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NURS 221 exam 3 > respiratpry meds > Flashcards

respiratpry meds Flashcards

1
Q

histamine

A

H1
H2 - GI system

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2
Q

H1

A

vasodilation
*prominent in the skin of the face, can lead to hypotension

increased capillary permeability:
*produces edmea
*lead to hypotension

bronchoconstriction:
*asthma can make it severe (release of histamine)

CNS:
roles in cognition, memory and sleep/wake cycle

other:
itching, pain, secretion of mucus

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3
Q

H2

A

gastric acid secretion

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4
Q

Allergy

A

histamine mediates allergic reactions

mild (runny, stuffy nose)

severe (anaphylaxis)

H1 antagonist (antihistamines) used to treat

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5
Q

H1 antagonists (antihistamines)
effects on the body

A

peripheral effects:
*decrease in localized flushing, edema, itching, pain, supression of mucus secretion

CNS:
*depression of the CNS with therapeutic dose leads to sedation properties
*excitation of the CNS with overdose: convulsions

others:
*blocking the muscarinic receptors lead to anticholinergic responses (SNS effects)
(dry mouth, nasal passages, and throat)
(urinary hesitancy, constipation, palpitations)

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6
Q

H1 antagonists
therapeutic uses

A

mild allergic reaction
severe allergic reaction
used inly as adjunct (1st we use epinephrine)
motion sickness
insomnia
common cold
mild transfusion reactions

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7
Q

H1 antagonists
SE/AR

A

sedation
dizziness
decreased coordination
confusion
N/V
diarrhea/constipation
dry mucous membranes

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8
Q

frist generation H1 antagonists (antihistamines)

A

have drowsy effects

chlorpheniramine (Chlortrimeton)

diphenhydramine (Benadryl)

promethazine (Phenergan)

hydroxyzine (Vistaril)

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9
Q

Second generation (less sedation)
H1 antagonists (antihistamines)

A

cetirizine (Zyrtec)

fexofenadine (Allegra)

loratadine (Claritin)

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10
Q

Asthma

A

disorder that includes:

chronic inflammation
bronchoconstriction
bronchospasm

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11
Q

classifcications and severity of asthma
step1 thru step5

A

step 1: mild (inhaler)

step 5: severe (need multiple meds)

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12
Q

peak expiratory flow rate (PEFR)

A

max airflow during expiration

assess qAM (upon waking)

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13
Q

peak expiratory flow rate (PEFR)

ZONES

A

Red zone:
*less than 50%
*seek medical tx immediately

Yellow zone:
*some symptoms
*50-80% of personal best
*control is insufficient
*f/u with PCP

Green zone:
*No symptoms
*PEFR > 80% of personal best

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14
Q

asthma triggers to avoid

A

pets

cockroaches

tobacco smoke

mold

temperature extremes

aerosol

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15
Q

inhalers

metered-dose inhalers (MDI)

dry powder inhalers

A

MDI:
*inhale prior to activating device
*seperate puffs by 1 min
*spacer helps deliver drug for children or pt who wont hold breath

dry powder inhaler:
*deliver more drug to lungs than MDI

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16
Q

teaching points for inhalers

A

shake—
take a deep breath in and out—
on next inhale depress the med—
have pt hold breath as long as comfortable—
rinse mouth with water after —

*important if inhalation containes steroids to avoid infections

17
Q

inhalers: nebulizers

A

convert solution into a fine mist

takes several min to adminiter

aerosolized

18
Q

main classifications utulized to treat asthma

A

inhaled corticosteroids

beta2 adrenergic agonists
*inhaled and oral
*short-acting (SABA)
*long-acting (LABA)

glucocorticoids (category of corticosteroids)
*oral

leukotriene modifiers

19
Q

inhaled corticosteroids (ICS)

A

containes one of sever cotricoids designed to decrease inflammtory process with asthma

med:
fluticasone (flonase)

