BLOCKERS
- ACTS more on GI
-reduce acid likke GERD
-examples are tagamet, pepcid, zantac
-
28
Emphysema
- enlarged air spaces in the lungs
- destroyed alveolar walls
- O2 and CO2 exchange becomes impaired
- smoke and irritants exacerbate
29
Types of bronchodilators
- Xanthine deriv
| - Beta-agonists
30
Xanthine derivatives
- plant alkaloids
-caffeine
-theophylline.. LEVELS? 10-20
-theobromine
- used primarily for asthma attacks
- increase cardiac contractility increasing HR
-Bioavailability? meaning
-
31
Side effects of Xanthine deriv?
- N/V/anorexia
- GI reflux during sleep
- Tachy, palpitations, V dysrrhytmia
- increased urination
- hyperglycemia
- nervousness/ tremors
32
Interactions of XD?
- oral contraceptives
- EES-
- allipurinol
- flu vaccine
- cimetadine
33
THEOPHYLLINE
- 10-20 mcg/ml is the safe levels
- slo-bid, theodur, uniphyl
- for chronic resp. disorders
- monitor level
34
Toxicity of theophylline?
- increased restlessness, irritability, N/V, tremors
- restlessness and anxiety
- dont omit or double-up doses
35
BETA AGONISTS?
```
- smooth muscle relaxants
for acute asthma attack
- stimulate SNS( beta and alpha adrenergic)
-imitate effects of epi/norepi
-dilate smooth m and airway
-vasoconstrict
```
36
terbutaline(brethine)
-relaxes uterus in preterm labor
37
Beta agonists drugs?
- albuterol, adrenalin, bronchaid
- causes bronchodilation
- causes tachy
- Epi is used for first line drug in CODE
38
COMBO drugs?
-albuterol and atrovent(combivent)
- COPD management
- not for acute attacks
SIDE -EFFECTS:anticholinergic, cough, HA, anxiety
- not use with hypersensitive to atrophine
39
What is leukotreine agents
- subs in body causing inflamm, bronchial constriction and mucous
- causes wheeze, cough, SOB
-
40
Anti-leukotreine drugs?
- Singulair ( safe for 2 years and older and few S/E
ACCOLADE- asthma prophlaxis for 12 years and older, interacts with ASA, EES, dilantin, theophylline
ZYFLO- 12 years and older, not with LIVER disease and interacts with inderal, coumadin, theophylline
41
contraindication of antileukotreine?
Cause N/V, dyspepsia, insomnia, dizziness. ACCOLADE can cause liver dysfunction
42
CORTICOSTEROIDS?
Commonly used for chronic asthma, potent anti-inlamm, not for acute asthma attacks, prophylaxis for asthma prevention,, systemic can cause fluid and elect imbalance, nervous, and dermatology. can cause pharyngeal irritation, cough, dry mouth, oral fungal , not for candida already, can exacerbate phycosis
43
Assessment for corticosteroids
baseline VS and lung sounds, skin color and cap refill, cough, dyspnea, SOB, orthopnea, distress, cardiac signs, restlessness, O2 sat,
44
EDUCATION for corticosteroids
stop smoking, avoid kwn allergies, OTC, ID band, wean most drugs over 1-2 weeks, cause cushinoid symptoms, weight gain, 3-5 /week mean trouble, oral care,
45
PREDNISONE
immunosuppresant can be used for inflamm diseases, lupus, arthritis, chron's disease,
46
hydrocortisone
skin conditions
47
bexamethasone
skin conditions
48
dexamethasone
bacterial meningitis
49
Mast cells stabilizers
chromolyn and tilade
-for COPD
chromylyn used for rhinitic and allergic eye disordres, chron's and ulcerative colitis
50
Chromolyn
less potent than tilade
| takes 4 weeks to start working
51
PEDI and resp drugs
one spray per nostrils, no more than 6 doses/24 hours
| clean tubing, mouth pieces with H20 and vinegar soln
52
scopalamine
```
anticholinergic
works on inner ear for balance
NOT USED with glaucoma
72 hour patch behind the ear
4 hours to start working
not with antidepressant
```
53
Meclazine/antivert
H1 blockers
inhibits Ach
for motion sickness or vertigo
safe antiemetic
54
Compazine
dopamine blocking
neuroleptic drug NOT FOR bone marrow suppression
NOT FOR parkinson's
not for seizure/ encepalopathy
55
Zofran
serotonin blockers
safe for adults
increase chemo tolerance
56
THC/Marinol (marijuana)
cause hypotensive effects
n/v for how long?
alters mood and relieves anxiety
57
TEST
TEST
