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Pharm > Respiratory Ppt > Flashcards

Respiratory Ppt Flashcards

1
Q

Which class of drugs blocks the cough reflex within the medullary cough center of the brain?

A

Antitussives

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2
Q

Dextromethorphan is the prototype drug for which class of drugs?

A

Antitussives

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3
Q

What other 3 drugs are used as Antitussives besides dextromethorphan?

A
  1. Benzonatate
  2. Codeine
  3. Hydrocodone
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4
Q

How are Antitussives metabolized?

A

In the liver; excreted in the urine

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5
Q

What is a cautionary indication for Antitussives to consider?

A

Crosses placenta and enters human milk

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6
Q

Which class of upper respiratory medications decreases the overproduction of secretions?

A

Decongestants

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7
Q

Decongestant mechanisms of action?

A

-Local vasoconstriction of upper respiratory tract = shrinking of swollen mucous membranes and opens up nasal passages.

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8
Q

Decongestant benefits:

A
  • relieves discomfort of blocked nose
  • promotes secretion drainage
  • improves air flow
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9
Q

3 types of decongestants:

A
  1. Topical nasal decongestants
  2. Oral decongestants
  3. Steroid nasal decongestants
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10
Q

Topical nasal decongestant mechanisms of action:

A

Sympathomimetics: mimics SNS causing vasoconstriction = decreased edema/inflammation of nasal membranes

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11
Q

Benefits/indications of nasal decongestants and oral decongestants?

A
  1. Relieves discomfort of nasal decongestion
    A) common cold
    B) sinusitis
    C) allergic rhinitis
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12
Q

What to look out for when administering nasal decongestants

A

Local burning/ irritation/ sores = systemic absorption

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13
Q

What to look out for when administering nasal decongestants

A

Local burning/ irritation/ sores = systemic absorption

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14
Q

Specific indications for oral decongestants:

A

Relieves otitis media (opening of nasal passage allows for better drainage of the Eustachian tube= relieves pressure of middle ear

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15
Q

Prototype drug for oral decongestants?

A

Pseudoephedrine

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16
Q

What chemical, when released, increases secretions and narrows airways, and is released during inflammation?

A

Histamine

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17
Q

Which class of drugs relieves respiratory symptoms and treats symptoms of allergies?

A

Antihistamines

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18
Q

What’s the main difference between 1st generation antihistamines and second?

A

Greater anticholinergic properties (sedates)

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19
Q

Prototype for first gen. Antihistamines?

A

Diphenhydramine

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20
Q

Which is the 1st line of antihistamine use?

A

2nd gen

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21
Q

Two first line 2nd gen antihistamines:

A

1) certirizine (Zyrtec)
2) loratidine (Claritin)

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22
Q

Two first line 2nd gen antihistamines:

A

1) certirizine (Zyrtec)
2) loratidine (Claritin)

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23
Q

Can antihistamines be used if pregnant/lactating?

A

Only if benefits outweigh risks.
Passes through placenta and milk

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24
Q

Which class of drugs increases productive cough to clear the airways?

A

Expectorant

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25
Q

Can expectorants be used when pregnant/lactating?

A

No- potential for adverse effects

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26
Q

Prototype drug for expectorant?

A

Guaifenesin (mucinex)

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27
Q

Action of expectorants?

A

Liquify lower reps. Secretions; decreases viscosity = easier to cough up

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28
Q

Which class of drugs increase or liquify respiratory secretions to and in clearing the airways?

A

Mucolytics

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29
Q

Who is indicated for use of mucolytics?

A

-COPD
-cystic fibrosis
-pneumonia
-tuberculosis

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30
Q

Mucolytic prototype drug:

A

Acetylcysteine

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31
Q

What else can acetylcysteine be used for?

A

Acetaminophen toxicity

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32
Q

Action of mucolytic acetylcysteine?

A

Splits the mucoproteins in resp. Secretions

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33
Q

Drug classes of upper respiratory tract:

A
  • Antitussives
  • topical nasal decongestants
  • oral decongestants
  • steroid decongestants
  • antihistamines
  • expectorants
  • mucolytics
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34
Q

Drug classes of lower respiratory tract:

A

-Bronchodilators
-anti-inflammatory steroids
-leukotriene receptor antagonist
- immune modulators
- Lung surfactants
- mast cell stabilizers
-Drugs for pulmonary fibrosis

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35
Q

3 categories of bronchodilators:

A

1) Sympathomimetics
2) anticholinergics
3) xanthenes

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36
Q

Another name for sympathomimetics:

A

Beta-2 agonists

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37
Q

Prototype drug before bronchodilator sympathomimedic:

A

Albuterol

38
Q

Other sympathomimetics:

A

Levalbuterol

39
Q

Action of beta-2 agonists (sympathomimetics)

A

-Activates beta-2 in the lungs, which dilates the bronchi.= improved blood flow.
- Activates Beta-2 receptors in the heart = increases heart rate

40
Q

Action plan for severe asthma attack using beta-2 agonist:

A

-2-4 puffs every 20 min. X 3
If ineffective, call PCP.

41
Q

Effective beta-2 agonist outcomes:

A

Decreased respiratory rate; o2 sat. 90% or higher.

42
Q

3 T’s of beta-2 agonists

A

Tachycardia, tremors, toss/turning at night

43
Q

Which should be used first: steroid or beta-2 agonist?

A

Beta 2 agonist

44
Q

Which beta-2 agonist is slower-acting and is often used in combination with a steroid for long-term moderate-severe asthma?

