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Respiratory System Drugs (Upper And Lower) Flashcards

1
Q

Adrenergic bronchodilators MOA

A

Opens bronchi by relaxing smooth muscles, which allows more air to enter lungs, relieving respiratory distress

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2
Q

Adrenergic bronchodilators indications

A

Treatment of chronic respiratory problems due to chronic bronchoconstriction such as bronchospasm associated with acute and chronic bronchial asthma, exercise induced bronchospasm (EIB), bronchitis, emphysema, bronchiectasis

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3
Q

Adrenergic bronchodilators aren’t for people with

A

Tachycardia, palpitations, arrhythmia, brain damage, narrow angle glaucoma, cerebral arteriosclerosis

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4
Q

Adrenergic bronchodilators side effects

A

Tachycardia, palpitation, High blood pressure, anxiety, insomnia, cardiac arrhythmias, anxiety, can cause paradoxical bronchospasm when taken by inhalation

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5
Q

Adrenergic bronchodilators interactions

A

Adrenergics (additive effects), TCAs can cause hypotension, methyldopa can cause hypotension, oxytocic drugs have a risk for severe hypotension, theophylline increases risk of cardiotoxicity, beta blockers can inhibit the cardiac, bronchodilating and vasodilation effects of the adrenergic

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6
Q

Xanthine derivative bronchodilators MOA

A

Stimulate CNS to promote bronchodilation, and cause direct relaxation of the smooth muscles of the bronchi

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7
Q

Xanthine derivative bronchodilators indications

A

Symptomatic relief/prevention of bronchial asthma, reversible bronchospasm associated with chronic bronchitis and emphysema

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8
Q

Xanthine derivative bronchodilators side effects

A

Irritability , tremors, high HR, high RR, electrocardiograph changes, hyperglycemia, alopecia, restlessness, headache, nervousness, palpitations, nausea, vomiting, fever, flushing

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9
Q

Xanthine derivative bronchodilators aren’t for people with

A

peptic Ulcers, seizures (unless well controlled by anticonvulsants) , serious uncontrolled arrhythmias

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10
Q

Theophylline interactions

A

Barbiturates, nicotine, adrenergic, loop diuretics, hydantoins, ketoconazole, rifampin, charcoal, isoniazid all decrease theophylline serum levels and allopurinol, beta blockers, CCBs, cimetidine, oral contraceptives, corticosteroids, flu vaccine, macrolides, flouroquinolones, thyroid hormones, isoniazid and loop diuretics all increase theophylline serum levels

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11
Q

Inhaled corticosteroids MOA

A

Antiinflamatory, decrease airway hyperesponsiveness, decrease mast cells, block reaction to allergens

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12
Q

Inhaled corticosteroids indications

A

Prophylactic treatment and management of inflammation with chronic asthma, and can be used intranasal for nasal polyps and rhinitis

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13
Q

Inhaled corticosteroids side effects

A

Throat irritation, hoarseness, upper respiratory infections, fungal infection of mouth and throat

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14
Q

Inhaled corticosteroids aren’t for people with

A

acute Bronchospasm, acute asthma, status asthmaticus,

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15
Q

Inhaled corticosteroids interactions

A

Combination with systemic corticosteroids can increase the risk of hypothalamic-pituitary-adrenal (HPA) suppression, resulting in adrenal insufficiency

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16
Q

Mast cell stabilizers MOA

A

Stabilize mast cell membrane by preventing calcium ions from entering mast cells, which prevents the release of inflammatory mediators such as histamine and leukotrines

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17
Q

Mast cell stabilizers indications

A

Asthma, allergic disorders, EIB, allergic rhinitis, typically used in combination with other drugs, and used in step 2 of care for chronic asthma

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18
Q

Mast cell stabilizers side effects

A

Throat irritation, dryness, cough, unpleasant taste, wheeze, nausea

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19
Q

Mast cell stabilizers contraindications

A

Not for use during acute asthma attack

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20
Q

Zileuton MOA

A

Decrease formation of leukotrines

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21
Q

Leukotrine modifiers and immunomodulators indications

A

Chronic asthma in people older than 12

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22
Q

Leokotrine modifiers and immunomodulators aren’t for people with

A

Bronchospasm in acute asthma attacks, lactation

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23
Q

1st generation antihistamines MOA

A

Blocks actions of histamine at H1 receptor, bind non selectively, so they can result in CNS stimulation or depression

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24
Q

1st generation antihistamines side effects

A

Drowsiness, dry mouth, blurred vision, urinary retention, sedation, disturbed coordinations