20
Q

ICS how to use

A

breath in and out—
on next inhale depress med—
inhale deeply

paint tip towards the ear on the side your doing it on

rinse or wipe off the tip of the applicator

2 spray per nostril

21
Q

Albuterol

A

the main short-acting Beta2 adrenergic agonist bronchodilator (SABA) inhaled med

beta2 receptors are in lungs
*stimulation of them cause bronchodilation

SABAs cause an immediate opening of the airways
*referred to as rescure inhaler

22
Q

albuterol (Proventil, Ventolin)
use and effects

A

do not change dosage without contacting provider

may cause:
paradoxical (rebound) bronchospasm
hyperactive response in children

result of taking:
*decrease in anxiety once breathing is restored

always watch for paradoxical reaction: code situation if occurs

23
Q

albuterol (Proventil, Ventolin)
route

A

inhaler
nebulizer

po via liquid
(when given po its nolonger rapid-acting)
not a resue inhaler anymore

24
Q

other B2 adrenergic agonist inhalers

A

short acting inhaled:
*levalbuterol (Xopenex)

long acting inhaled:
*salmeterol (Serevent)

Oral agents (liquid):
when given this route, no longer a rescue inhaler
*albuterol (Proventil, Ventolin, Volmax)

25
Q

SABAs
SE/AR

A

minimal

*tachycarida

*angina pectoris

*exacerbation of HF

*tremors

*hyperactivity

26
Q

Leukotriene Modifiers

A

added in 2nd or 3rd step asthma or if SABA and ICS are not producing needed outcomes

LM are chemical mediators released within body upon the exposure to known allergens

block the action of leukotrienes

slow acting so not used as rescue med

27
Q

Leukotrienes ( why we use modifiers to block it)

causes the following

A

bronchoconstriction

excess respiratory and oral mucus production

excess respiratory and mucosal fluid production

28
Q

Leukotriene Modifiers

med
SE/AR

A

montelukast (Singulair)

flu-like symptoms
nervousness
HA
gastric irritation
N/V
Nasal congestion

29
Q

glucocorticoids
route
uses

A

route: inhalation usually, or po, iv

uses:
*decrease the inflammation
*used in acute situations
*used for prophylaxis with asthma attack, taken on a fixed schedule

30
Q

glucocorticoids

SE/AR

A

oropharyngeal condidiasis

dysphonia (hoarseness)

shakiness

loss of appetite

mood swings

31
Q

glucocorticoid

meds

A

prednisone
prednisolone: easier on liver for peds

must taper off slowly to avoid major hormonal imbalance and mood swings

add other meds very cautiously

5-7 dose pack is most common administstration schedule

32
Q

education points with inhalers

A

rinse mouth out to avoid oral fungal infection

rinse mouthpiece

avoid OTC inhalers due to med interactions

33
Q

decongestants

A

sympathomimtics
*stimulates apha1 adrenergic receptors on nasal blood vessesl causing loacal vasoconstriction

vasoconstriction takes up less space and opens the airway

34
Q

decongestants

sympathomimetics meds

SE/Ar

A

oxymetazoline (afrin, No-synephrine)

pseudoephedrine (sudafed)

epinephrine (Adrenalin)

SE/AR:
rebound congestion
CNS stimulation
Cardiovascular effects

35
Q

medications for coughs

A

antitussives

expectorants

mucolytic

36
Q

medications for coughs

antitussives

A

opioid antitussives: effective with chronic or induced cough
*codeine
*low-dose morphine
*hydrocodone

Non-opioid antitussives: effective with acute cough due to cold, rhinitis
*dextromethorphan (common)
*benxonatate (Tessalon Perles)

37
Q

medications for cough

Expectorants

A

gets you to cough it up

Guaifenesin (used often in Robitussin)
*taken with full glass of water

38
Q

medications for cough

Mucolytic

A

thins mucus

acetylcystine (Mucomyst)

NURS 221 exam 3 (5 decks)

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