A

Salmeterol

45
Q

Three drugs used during an asthma atack:

A
  1. albuterol
  2. ipratropium
    -methylprednisolone (solumedrol)
46
Q

Abbreviation for beta-blockers

A

LOL’s

47
Q

Avoid what 3 things when taking beta 2 agonists?

A

-Don’t take at bedtime
-Avoid beta-blockers (can cause bronchospasms)
-NSAIDS (Naproxen, Ibuprofen) = can worsen asthma

48
Q

Cleaning/maintenance of metered dose inhalers (MDIs)

A

Clean 1-2 times per week with water.

49
Q

Most anticholinergics end in?

A

“tropium”

50
Q

Prototype drug for anticholinergics?

A

Ipratropium

51
Q

Other anticholinergic drug names:

A

Tiotropium

52
Q

Action of anticholinergics:

A

Decreases secretions, anticholinergic effects, and blocks acetylcholine
“Can’t see, pee, spit, or poop”
Longer acting bronchodilator

53
Q

Side effects of anticholinergics?

A

Dry mouth/throat

54
Q

What drug are anticholinergics usually paired with?

A

Albuterol
*2nd in line during active/severe asthma attack

55
Q

Conditions anticholinergics usually treat:

A

Severe asthma and COPD

56
Q

3 contraindications for anticholinergics:

A

glaucoma, urinary retention, bowel obstruction

57
Q

Xanthines typically end in:

A

“phylline”

58
Q

Prototype drug for xanthines:

A

Theophylline

59
Q

What interaction can increase toxicity if using xanthines?

A

Caffeine
Cimetidine (H2 blocker given for heartburn)
Ciprofloxacin (antibiotic)

60
Q

Normal range of xanthines

A

10 MCG/mL

61
Q

3 Ts of xanthines:

A

-Toxic over 20 mcg/mL (frequent blood draws)
-Tachycardia and dysrhythmias
-Tonic-clonic seizures (severe toxicity)

62
Q

Other signs of xanthine toxicity:

A

Anorexia, N/V, restlessness, insomnia

63
Q

What drug class should be avoided when taking xanthines?

A

Beta-blockers (can block effects of theophylline)

64
Q

What should a pt. taking xanthines alert PCP of before being given another dose?

A

Tachycardia

65
Q

Considerations for those taking xanthines (3)

A
  1. Take in the AM
  2. Avoid caffeine or other stimulants
  3. Stop taking before cardiac stress test (will augment the test)
66
Q

Which of the following prescriptions should the nurse question?
A. naproxen for an asthmatic patient
B. ipratropium for a patient with glaucoma
C. Losartan for a patient with diabetes
D. Theophylline for a patient taking cimetidine
E. atenolol for patient with asthma

A

A, B, D, E

67
Q

Phenobarbital does what?

A

Sedative for anxiety

68
Q

Anti-inflammatory drugs, or steroids, usually end in what?

A

“-SONE”

69
Q

Which three anti-inflammatory drugs are used to decrease swelling? (corticosteroids)

A

-Beclamethasone
-Fluticasone
-Methylprednisolone (Sol-U-Medrol)

70
Q

Prototype drug for anti-inflammatory steroids:

A

Budesonide

71
Q

5 S’s of anti-inflammatory steroids:

A

-swelling
-slow onset
-sugar increase
-sores in mouth
-slow wound healing

72
Q

Patient care to reduce thrush risks when taking an anti-inflammatory steroid:

A

-Use spacer
-rinse mouth after each use- do not swallow water
-wash mouth piece with warm water daily

73
Q

—— are steroid hormones produced from the cortex of the adrenal glands, which play a role in glucose, protein, and fat metabolism.

A

Glucocorticoids

74
Q

Which three anti-inflammatory glucocorticoids decreasing total body swelling?

A

-prednisone
-dexamethasone
-hydrocortisone

75
Q

Leukotriene receptor antagonists usually end in what?

A

“-LUKAST”

76
Q

Prototype drug for leukotriene receptor antagonists:

A

Zafirlukast

77
Q

Other leukotriene receptor antagonist drug:

A

montelukast

78
Q

What to leukotriene receptor antagonists do?

A

opens the airway

79
Q

What is the purpose of leukotriene receptor antagonists?

A

long-term management for inflammation

80
Q

How long do leukotriene receptor antagonists take to reach therapeutic range?

A

1-2 weeks

81
Q

Primary condition leukotriene receptor antagonists are used for?

A

Asthma; asthma attack prevention. (NOT a rescue drug)

82
Q

How do leukotriene receptor antagonists prevent inflammation that can cause asthma attacks?

A

Reducing inflammation response of leukotrienes = stops inflammation response of the irritant/antigen.

83
Q

What is the prototype drug for immune modulators?

A

Omalizumaba

84
Q

What condition do immune modulators usually treat?

A

Moderate to severe asthma

85
Q

How are immune modulators administered?

A

Sub-Q (into the fat)

86
Q

Prototype lung surfactant medication:

A

beractant

87
Q

Administration of lung surfactant:

A

intratracheal route

88
Q

Action of Mast Cell Stabilizers:

A

Prevents release of inflammatory and bronchoconstriction substances (like histamine) when mast cells are stimulated to release their contents in response to irritation/presence of antigen

89
Q

Only mast cell stabilizer still used today:

A

Cromolyn (other drugs are safer and more specific)

90
Q

2 drugs for pulmonary fibrosis:

A

-nintedanib
-pirfenidone

91
Q

Side effects of nintedanib and pirfenidone?

A

Liver toxicity and GI issues I.E. contraindicated for renal impaired and liver impaired individuals.

Pharm (5 decks)

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