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25
1st generation antihistamines contraindications
Certain heart conditions, pregnancy, taking MAOI's, have angle closure glaucoma, peptic ulcer, prostatic hypertrophy, bladder neck obstruction, lactation, newborns, premature infants
26
Benadryl indications
Allergy, anaphylaxis, transfusion reactions, motion sickness, sleep aid, antitussive
27
Benadryl side effects
Anorexia, urinary frequency
28
Benadryl administration
Oral, IV, IM
29
Benadryl interactions
Increased effects with beta blockers
30
Chlorpheniramine indications
Temporary relief of itchy & watery eyes, sneezing , itchy throat, runny nose caused by hay fever, allergies, or cold
31
Chlorpheniramine side effects
Sedation, hypotension, palpitation, urinary hesitancy
32
Chlorpheniramine administration
Oral
33
2nd generation antihistamines side effects
Dry mouth
34
2nd generation antihistamines restrictions
Not for use during pregnancy
35
Cetirizine indications
Seasonal/perennial rhinitis, urticaria
36
Cetirizine side effects
Sedation, pharyngitis, dizzy, somnolence
37
Cetirizine restrictions
Not for people sensitive to hydroxyzine
38
Fexofenadine side effects
Upset stomach, back pain URI
39
Fexofenadine restrictions
Rifampin reduces absorption, and shouldn’t be taken within 2 hours of taking antacid because it decreases concentration of drug in blood
40
Loratidine indications
Allergic rhinitis
41
Loratidine side effects
Dizzy, headache, tremor, insomnia
42
Loratidine administration fact
Rapidly disintegrating
43
Topical decongestants MOA
Localized vasoconstriction of small blood vessels in nasal membranes
44
Topical decongestants indications
Common cold, hay fever, sinusitis, allergic rhinitis, congestion associated with rhinitis
45
Topical decongestants side effects
nasal Burning, stinging, dryness, tachycardia and cardiac arrhythmias, nervousness, restlessness and insomnia, blurred vision, nausea, vomiting
46
Topical decongestants aren’t for people with
MAOIs
47
Oxymetazoline indications
Nasal congestion
48
Oxymetazoline side effects
Anxiety, anorexia, restlessness, arrhythmia, nervousness
49
Phenylephrine indications
Nasal congestion
50
Phenylephrine side effects
Anxiety, restlessness, anorexia, arrhythmia, blurry vision
51
Pseudophedrine indications
Nasal congestion
52
Pseudophedrine side effects
Anxiety, restlessness, anorexia, arrhythmia, blurry vision
53
Antitussives MOA
Depress cough center in medulla, raise cough threshold and dampen cough reflex
54
Antitussives indications
Relieve nonproductive cough
55
Antitussive aren’t for people with
Use of cosine, premature infants, during labor when premature infants are anticipated
56
Antitussives side effects
High fever, rash, headache
57
Codeine indications
Suppression of non-productive cough, relief of mild-moderate pain
58
Codeine side effects
Sedation, dizzy, constipation, CNS depression, orthostatic hypotension
59
Benzonatate indications
Symptomatic relief of cough
60
Benzonatate Side effects
Sedation, headache, dizzy, GI, upset, pruritus, congestion, chewing tablets can cause local anesthetic effect
61
Dextrometorphan indications
Symptomatic cough relief
62
Dextrometorphan side effects
Drowsy, dizzy, upset GI
63
Mucolytics MOA
Reduce viscosity of respiratory secretions by direct action on mucous (treat cystic fibrosis)
64
Acetylcysteine indications
Pneumonia, bronchitis, tracheobronchitis, pulmonary complications with CF, pulmonary complications with surgery and anesthesia, post traumatic chest conditions, atelecastis due to mucous obstruction, acetaminophen overdose, diagnostic bronchital studies, tracheostomy care
65
Mucolytics side effects
Lightheaded, dizzy, drowsy, sedation (especially with antihistamines)
66
Acetylcysteine side effects
Stomatitis, fever, drowsy, bronchospasm, irritation of trachea/bronchi
67
Expectorants MOA
Increase respiratory secretion production, and decrease mucous viscosity, which raises secretions from the respiratory passages
68
Expectorants indications
Bring up respiratory secretions
69
Expectorants side effects
Lightheaded, dizzy, drowsy, sedation
70
Expectorants aren’t for people with
Pregnancy, persistent cough, severe respiratory insufficiency, asthma, elderly people
71
Guaifenesin indications
Cough relief associated with RTI (sinusitis, asthma, bronchitis, pharyngitis, especially if cough is dry and unproductive)
72
Guaifenesin side effects
Nausea, dizzy, headache, rash
73
Potassium iodide indications
Emergency treatment for hyperthyroidism or radiation exposure
74
Potassium iodide side effects
Iodine sensitivity
75
Histamine
