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Pharm > Respiratory system meds - exam 3 > Flashcards

Respiratory system meds - exam 3 Flashcards

1
Q

Methylxanthines Prototype

A

theophylline (Theolair)

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2
Q

methylxanthines EPA

A

relaxes the bronchial smooth muscle, promoting bronchodilation

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3
Q

methylxanthines therapeutic use

A

second line treatment for chronic lung disorders that cause bronchoconstriction (COPD) EBP no longer recommends to use to treat COPD

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4
Q

methylxanthines administration

A

PO

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5
Q

methylxanthines ADRs

A

tachycardia, agitation and seizures. Toxicity - ventricular dysrhythmias and convulsions

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6
Q

methylxanthines contraindications and interactions

A

heart disease, liver dysfunction, and use with caution with seizure disorders

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7
Q

methylxanthines RN intervention and client education

A

Need to monitor serum blood levels - narrow therapeutic range

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8
Q

inhaled glucocorticoids prototype

A

beclomethasone (QVAR)

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9
Q

inhaled glucocorticoids EPA

A

suppress the release of inflammatory mediators and decrease the recruitment of airway eosinophils. Increases the number and sensitivity of beta 2 adrenergic bronchodilators

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10
Q

inhaled glucocorticoids therapeutic use

A

prophylactic management of asthma with inhaled steroids. Acute asthma flare-ups, systemic corticosteroids used

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11
Q

inhaled glucocorticoids administration

A

inhaled orally or nasally

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12
Q

inhaled glucocorticoids ADRs

A

pharyngitis, cough, dry mouth, and candidiasis (thrush)

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13
Q

inhaled glucocorticoids contraindications and interactions

A

recent live virus immunization and oral candidiasis

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14
Q

inhaled glucocorticoids RN intervention and client education

A

Rinse mouth and throat with water after using inhaler
Use with a spacer
Educate client on how to administer inhaler

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15
Q

glucocorticoids prototype and other drug names

A

prednisone
Other: methylprednisone -IV

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16
Q

glucocorticoids EPA

A

multiple mechanisms of action and each one varies depending on the cell tissue. All affect the inflammatory process to reduce inflammation

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17
Q

Glucocorticoids therapeutic use

A

decreases inflammatory symptoms and alters the immune response produced by nonendocrine disorders. Used to treat:
Asthma
COPD
Arthritis
Rhinitis
Cancer
Inflammatory bowel disease
Spinal cord injury
Prevention of acute adrenocortical insufficiency

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18
Q

glucocorticoids administration

A

PO, IM, IV

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19
Q

glucocorticoids ADRs

A

if take 5 mg of glucocorticoids daily could result in the following AE:
CNS stimulant (jittery inside) - Insomnia
Adrenocortical insufficiency - Fainting, Weakness, Hypotension
Adrenocortical excess
Cardiovascular symptoms - Heart failure, Shock, Cardiac dysrhythmias
Increase appetite (weight gain)
Hyperglycemia… need to monitor patient with diabetes very carefully
Immunosuppressive - delayed wound healing more susceptible to infection
Bone disease
Very fragile skin… paper thin

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20
Q

glucocorticoids Contraindications and interactions

A

immunosuppression, live vaccines, systemic fungal infections, antibiotic resistant infections

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21
Q

glucocorticoids RN intervention and client education

A

Treats symptoms, does not cure underlying disease
Take as directed, DO NOT stop taking abruptly
Tapered off
Take with food
Educate on numerous ADRs

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22
Q

anti-inflammatory/leukotriene modifiers prototype

A

montelukast (Singulair)

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23
Q

leukotriene modifiers EPA

A

prevents leukotrines from binding to its receptors therefore reducing bonchoconstriction, inflammation, and mucus production

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24
Q

leukotriene modifiers therapeutic use

A

used in patient with asthma that do not respond to other treatments. Used as a long-acting antiasthmatic med. Only tablet approved for exercise-induced asthma. Can also treat allergies.

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25
Q

leukotriene modifiers administration

A

PO

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26
Q

leukotriene modifiers ADRs

A

behavioral changes
BLACK BOX WARNING: neuropsychiatric events have been reported in pts that take this drug (aggressive behavior, hallucinations, insomnia, and suicidal ideation)

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27
Q

leukotriene modifiers contraindications and interactions

A

liver disease

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28
Q

leukotriene modifiers RN interventions and client education

A

Not used to manage acute asthma attack
Take 2 hours before exercise to prevent exercise-induced asthma
Take in evening daily to treat allergies

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29
Q

First generation/sedating antihistamines prototype

A

diphenhydramine (Benadryl)

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30
Q

first gen antihistamine therapeutic use

A

treat allergic reactions, anaphylaxis, motion sickness, and insomnia

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31
Q

first gen antihistamines EPA

A

structurally like histamine and occupy the same receptor sites preventing histamine acting on target tissues and thus preventing histamine response. Binds to central H1 receptors

32
Q

first gen antihistamines administration

A

PO (tablet and liquid), topical ointment, IV and IM

33
Q

first gen antihistamines ADRs

A

CNS depression = drowsiness and sedation, paradoxical effect causing CNS stimulation and anticholinergic effects

