Respiratory: Purpose, Action, Contraindications Flashcards
Antitussive
Purpose: suppress NON PRODUCTIVE cough (expectorating for you)
Actions: suppress cough reflex by suppressing the medulla (suppress the CNS!), crosses BBB, you get sleepy/dizzy/vitals decrease, FALLS
Contraindicated: patients who NEED to cough, anything that suppresses the CNS
Decongestant: Topical and Oral
Topical (on mucus mem of nose and sinuses) and Oral
Purpose: decrease overproduction of mucous
Actions: sympathomimetic (cause vasoconstriction which decreases edema and inflammation) or adrenergic (interchangeable)
Contraindicated: rhinitis medicamentosa (what we get when we overuse decongestant drugs - three days of Afrin gives you a runny nose, ASK if they’re using one already), things that are exacerbated by sympathetic stimulation (cardiac compromise - tachycardia, hypertensive), topicals when mucus membrane not intact, glaucoma (pressure in eye gets worse)
Decongestant: Topical Steroids
Topical Steroids - antiinflammatories
Purpose: decrease overproduction of mucus, especially for allergic rhinitis
Actions: anti inflammatory locally
Contraindicated: infection!
Antihistamine
Purpose: to avert allergic response
Actions: selective blocking of H-1 receptors (in CNS & PNS) = more dangerous because affects both, anticholinergic stimulation
*H-2 receptors in parietal cells - stomach
Contraindicated: cardiac arrhythmias (causes increase work for heart) , low BP, tachycardia, urinary retention (post-op patients: turn off info getting to bladder, bladder will swell → give cholinergic drug)
Anticholinergic effect: blind as a bat (eyes dilate), Red as a beet (flushed from vasodilation), hot as a hare (hyperthermia), dry as a bone (dry skin), mad as a drowsy hatter (sleepy, hallucination), bloated as a toad (urinary retention), and the heart runs along (tachycardia)
Expectorant
Purpose: dry cough, excessive mucus in respiratory tract
Actions: reduces adhesiveness and surface tension of fluids, draws water into the bronchi, thins secretions. Also a centrally acting muscle relaxant.
Contraindicated: persistent (> than two weeks = needs to be evaluated) undiagnosed cough
Mucolytic
Purpose: tenacious and viscous mucus removal in high risk respiratory patients (co-morbidity, chronicity)
Actions: splits disulfide bonds that hold mucus together
Contraindicated: bronchospasm
Bronchodilators: Sympathomimetic
Purpose: bronchodilation/asthma - airway is too narrow
Airway in a two year old is the thickness of a straw*
Actions: (short or long acting) beta 2 selective adrenergic agonists
beta 2 receptors are in the bronchi (in the lung), deal with sympathetic
selective means they mostly only go to one site or one receptor
adrenergic means sympathetic
agonist is “for it”
beta 1’s are in the heart
Contraindicated: conditions aggravated by SNS stim
Bronchodilators: Anticholinergic
Purpose: bronchodilation/asthma
Actions: blocks Ach receptors in smooth muscle
Contraindicated: things aggravated by loss of Ach (Myasthenia Gravis - they will have a huge event), allergy to soy or peanuts!, glaucoma, BPH (Benign prostatic hypertrophy?)
Brochodilators: Xanthine
**DANGEROUS = narrow therapeutic index
Purpose: decrease bronchial swelling, treat apnea, SNS stimulators
Actions: inhibit the release of histamine, effect CA mobilization thereby relaxing smooth muscle
Contraindicated: Things that have SNS stim, NTI issues
Anti-Inflammatory: Inhaled Steroids
maintenance, but don’t help immediately - they take hours or days, not a rescue drug
Purpose: treat and prevent airway and lung tissue inflammation
Actions: interfere with the inflammatory cascade and promotes beta-adrenergic receptor activity so we get a sympathetic effect, suppress immune system
Contraindicated: NOT FOR ACUTE SYMPTOMS!
Anti-Inflammatory: Leukotriene Receptor Antagonists
maintenance, but don’t help immediately - they take hours or days, not a rescue drug
Purpose: treat and prevent airway and lung tissue inflammation
Actions: interfere with the inflammatory cascade and promotes beta-adrenergic receptor activity so we get a sympathetic effect, suppress immune system
Contraindicated: NOT FOR ACUTE SYMPTOMS!
Anti-Inflammatory: Mast Cell Stabilizer
Mast cells pop open and release histamine
Purpose: prevent inflammatory cascade, asthma/allergies
Actions: inhibits the release of histamine and SRSA (slow reacting substance of anaphylaxis) from mast cells
Contraindicated: NOT FOR ACUTE SYMPTOMS!, takes a while to work
Surfactant
Purpose: preemie lung surfactant replacement
Actions: replaces natural lipoproteins in the lungs
Contraindicated: None because emergency intervention***