Substance found in various parts of the body (liver, lungs, intestines, skin), and produced from the amino acid histidine in response to injury to trigger the inflammatory response
76
Nonproductive cough
Dry, hacking cough that produces no secretions
77
Productive cough
Cough by which secretions from the respiratory tract are expelled
78
Rhinitis
Inflammation of the nasal passages
79
Intranasal steroids MOA
Inhibit response of mast cell,scans white blood cells, and also reduce mediators such as, histamine, which reduces the inflammatory response
80
Intranasal steroids uses
First line of treatment for symptoms of allergic rhinitis, and also can treat rhinitis caused by nonallergens, nasal polyps, and chronic sinusitis
81
Intranasal steroids side effects nature
Mild and minimal
81
Intranasal steroids side effects
Unpleasant smell or taste, nasal passage irritation, nosebleeds, fungal infections are rare, and discontinuation is recommended if nosebleeds persist
81
Epistaxis
Nose bleeds
81
Intranasal steroids pregnancy cat
C
81
Intranasal steroids precautions
Systemic steroids, can slow growth rate in children
82
Budesonide interactions
Cimetidine makes the intranasal steroids less effective
83
2nd generation antihistamines MOA
Selective for peripheral H1 receptors, and are less sedating
84
Antihistamines general uses
Relief of the symptoms of seasonal and perennial allergies, allergic and vasomotor rhinitis, allergic conjunctivitis, mild and uncomplicated angioneurotic edema and urticaria, relief of allergic reactions to drugs, blood or plasma, relief of cough caused by cold or allergies, adjunctive therapy in anaphylactic shock, treatment of Parkinson-like symptoms, nausea and vomiting relief, motion sickness relief, sedation, and adjuncts to analgesics
85
Antihistamine allergy signs
Skin rash or urticaria
86
Antihistamines precautions
Bronchial asthma, cardiovascular disease, narrow angle glaucoma, hypertension, impaired kidney function, urinary retention, pyloroduodenal obstruction, and hyperthyroidism
87
Antihistamines interactions
MAOIs increase anticholinergic and sedative effects, possible additive CNS depressant effect
88
Diphenhydramine interactions
Beta blockers increase risk of cardiovascular effects
89
Decongestants ex
Phenylephrine, oxymetazoline, and pseudophedrine
90
Pseudophedrine contraindications
Sustained release version isn’t for children under 12
91
Decongestants precautions
Thyroid disease, diabetes mellitus, cardiovascular disease, prostatic hypertrophy, coronary artery disease, peripheral vascular disease, hypertension, glaucoma, pregnancy (cat C)
92
Decongestants interactions
MAOIs cause severe headache, and possible hypertensive crisis, beta blockers cause initial hypertensive episode followed by bradycardia
93
Benzonatate MOA
Anesthetizing stretch receptors in the respiratory passages
94
Dornase alfa use
Cystic fibrosis
95
Acetylcysteine administrations
Nebulizer, but can also be directly instilled into a tracheostomy to liquefy secretions
96
OTC cough meds combined with antihistamines side effects
Lightheadedness, dizziness, drowsiness, sedation
97
Mucolytics contraindications
Asthma
98
Potassium iodide contraindications
Pregnancy (cat D)
99
NHs Antitussives precautions
Persistent or chronic cough, cough with excessive secretions, high fever, rash, persistent headache, nausea, vomiting
100
Codeine precautions
Pregnancy (cat C), and labor (cat D), COPD, acute asthmatic attack, pre existing respiratory disorders, acute abdominal conditions, head injury, increased intracranial pressure, convulsive disorders, hepatic or renal impairment, and prostatic hypertrophy
101
Guaifenesin pregnancy cat
C
102
Acetylcysteine pregnancy cat
B
103
Expectorants precautions
Pregnancy, lactation, persistent cough, severe respiratory insufficiency, asthma, elderly or debilitated patients
104
Codeine interactions
CNS depressants and alcohol can cause additive depressant effects
105
Dextrometorphan interactions
MAOIs cause hypotension, fever, nausea, jerking motions of the leg, coma
106
Potassium iodide interactions
Lithium and anti thyroid drugs effects may potentiate with iodine product and can cause hypokalemia, cardiac arrhythmias, or cardiac arrest, and thyroid function test results can be altered with iodine
107
Codeine contraindications
Persistent or chronic cough, or when cough is accompanied by excessive secretions
108
Antihistamines elderly considerations
Elderly are more likely to experience anticholinergic effects (dryness in mouth, nose and throat), dizziness, sedation, hypotension, confusion
109
Intranasal steroids ex