34
Q

first gen antihistamines contraindications and interactions

A

Newborns and children <2 years
Breastfeeding women
Do not take with ETOH or other CNS depressants

35
Q

first gen antihistamines RN intervention and client education

A

Do not take with ETOH or other CNS depressants
Use with caution in older adults
Assess LOC
Advise against driving and operating machinery requiring mental alertness
Can cause: Dry mouth, Urinary retention, Constipation, Blurred vision

36
Q

second generation/nonsedating antihistamines prototype and other drug names

A

cetirizine (Zyrtec)
Others: loratadine (Claritin) and fexofenadine (Allegra)

37
Q

second gen antihistamines therapeutic use

A

treats seasonal allergies, and urticaria

38
Q

second gen antihistamines EPA

A

binds to histamine receptors to prevent histamine response, but binds to peripheral, not central H1 receptors. Therefore, does not cause drowsiness like the first-generation agents

39
Q

second gen antihistamines administration

40
Q

second gen antihistamines ADRs

A

drowsiness and fatigue (higher doses and anticholinergic effects)

41
Q

second gen antihistamines contraindications and interaction

A

Breastfeeding women
Impaired kidney or liver function

42
Q

second gen antihistamines RN intervention and client education

A

Take once a day
Take with water

43
Q

sympathomimetics (nasal decongestants) prototype and other drug names

A

phenylephrine (neo-synephrine)
Other: pseudoephedrine (Sudafed)

44
Q

sympathomimetics therapeutic use

A

relieves pressure, swelling and congestion of the nasal mucosa

45
Q

sympathomimetics EPA

A

alpha 1 adrenergic agonist, causes vasoconsrtiction of the blood vessels… causing the nasal turbinates in the nares to shrink, in turn opening nasal passages and relieving nasal congestion

46
Q

sympathomimetics administration

A

PO (regular and XR tablets), topical and nasal sprays

47
Q

sympathomimetics ADRs

A

CNS excitation = tachycardia, insomnia, dizziness, palpitations, urinary retention

48
Q

sympathomimetics contraindications and interations

A

Uncontrolled heart disease
Dysrhythmias
HTN
Narrow angle glaucoma
Older adults
Caffeine may increase effects

49
Q

sympathomimetics RN intervention and client education

A

Do not use for more than 3 to 5 days
Assess for cardiac symptoms
Educate about rebound effect
Rebound congestion
Multiple drug interactions

50
Q

antitussives - nonnarcotic prototype and other drug names

A

dextromethorphan (Delsym)
Other drugs: benzonatate (Tessalon)

51
Q

antitussives - nonnarcotic therapeutic use

A

to suppress nonproductive cough

52
Q

antitussives - nonnarcotic EPA

A

depresses the cough reflex in the brain

53
Q

antitussives - nonnarcotic administration

A

PO liquid, lozenge, syrup

54
Q

antitussives - nonnarcotic ADRs

A

CNS depression - drowsiness and sedation

55
Q

antitussives - nonnarcotic contraindications and interactions

A

MAOIs
SSRIs
ETOH use

56
Q

antitussives RN intervention and client education

A

Medication interactions
Avoid alcohol

57
Q

antitussives - narcotic prototype

58
Q

antitussives - narcotic therapeutic use

A

relief of cough

59
Q

antitussives - narcotic EPA

A

depresses the cough reflex in the brain

60
Q

antitussives - narcotic administration

A

PO, usually combined with acetaminophen in liquid form (tylenol #3)

61
Q

antitussives - narcotic ADRs

A

nausea, vomiting, respiratory sedation, constipation and dizziness

62
Q

antitussives - narcotic contraindications and interactions

A

Any respiratory impairments
Head injuries
Seizure disorders
ETOH

63
Q

antitussives - narcotic RN intervention and client education

A

Assess GI and respiratory status
Avoid in patient with asthma or head injury

64
Q

expectorants prototype

A

guaifenesin (Mucinex)

65
Q

expectorants therapeutic use

A

loosens mucus from respiratory tract in a productive cough

66
Q

expectorants EPA

A

reduces viscosity of secretions

67
Q

expectorants administration

68
Q

expectorants ADRs

A

dizziness, drowsinessm HA, and skin rash

69
Q

expectorants contraindications and interactions

A

Inability to expectorate

70
Q

expectorants RN intervention and client education

A

Give med with food and water
Hydration
Swallow tablets whole
Change positions carefully

71
Q

mucolytics prototype

A

acetylcystine (Acetadote)

72
Q

mucolytics therapeutic use

A

to liquify mucus in the respiratory tract

73
Q

mucolytics EPA

A

attacks protein bonds in the mucus, reducing viscosity

74
Q

mucolytics administration

A

Nebulizer, PO, and IV

75
Q

mucolytics ADRs

A

bronchospsm, GI distress (due to rotten egg smell and ingestion of secretions)

76
Q

mucolytics contraindications and interactions

A

Inability to expel secretions
asthma

77
Q

mucolytics RN intervention and client education

A

Assess respiratory status
Difficulty breathing? Bronchospasm?Inability to expel secretions
Hydration
Report difficulty breathing or worsening cough

Pharm (13 decks)

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