Beclmethasone, budesonide, cicleonide, flinisolide, fluticasone, mometasone, triamcinolone
110
1st generation antihistamines ex
Brompheniramine, chlorpheniramine, clemastine, diphenhydramine, promethazine,
111
2nd generation antihistamines ex
Azelastine, cetirizine, desloratidine, fexofenadine, levocetirizine, loratidine
112
Decongestants ex
Epinephrine, fexofenadine and pseudophedrine, naphazoline, oxymetazoline, phenylephrine, tetrahydrozoline, xylometazoline
113
Opioid antitussives
codeine
114
Nonopioid antitussives
Benzonatate, dextrometorphan, diphenhydramine
115
Mucolytics ex
Acetylcysteine
116
Expectorants ex
Guaifenesin
117
Asthma
Respiratory disorder characterized by bronchospasm and difficulty in breathing, especially exhaling
118
Dyspnea
Shortness of breath, labored or difficult breathing
119
Leukotrine
Inflammatory substance that is released by mast cells during an asthma attack
120
Tachypnea
Rapid breathing
121
Theophyllinization
Delivery of a high enough dose of theophylline to bring blood levels to a therapeutic range more quickly than over several days
122
First line intervention for long term asthma control
Inhaled corticosteroids
123
Quick relief asthma drugs
Short acting beta 2 Agonists (SABA) and oral steroids
124
SABA bronchodilators use
Relieve bronchsospasm associated with bronchial asthma, chronic bronchitis, and emphysema
125
SABA bronchodilators ex
Albuterol, epinephrine, salmeterol, terbutaline, ephedrine, levabuterol, metaproterenol
126
Along with bronchodilators, what is helpful in treating asthma
ICSs, mast cell stabilizers, leukotrine formation inhibitors, leukotrine receptor Agonists and immunomodulators
127
LABAs side effects
May increase risk of asthma related death
128
Salmeterol contraindications
Acute bronchospasm
129
Adrenergic bronchodilators precautions
Hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, prostatic hypertrophy, history of seizures, pregnancy (cat C), lactation
130
Terbutaline pregnancy cat
B
131
Xanthine derivative bronchodilators ex
Theophylline and aminophylline, dyphylline, oxtriphylline
132
LABAs ex
Salmeterol, arformoterol, formoterol, indicaterol, olodaterol
133
Xanthine derivative bronchodilators precautions
Cardiac disease, hypoxemia, hypertension, congestive heart failure, liver disease, Alcohol, pregnancy (cat C), lactation
134
Inhaled corticosteroids ex
Beclomethasone, flunisolide, budesonide, ciclesonide, fluticasone, mometasone
135
Beclomethasone contraindications
Relief of symptoms that can be controlled by a bronchodilator and other non steroidal meds and in the treatment of nonasthmatic bronchitis
136
Inhaled corticosteroids precautions
Compromised immune systems, glaucoma, kidney disease, liver disease, convulsive disorders, diabetes, pregnancy (cat C), lactation,
137
Budesonide pregnancy cat
B
138
Budesonide interactions
Ketoconazole can increase plasma levels of budesonide
139
Fluticasone interaction
Ketoconazole can increase plasma levels of fluticasone
140
Mast cell stabilizers ex
Cromolyn
141
Mast cell stabilizers precautions
Pregnancy (cat B), lactation, impaired renal or hepatic function
142
Leukotrine receptor antagonists ex
Montelukast, zafirlukast
143
Leukotrine formation inhibitor ex
Zileuton
144
Monoclonal antibody
Omalizumab
145
Leukotrine receptor antagonists MOA
Inhibit leukotrine receptor sites in the respiratory tract, by preventing the binding of immunoglobulin to the receptors on basophils and mast cells, limiting the allergic reaction
146
Omalizumab indications
Adjunctive therapy for patients 12 or older who are sensitive to allergens and who require step 5 or 6 care
147
Leukotrine modifiers precautions
Pregnancy (cat C)
148
Zileuton pregnancy cat
C
149
Leukotrine modifiers side effects
Headache, flu-like symptoms, anaphylactic reactions, emergency equipment should be available when administering this
150
Zafirlukast interactions
Increased plasma levels with aspirin, increased effect of warfarin, which also decreased zafirlukast levels, erythromycin decreases levels of zafirlukast
151
Zileuton interactions
Increased theophylline serum levels
152
Adrenergic bronchodilators elderly consideration
Elderly are at a higher risk for cardiovascular reactions (tachycardia, arrhythmia, palpitation, hypertension) and CNS reactions (restlessness, agitation and insomnia)
153
Oral corticosteroids elderly considerations
If elderly are at risk for osteoporosis, a calcium or vitamin D supplement can be given
154
Lower respiratory system anticholinergic
Aclidinium, ipratropium, tiotropium, umeclidinium

Pharmacology HOSA (37 decks)

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